深圳市场所中男男性行为者HIV感染情况及影响因素调查

Prevalence of HIV infection and related factors among men who have sex with men at venues in Shenzhen

目的了解深圳市场所中男男性行为者(MSM)的性行为特征,艾滋病病毒(HIV)感染状况及其影响因素。方法于2017年4-11月在深圳采用横断面调查,利用时间空间抽样法招募MSM。使用基于电脑辅助问卷调查系统收集调查对象的人口学信息,性行为特征,HIV既往检测情况,HIV、梅毒感染状况等信息,并采用SPSS 23软件进行相关统计分析。结果共招募MSM 490人,HIV检出率为11.2%(55/490),梅毒检出率为16.3%(80/490)。场所中的MSM具有多性伴、肛交性行为频繁、被动肛交比例较高等特征。与2014年深圳市场所的调查结果相比,性伴数≥2的比例显著上升(63.1%vs.56.1%,P=0.03),安全套的使用率(62.9%vs.52.3%,P=0.001)和HIV检测率(80.6%vs.64.3%,P<0.001)显著提高,HIV感染率显著降低(11.2%vs.16.8%,P=0.01),梅毒感染率略微下降(16.3%vs.17.4%,P=0.65)。多因素分析结果显示:学历较低[调整比值比(aOR)=2.73,95%可信区间(CI):1.25~5.99],梅毒阳性(a OR=3.65,95%CI:1.92~6.96)是HIV感染的危险因素。结论深圳市场所中MSM的HIV、梅毒感染率较高。尽管MSM中性伴数≥2的比例较过去显著上升,但由于安全套的使用率和HIV检测率显著提高,所以HIV和梅毒感染率较过去有所降低。因此,加强场所MSM的检测和行为干预,可降低人群HIV感染率。

Objective To investigate the sexual behavior characteristics,HIV infection status and associated risk factors among men who have sex with men(MSM)at venues in Shenzhen.Methods A cross-sectional study with time location sampling was conducted between April and November 2017 in Shenzhen.Computer aided questionnaires were used to collect information on socio-demographic characteristics,sexual behavior,HIV/syphilis infection,and testing behavior.All statistical analysis was conducted in SPSS 23.Results A total of 490 MSM were recruited.The HIV infection rate was 11.2%(55/490),and the syphilis infection rate was 16.3%(80/490).Compared with the data from the previous survey in 2014,the proportion of sexual partners≥2 increased significantly(63.1%vs 56.1%,P=0.03).However,the condom use(62.9%vs 52.3%,P=0.001)and HIV detection rate(80.6%vs 64.3%,P<0.001)also increased significantly.HIV infection rate decreased significantly(11.2%vs 16.8%,P=0.01),while syphilis infection rate fell slightly(16.3%vs 17.4%,P=0.65).Multivariate analysis indicated that MSM who had lower education level(AOR=2.73,95%CI:1.25-5.99),and had been infected with syphilis(AOR=3.65,95%CI:1.92-6.96)had higher risks of HIV infection.Conclusion HIV prevalence is high among MSM at venues.Although the proportion of sexual partners among MSM≥2 has significantly increased compared with that of 2014,the rate of HIV infection has decreased,which may be attributed to the significantly increased rates of condom use and HIV testing.This finding suggests that HIV interventions such as condom use and HIV testing promotion among MSM at venues can effectively reduce the risks of HIV infection.Therefore,HIV surveillance and intervention should be strengthened for MSM at venues.