柳州市男男性行为队列人群HIV感染影响因素分析

Cohort study on the influential factors of HIV infection among men who have sex with men in Liuzhou City

目的利用队列人群数据探讨影响柳州市男男性行为人群(men who have sex with men,MSM)感染艾滋病的影响因素,为制定柳州市艾滋病预防控制策略和措施提供依据。方法 2014年6月在柳州市区采用雪球抽样方法招募MSM并建立队列,每半年随访一次,每次随访时进行问卷调查、采集静脉血进行艾滋病病毒(human immune deficiency virus,HIV)抗体检测。结果基线和三次随访共招募MSM 1 369人次,成功完成一次、二次、三次随访的人数分别为158例、126例、74例。随着随访次数增加,MSM队列人群对艾滋病相关知识的知晓率升高(x^2趋势=7.698,P=0.006);最近一次肛交性行为(x^2趋势=7.510,P=0.006)和商业同性肛交性行为(x^2趋势=5.005,P=0.025)中安全套使用情况均有上升的趋势。多因素Cox回归分析显示:艾滋病相关知识得分较高(OR=0.119,95%CI:0.021~0.686,P=0.017)及最近6个月未使用过毒品(OR=0.036,95%CI:0.006~0.212,P<0.001)者,其感染艾滋病的风险低。结论应进一步加强MSM人群艾滋病知识宣传,提高艾滋病相关知识知晓率和安全套使用频率,降低毒品使用,以遏制艾滋病在该人群的蔓延。

Objective To understand the prevalence and influential factors of human immune deficiency virus（HIV） infection among men who have sex with men（MSM） in Liuzhou City, so as to provide the evidence for HIV prevention and control. Methods Snowball sampling method was used to set up MSM cohort in the urban area of Liuzhou from June 2014, and they were followed up each six months. Blood samples were taken from these MSM to detect antibodies of HIV. Results Baseline and,three followers were recruited for 1 369 MSM. We successively completed the first foll0w-up （ 158 cases） , the second follow-up （1＂26 cases）, and the third follow-up （74 cases）. MSMs＇ knowledge of HIV/AIDS increaseed with the rise as the number of follow-up （ χ2 = 7. 698, P = 0. 006）. Condom usage in the latest commercial anal sex （ χ2 = 7. 510, P = 0. 006 ） and anal same-sex sexual behavior （ χ2 =5. 005 ,P = 0.025 ） were in rising trend. Muhifactorial Cox regression analy- sis showed that higher scores of HIV/AIDS related knowledge（ OR = 0. 119,95% CI：O. 021-0. 686,P = 0. 017 ）and less drug use in the last 6 months （OR =0, 036,95% CI：O. 006-0. 212 ,P 〈0. 001 ）, the risk of HIV infections was lower. Conclusions It is＇important to strengthen AIDS knowledge propaganda among MSM, raise the rate of AIDS related knowledge and the frequency of using comdom, reduce the drug use in order to curb the spread of AIDS in the MSM.