医院肛肠专科针对男男性行为者提供艾滋病及性病检测和转介服务的探索

HIV/STD detection and referral services to MSM provided by anorectal departments of hospitals

目的探索在医院肛肠专科开展针对男男性行为者(MSM)提供艾滋病防治服务的可行性和有效措施,减缓艾滋病病毒(HIV)在MSM中的传播。方法选择了不同类型和规模的医院肛肠专科,由临床医务人员针对男性就诊患者进行主动辨识,并对识别出的MSM进行HIV和梅毒血清抗体检测和转介治疗。结果2015年9月至2016年5月期间的15 860名男性就诊患者中,共辨识出108例MSM,总辨识率0.68%,其中门诊患者中辨识率0.61%(74/12 120),住院患者辨识率0.91%(34/3 740);辨识出的MSM均接受HIV和梅毒血清抗体检测,HIV初筛阳性23例,阳性检出率21.30%(23/108),新报告HIV抗体阳性病例发现率14.14%(14/99);梅毒阳性1例,阳性检出率0.93%(1/108)。结论通过提高临床医务人员对于MSM的敏感度和辨识能力,结合医务人员主动提供HIV检测咨询,可以在肛肠专科针对MSM开展有效的艾滋病防治工作。

Objective To explore effective measures of HIV/STD detection and referral services for men who have sex with men(MSM)by anorectal departments of hospitals to reduce HIV transmission among MSM population.Methods Clinicians identified MSM actively among male clients in anorectal departments of different hospitals,and HIV and syphilis antibody tests as well as referral services were provided accordingly to the MSM identified.Results A total of 108 MSM(0.68%)were identified among 15 860 male clients during Sept 2015-May 2016,of which the recognition rate was 0.61%(74/12 120)among outpatients and 0.91%(34/3740)among inpatients.Out of the MSM tested for HIV and syphilis,there were 23 cases screened as HIV positive with the rate of 21.3%(23/108),and 9 cases was previously confirmed as HIV positive and 14 cases the newly confirmed as HIV positives,and one case of syphilis positive.Conclusion Capacity building of clinicians,esp.in the anorectal departments of hospitals and application of PITC(provider-initiated HIV testing and counseling)strategy are one of the effective HIV prevention measures to find more infections among MSM.