贵州省2012-2018年男男性行为者HIV感染率及新发感染率分析

HIV prevalence and incidence among men who have sex with men in Guizhou from 2012 to 2018

目的了解贵州省男男性行为者(MSM)的艾滋病病毒(HIV)感染率、新发感染率及其影响因素。方法对2012-2018年贵州省MSM哨点监测的对象进行调查,问卷调查收集调查对象的人口学、行为学信息;同时采集血样进行HIV抗体及新发感染检测。估算该人群的HIV新发感染率,并运用Logistic回归模型分析影响HIV感染及新发感染的影响因素。结果2012-2018年,贵州省MSM哨点共调查3449人,HIV感染率均在18%以上;HIV新发感染率除2013年(1.3%)、2015年(4.7%)外,均在12%以上;多因素分析显示,年龄>30岁[调整比值比(a OR)=1.488,95%可信区间(CI):1.049~2.110]、未婚(aOR=0.670,95%CI:0.492~0.912)、贵阳(a OR=0.521,95%CI:0.374~0.727)、近6个月男男性行为未每次都使用安全套(aOR=0.541,95%CI:0.445~0.656)、近一年被诊断患过性病(a OR=2.489,95%CI:1.701~3.643)及近一年未接受过艾滋病咨询检测(aOR=0.714,95%CI:0.565~0.902)MSM的HIV感染率更高;年龄≤20岁(aOR=0.476,95%CI:0.296~0.767)、贵阳(aOR=0.286,95%CI:0.156~0.526)、近6个月男男性行为未每次都使用安全套(aOR=0.471,95%CI:0.313~0.708)MSM的HIV新发感染率更高。结论贵州省MSM中的HIV感染率和新发感染率均处于较高的水平,但是有高估的可能性,建议针对该群体的艾滋病流行状况开展专题调查。

Objective To understand the HIV prevalence,incidence and the risk factors among MSM in Guizhou province.Methods The demographic and behavioral information were collected by questionnaires.Blood samples were also collected to detect HIV-1 antibody and to identify the recent HIV infection.The recent HIV infection rate among the MSM was estimated.Logistic regression model was conducted to analyze the risk factors of HIV infection and the recent HIV infection.Results From 2012 to 2018,a total of 3449 people was investigated through MSM sentinel surveillance.The HIV infection rates were all above 18%,and the recent HIV infection rates were all above 12%except in 2013(1.3%)and 2015(4.7%).Multiple logistic regression analysis showed that high risks of HIV infection were related to those at the age>30(aOR=1.488,95%CI:1.049-2.110),unmarried(aOR=0.670,95%CI:0.492-0.912),locally living in Guiyang(aOR=0.541,95%CI:0.374-0.727),having sex with man without consistent condom use during the past six months(aOR=0.541,95%CI:0.445-0.656),diagnosed with sexually transmitted diseases(aOR=0.286,95%CI:0.156-0.526),and not receiving VCT services(aOR=0.714,95%CI:0.565-0.902).The MSM had higher rate of recent HIV infection than other groups,among those with age≤20(aOR=0.476,95%CI:0.296-0.767),local residents in Guiyang(aOR=0.286,95%CI:0.156-0.526),and without consistent condom use during the last six months(aOR=0.471,95%CI:0.313-0.708).Conclusion Both prevalence and incidence among MSM in Guizhou province are high,which might be overestimated.It is suggested to carry out a special investigation on the prevalence of the MSM group.