HIV阳性男男性行为者的Rush使用状况及其与HIV高危性行为的关联性

Association between Rush poppers use and high risk sexual behaviors among HIV positive men who have sex with men in Shenyang

目的探讨艾滋病病毒（HIV）阳性的男男性行为者（MSM）中,Rush poppers（简称Rush）的使用情况与HIV传播相关高危性行为的关联性。方法通过访谈式问卷调查2012—2016年知晓自己感染状况的沈阳HIV阳性MSM的相关信息。采用多因素Logistic回归分析使用Rush与HIV传播相关高危性行为的关联性。结果共调查了528例HIV阳性MSM,其中知晓HIV确认阳性中位时间为5个月,近3个月Rush使用率为30.9%（163例）。与未使用Rush者相比,使用者具有年龄≤24周岁（22.1%vs.14.8%,P=0.040）的比例更高、高中及以上文化程度（85.3%vs.77.0%,P=0.029）的比例更高等特征。Rush使用者未将HIV感染状况告知偶然性伴比例高于对照组（99.1%vs.94.3%,P=0.039）。多因素Logistic回归分析显示,相对于非Rush使用者,通过互联网寻找MSM性伴[调整比值比（aOR）=6.8,95%可信区间（CI）=2.6-17.9）]、有外地MSM性伴（aOR=2.2,95%CI=1.1-4.2）、安全套使用率低（aOR=3.9,95%CI=2.2-7.0）、有多个MSM性伴（aOR=1.5,95%CI=1.0-2.3）,是研究对象使用Rush的独立关联因素。结论 HIV阳性MSM知晓HIV感染状态后Rush使用率高,使用Rush的MSM更倾向于通过互联网寻找性伴,安全套使用比例低且性伴数更多,易造成HIV的传播扩散,需加强相关监测和防控。

Objective To explore the relations between Rush poppers use and HIV secondary transmission related high risk behaviors among HIV-positive MSM in Shenyang city.Methods Questionnaire survey was used to collect information from 2012 to 2016,including demographic characteristics,Rush use,duration of HIV-positive diagnosis,sexual behaviors,and HIV status disclosure to sexual partners.Multivariate logistic regression analysis was used to study the relations between Rush use and sexual behaviors with high risks related to HIV.Results Among the 528 MSM participants diagnosed as HIV-positive,the median time of HIV-positive diagnosis was 5 months,and 30.9% reported they used Rush in the past 3 months.Compared with non-Rush popper users,the user were mainly below the age of 24 years（22.1% vs.14.8%,P=0.040）and educated above high school（85.3% vs.77.0%,P=0.029）etc.The proportion of those who did not inform their casual sexual partners of their HIV infection was high（99.1% vs.94.3%,P=0.039）.Multivariate logistic analysis showed that the factors independently associated with Rush use,compared with nonRush users,included seeking male sexual partners through the internet（aOR=6.8,95%CI=2.6-17.9）,looking for sex partners living outside Shenyang（aOR=2.2,95% CI=1.1-4.2）,having multiple sexual partners（aOR=1.5,95%CI=1.0-2.3）,and low condom use（aOR=3.9,95%CI=2.2-7.0）are.Conclusion The Rush using rate is high among the participants.MSM are more likely to find sexual partners through the internet,less condom use in anal intercourse and have multiple sexual partners which may easily lead to HIV transmission.The public health sections need to strengthen surveillance and prevention of further HIV transmission in MSM.