在婚男男性行为者355例性行为特征及HIV感染状况分析

Characteristics of Sexual Behavior and Influencing Factors of HIV Infection Among Married Men Who Have Sex With Men

目的了解在婚男男性行为(MSM)者的性行为特征、HIV和梅毒感染状况,探究HIV感染相关影响因素。方法在江苏省疾病预防控制中心VCT门诊,采用滚雪球法,招募调查对象,开展问卷调查,内容包括人口学特征、艾滋病相关知识知晓情况,同性和异性性行为、安全套使用、干预检测服务、性病感染等。并采集静脉血进行HIV和梅毒抗体检测。结果355例在婚MSM调查对象,平均年龄(43.7±11.8)岁。HIV感染率为11.55%(41/355),现症梅毒感染率为4.79%(17/355)。自觉有感染HIV风险290例(81.69%)。最近6个月发生同性性行为坚持每次使用安全套的比例为53.36%(143/268),最近6个月与异性发生性行为坚持每次使用安全套的比例为37.74%(60/159)。多因素Logistic回归分析结果显示,梅毒现症感染(与梅毒抗体阴性者相比,aOR=5.394,95%CI:1.320~22.040)、自觉有感染HIV风险(与自觉没有感染HIV风险相比,aOR=8.358,95%CI:1.037~67.331)是在婚MSM人群感染HIV的危险因素;最近1年接受HIV干预服务(与未接受干预服务相比,aOR=0.378,95%CI:0.150~0.951)、最近1年做过HIV抗体检测(与未做过HIV抗体检测相比,aOR=0.360,95%CI:0.144~0.899)是在婚MSM人群感染HIV的保护因素。结论在婚MSM人群的HIV感染率较高,该人群存在的高比例无保护同性和异性性行为,将加剧HIV在MSM人群和普通女性人群之间传播,应重点关注该人群。

Objective To understand characteristics of sexual behavior,status of HIV and syphilis infection,and influencing factors of HIV infection among married men who have sex with men(MSM).Methods In the VCT Clinic of Jiangsu Provincial Center for Disease Control and Prevention,the snowball method was adopted to recruit survey subjects and conduct a questionnaire survey,which included demographic characteristics,awareness of AIDS-related knowledge,homosexual and heterosexual sexual behavior,condom use,intervention testing services,and STD infections.Blood samples were collected for HIV and syphilis antibody detection.Results Among 355 married MSM,average age was(43.7±11.8)years.The HIV infection rate was 11.55%(41/355),and the present syphilis infection rate was 4.79%(17/355).The percentage of subjects who consciously had an HIV infection risk was 81.69%(290/355).In the past six months,the proportion of those who insisted on using condoms every time for homosexuality was 53.36%(143/268),for heterosexuality was 37.74%(60/159).Results of multivariate Logistic regression analysis showed that the risk factors for HIV infection in married MSM included present syphilis infection(compared with present syphilis negative group,aOR=5.394,95%CI:1.320~22.040)and the conscious risk of HIV infection(compared with those with no risk,aOR=8.358,95%CI:1.037~67.331).The protective factors for HIV infection among married MSM included HIV intervention services(compared with those receiving no HIV services,aOR=0.378,95%CI:0.150~0.951)and HIV antibody testing in the past year(compared with those who had no HIV test,aOR=0.360,95%CI:0.144~0.899).Conclusion The HIV infection rate was relatively higher in married MSM,and a high proportion of unprotected homosexual and heterosexual behaviors in this population would aggravate the spread of HIV between MSM population and general female population,who should be paid more attention to.