哈尔滨市2013-2015年男男性行为者HIV-1新发感染情况分析

Analysis of HIV new infections among MSM in Harbin,2013-2015

目的了解哈尔滨市男男性行为者（MSM）艾滋病病毒（HIV）感染情况,估算及分析该人群中的HIV-1新发感染率及其影响因素。方法 2013-2015年开展四轮横断面调查,对2 531名MSM进行行为学调查及生物学检测。对HIV-1阳性的样本,进行BED HIV-1IgG捕获酶免疫法（BED-CEIA）检测,以此估算该人群的HIV-1新发感染率。结果 2013-2015年,四轮调查中HIV感染率分别为9.6%、16.8%、14.7%及17.3%。2013年、2014年HIV-1年平均新发感染率为4.6%[95%可信区间（CI）：2.5%~6.8%],2014年9-11月、2015年4-6月新发感染率分别为9.2%（95%CI：4.8%~13.6%）,6.2%（95%CI：2.4%~9.9%）。HIV-1新发感染的影响因素分析显示,性角色为被插入方[比值比（OR）=5.105,95%CI：2.626~9.925]和既作为插入方与又作为被插入方（OR=2.454,95%CI：1.306~4.613）的危险性显著高于插入方;现患梅毒者感染HIV-1的危险性（OR=4.006,95%CI：2.320~6.915）高于未患梅毒者;最近一年进行过HIV检测（OR=0.532,95%CI：0.327~0.868）是HIV-1新发感染的保护性因素。结论哈尔滨市MSM中,HIV感染率及新发感染率均较高,HIV感染的危险因素广泛存在,但在MSM中开展艾滋病知识的宣传教育、咨询及检测,对于遏制艾滋病的发展是有积极意义的。

Objective To understand human immunodeficiency virus（HIV）infection situation of men who have sex with men（MSM）,and estimate HIV-1 incidence and analyze the risk factors among MSM in Harbin.Methods Four rounds of cross-sectional surveys were conducted during 2013-2015,and 2531 MSM were investigated and received serological tests.HIV positive samples were tested with BED HIV-1 IgG capture enzyme immunoassay（BED-CEIA）to estimate HIV incidence in MSM.Results The prevalence of HIV were 9.6% ,16.8% ,14.7% and 9.6% respectively in the four rounds.The average annual incidence of HIV-1 in 2013 and 2014 was 4.6% （95% CI 2.5% -6.8% ）.The incidence was 9.2% （95% CI 4.8% -13.6% ）from Sept.to Dec.2014,and 6.2% （95% CI：2.4% -9.9% ）from Apr.to Jun.2015.The analysis of influencing factors of new HIV-1 infection identified that the risks of receptive partners（OR5.105 95% CI 2.626-9.925）and both of receptive/insertive partners（OR2.454 95% CI1.306-4.613）among MSM were higher than those of insertive partners;syphilis infection（OR 4.006 95% CI2.320-6.915）was an independent risk factor associated with HIV infection,and being HIV tested in the past year（OR0.532 95% CI0.327-0.868）was an independent protective factor of HIV infection.ConclusionThe prevalence and incidence of HIV are high among MSM in Harbin.Although the risk factors for HIV infection is widespread,AIDS prevention education activities,counselling,testing and condom use among MSM can play positive roles to curb AIDS transmission.