广州市男男性行为者HIV感染状况及影响因素

Analysis of HIV infection status and factors among men who have sex with men in Guangzhou

目的了解广州市男男性行为者(men who have sex with men,MSM)的人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染现况,并分析影响因素。方法 2014-2017年连续四年对广州市MSM进行面对面问卷调查,采集静脉血检测HIV抗体和采用SPSS 19.0软件分析资料。结果本次研究共调查2 419例MSM,HIV确证阳性200例,感染率为8.27%。多因素Logistic逐步回归分析结果显示,以广州市和月经济收入>0.5万元为参照,非广州市(OR=1.712,95%CI:1.176~2.492,P=0.005)和月经济收入≤0.5万元(OR=1.998,95%CI:1.409~2.833,P<0.001)与MSM感染HIV存在关联。MSM被诊断为梅毒(OR=2.461,95%CI:1.375~4.405,P=0.002)和没检测梅毒(OR=2.333,95%CI:1.635~3.331,P<0.001)、肛交角色为被动(OR=2.015,95%CI:1.244~3.267,P=0.004)和主动被动均有(OR=2.115,95%CI:1.374~3.251,P=0.001)、肛交时非每次使用安全套(OR=1.955,95%CI:1.374~2.781,P<0.001)、肛交对象非固定(OR=2.150,95%CI:1.463~3.160,P<0.001)是MSM感染HIV的主要危险因素。结论广州市MSM人群HIV感染率和高危性行为发生率高,亟需在MSM人群中扩大HIV检测范围和倡导安全性行为。

Objective To understand infection status of human immunodeficiency virus(HIV) and analyze the influencing factors among men who have sex with men(MSM) in Guangzhou. Methods Men who have sex with men(MSM) were recruited from 2014 to 2017. Face-to-face questionnaire survey was conducted to collect information of characterisitc and behaviors. Blood samples were used to detect HIV antibodie. Data were analyzed using SPSS 19.0. Results Among 2 419 MSM, 200(8.27%) participants were confirmed positive for HIV. Multivariate Logistic regression analysis showed that with Guangzhou and monthly economic income >0.5 million as reference, non-Guangzhou(OR=1.712, 95% CI: 1.176-2.492,P=0.005) and monthly economic income ≤0.5 million(OR=1.998, 95% CI: 1.409-2.833,P<0.001) were associated with HIV infection among MSM. Diagnosed syphilis(OR=2.461, 95% CI: 1.375-4.405,P=0.002), undetected syphilis(OR=2.333, 95% CI: 1.635-3.331,P<0.001), anal sex role passive(OR=2.015, 95% CI: 1.244-3.267,P=0.004), both active and passive(OR=2.115, 95% CI: 1.374-3.251,P=0.001), non-using condoms every time during anal sex(OR=1.955, 95% CI: 1.374-2.781,P<0.001), non-fixed anal sex objects(OR=2.150, 95% CI: 1.463-3.160,P<0.001) were major risk factors for HIV infection among MSM. Conclusions The prevalance of HIV infection and high-risk sexual behavior were high among MSM in Guangzhou. It is urgent to expand the scope of HIV testing and advocate safe sexual behaviors among MSM.