杭州市男男性行为人群HIV新发感染及影响因素研究

Incidence and influencing factors for HIV infection among men who have sex with men in Hangzhou

目的了解杭州市男男性行为(MSM)人群HIV新发感染情况及影响因素。方法于2014年9月—2015年9月在杭州市招募523名HIV阴性MSM进行前瞻性队列研究,通过问卷调查收集人口学和行为学信息,并检测HIV抗体和梅毒,每3个月随访一次。以HIV抗体阳转为研究终点事件,计算HIV新发感染率,采用Cox回归模型分析MSM人群HIV新发感染的影响因素。结果 12个月累计随访374人,队列总随访率为71.51%;累计HIV新发感染16例,HIV新发感染率为6.57/100人年。Cox回归分析结果显示:年龄<30岁(HR=10.050,95%CI:2.576~39.212),本地居住时间>2年(HR=0.082,95%CI:0.020~0.341)和近3个月与临时同性性伴肛交时使用安全套(HR=0.060,95%CI:0.019~0.188)是MSM人群新发感染HIV的影响因素。结论杭州市MSM人群HIV新发感染率较高,年龄<30岁、本地居住时间少于2年、与临时性伴无保护肛交的MSM人群感染HIV的风险升高。

Objective To study HIV incidence and related factors among men who have sex with men（MSM） in Hangzhou.Methods We conducted a prospective cohort study consisted of 523 HIV-negative MSM in Hangzhou.We collected their sociodemographic and behavior information by questionnaire and blood samples for HIV and syphilis detection at baseline and during follow-up period. HIV seroconversion was defined as the end point to calculate the HIV incidence. We analyzed the influencing factors for HIV infection among MSM by cox regression. Results We observed a total of 374 participants for 12 months, accounting for 71.51%. There were 16 HIV positive cases and the HIV incidence rate was 6.57/100 person-years.Multivariate cox regression analysis showed that less than 30 years old（HR=10.050, 95% CI： 2.576-39.212）, living in Hangzhou for more than 2 years（HR=0.082,95%CI：0.020-0.341） and having unprotected anal intercourse with casual male partners in the past 3 months（HR=0.060, 95% CI： 0.019-0.188） were associated with HIV incidence. Conclusion HIV incidence among MSM in Hangzhou was relatively high. The MSM who were less than 30 years old,living in Hangzhou for less than 2 years and having unprotected anal intercourse with casual male partners have higher risk of HIV infection.