乌鲁木齐市男男性行为者HIV新发感染及危险因素研究

Recent HIV infection and its risk factors among men who have sex with men in Urumqi City

目的获得乌鲁木齐市男男性行为者(MSM)HIV新发感染率,了解MSM人群新发感染的相关危险因素,为估计艾滋病流行趋势,判断疫情形势以及高危行为干预提供科学依据。方法对2015年乌鲁木齐市艾滋病哨点监测MSM人群866例样本纳入研究,用ELISA方法对所有研究对象血清样本进行HIV抗体初筛,对于HIV抗体初筛阳性者,使用免疫印迹法进行确证,符合条件的HIV抗体阳性血清再用HIV-1 BED捕获酶联法(BED方法)检测,从而估算该人群2015年的新发感染率;通过问卷调查,了解MSM人群与HIV感染相关的危险因素。结果共调查866例MSM人群,平均年龄(31.03±7.44)岁,其中汉族734(84.76%)例,维吾尔族54(6.24%)例,回族54(6.24%)例,其它少数民族24(2.76%)例;文化程度以大专及以上为主(83.60%);艾滋病防治知识知晓率为97.92%;最近6个月,95.84%(830例)发生过肛交行为,每次都使用安全套的占52.04%(432例);HIV抗体检出率为5.31%(46例),其中既往感染7例;进一步采用BED检测,结果表明其中14例为长期感染,25例为新发感染,利用Mc Dougal法计算出新发感染率为5.95%(95%CI:4.37%~7.52%);多因素logistic回归显示年龄≥45岁(OR=3.105)、近6个月同性性行为安全套使用情况为每次都用(OR=0.205)、艾滋病防治知识知晓情况为知晓(OR=0.151)是乌鲁木齐MSM人群HIV新发感染的独立影响因素。结论乌鲁木齐市MSM人群HIV新发感染率较高,应继续加强干预力度,给予该人群中年龄较大者重点关注。

Objective To investigate the status of recent HIV infection and its related risk factors among men who have sex with men（ MSM） in Urumqi City,and to provide a scientific basis for estimating the epidemic tendency of HIV/AIDS and assessing the epidemic situation and high-risk behavior intervention. Methods A total of 866 MSM were recruited from HIV/AIDS sentinel surveillance in Urumqi City in 2015,and their serum samples were tested by using ELISA. The HIV-antibody positive samples in primary screening were confirmed with Western blot. All HIV-antibody positive samples were further tested with BEDcapture enzyme immunoassay（ CEIA） to find recent HIV-1 infection,and then the recent HIV infection rate among the MSM in 2015 was estimated. A questionnaire survey was conducted to investigate the risk factors of HIV infection among the MSM. Results A total of 866 MSM were surveyed,and the mean age was（ 31.03±7.44） years old,of which the Han,Uyghur,Hui and other ethnic groups accounted for 84. 76%（ n = 734）,6. 24%（ n = 54）,6. 24%（ n = 54）,and 2. 76%（ n = 24） respectively.83. 60% of the MSM had received college or higher education. The awareness rate of knowledge concerning HIV/AIDS prevention and treatment was 97.92%. 95.84%（ 830/866） had anal sex with men in the last 6 months,and the ratio of consistent condom use was 52.04%（ 432/830）. The HIV-positive detection rate was 5.31%（ 46/866）,including 7 cases with previous infection. The results of BED-CEIA indicated that there were 14 cases of long-term HIV infection and 25 cases of recent HIV infection. The annual recent infection rate calculating by Mc Dougal was 5.95%（ 95% CI： 4.37%-7.52%）. Multivariate logistic regression analysis showed that the age of ≥45 years（ OR = 3.105）,consistent condom use during homosexual behavior in the last 6 months（ OR =0. 205） and having knowledge concerning HIV/AIDS prevention and treatment（ OR = 0.151） were the independent factors influencing newly-diagnosed HIV infection in the MSM. Conclusions The recent HIV infection rate in the MSM in Urumqi City in 2015 was high. It is necessary to continuously strengthen the intervention and pay special attention to the elder among the MSM.