浙江省杭州市西湖区男男性行为人群HIV感染情况及影响因素分析

Prevalence of HIV infection and related factors in men who have sex with men in Xihu district of Hangzhou

目的了解浙江省杭州市西湖区男男性行为人群(MSM)同性性行为特征、感染风险情况、HIV感染情况及影响因素分析。方法本项目采用滚雪球和同伴推荐的非概率抽样方法在非政府组织中招募研究对象进行问卷调查,采用唾液快检试剂进行初筛,蛋白印迹试验(WB)进行实验室确证,logistic回归用于调查对象HIV感染影响因素的分析。结果共调查1 906人,唾液快检试剂检测结果显示有96人(占5.04%)HIV抗体阳性,阳性告知率89.63%;最终HIV确证阳性45人(占2.36%),阳性告知率100.00%。仅有110人(5.77%)每次发生性关系前知道对方HIV感染状况,1 054人(占55.30%)对在发生性关系前是否了解对方HIV感染情况持无所谓态度,649人(34.05%)认为自己不可能感染HIV,1 079人(56.61%)没想过这个问题。多因素logistic回归分析结果显示,近6个月与男性发生性交时从不使用安全套(OR=4.545,95%CI:1.093~18.894)、近6个月与男性发生性交时有时使用安全套(OR=3.134,95%CI:1.133~8.666)、从未做过HIV抗体检测(OR=37.027,95%CI:10.928~125.459)、只做过1~2次HIV抗体检测(OR=12.291,95%CI:3.338~45.254)、没有想过HIV感染风险问题(OR=5.792,95%CI:2.271~14.771)是HIV感染的危险因素。结论推广安全套的使用,提高艾滋病感染风险意识,并且提高快检试剂初筛阳性人群的确诊比例是当前西湖区MSM艾滋病防治工作的重点。

Objective To investigate the characteristics of homosexual behavior,HIV infection risk,HIV infection status and influencing factors in men who have sex with men（ MSM） in West Lake district of Hangzhou. Methods The study subjects were recruited from non-governmental organizations by using a snowball and peer-recommended sampling method for a questionnaire survey. The HIV positive samples were screened by using saliva rapid test and confirmed with Western blot test,logistic regression analysis was used to analyze the influencing factors for HIV infection. Results A total of 1 906 MSMwere surveyed. Saliva rapid test indicated that 96 MSMwere HIV positive（ 5. 04%）,in which 45 were confirmed by Western blot test（ 2. 36%）. Only 110 MSM（ 5. 77%） were aware of the HIV infection status of sexual partners before sexual intercourse,1 054 MSM（ 55. 30%） had indifferent attitudes to the HIV infection status of sexual partners,649 MSM（ 34. 05%） believed that it was impossible for them to be infected with HIV and 1 079 MSM（ 56. 61%） never thought about this problem. Multivariate analysis showed that using no condom（ OR = 4. 545,95% CI： 1. 093-18. 894） or occasional use of condom（ OR = 3. 134,95% CI： 1. 133-8. 666） in anal sex during past 6 months,receiving no HIV test（ OR = 37. 027,95% CI： 10. 928-125. 459）,receiving only 1-2 HIV tests in the past（ OR = 12. 291,95% CI： 3. 338-45. 254）,never thinking about HIV infection（ OR = 5. 792,95% CI： 2. 271-14. 771） were the brisk factors for HIV infection. Conclusion It is essential to promote condom use,increase the awareness of HIV infection risk in MSMand improve the performance of saliva rapid test for the prevention and control of HIV infection in MSMin Xihu district.