青年学生与非学生男男性行为人群HIV感染风险对比分析

Comparison of HIV infection risk between 15 to 24 year‑old student men who have sex with men and non‑student men who have sex with men:a cross‑sectional study

目的比较中等职业院校/高中在读学生男男性行为人群(MSM)、大学及以上在读学生MSM及同龄非学生MSM HIV感染风险的差异。方法2019年7—10月,利用某社会公益小组微信公众号平台招募满足以下标准的研究对象:年龄15~24岁;生理男性;调查开始前自报发生过男男同性性行为(口交/肛交);自报HIV感染状态阴性或不知;自愿参加研究。利用自行设计的调查问卷收集研究对象的一般人口学资料、HIV检测、社交软件使用情况等,同时利用《MSM个体HIV感染风险评估工具》调查研究对象近6个月的HIV感染风险。采用非条件logistic回归分析不同人群的HIV感染风险的差异。结果最终获得有效问卷1707份。45%(771名)的调查对象首次同性性行为的年龄<19岁,做过HIV自检的比例为49%(833名),接受HIV检测点检测的比例为34%(587名)。与大学及以上在读学生MSM相比,非学生MSM处于中高度HIV感染风险的可能性更高[OR(95%CI):1.53(1.10~2.12)],与大学及以上在读学生MSM相比,中等职业院校/高中在读学生MSM处于中高度HIV感染风险的可能性更高[OR(95%CI):1.80(1.06~3.07)],但中等职业院校/高中在读学生MSM与非学生MSM之间相比处于中高度HIV感染风险的可能性不具有统计学差异[OR(95%CI):0.95(0.57~1.58)]。结论中等职业或高中在读学生MSM及同龄非学生MSM是艾滋病感染的高危人群,健康管理者在关注大学生艾滋病健康教育的同时,应设计针对性的干预措施来降低艾滋病在中等职业院校/高中学生MSM及同龄非学生MSM人群中的威胁。

Objective To compare the difference of HIV infection risk among student Men who have sex with men(sMSM)attending secondary vocational colleges or high school,sMSM attending universities or above,and non‑student men who have sex with men(MSM).Methods A cross‑sectional study was conducted between July and October,2019.Inclusion criteria of participants include:15-24 years old,male at birth,had homosexual oral or anal intercourse before survey,self‑reported HIV negative or unclear.Demographic information,HIV testing history and social media usage were collected by a self‑reporting questionnaire,the HIV risk assessment tool was used for HIV infection risk assessment.We used Logistic regression to analyze the difference of HIV infection risk among student sMSM attending secondary vocational colleges or high school,sMSM attending universities or above,and non‑student MSM.Results Of the 1707 participants,45%(771 projects)reported homosexual debut before the age of 19,the proportion of HIV self‑testing was 49%(833 projects),and 34%(587 projects)received facility‑based testing.Comparing with sMSM attending universities or above,non‑student MSM and sMSM attending secondary vocational colleges or high school had higher probability of medium and high HIV infection risk[OR(95%CI):1.53(1.10-2.12),1.80(1.06-3.07),respectively],while the probability of medium and high HIV infection risk between sMSM attending secondary vocational colleges and non‑student MSM was not statistically different.Conclusion Non‑student MSM and sMSM attending secondary vocational college or high school have higher risk of HIV infection,health staff should allocate more education resources to Non‑student MSM and sMSM attending secondary vocational college or high school,in order to alleviate HIV threat to them.