广州市男男性行为者性伴感染状态知晓对HIV感染的影响研究

Effect of knowledge of sexual partners’HIV status on HIV infection among men who have sex with men in Guangzhou,China

目的了解广州市男男性行为者(MSM)性伴感染状态知晓现状及其对艾滋病病毒(HIV)感染的影响。方法2018年5-7月间对前往广州市各HIV自愿咨询检测门诊检测的MSM进行招募,收集HIV检测史、近6个月性行为特征和性伴感染状态知晓情况等信息,采用Logistic回归模型分析近6个月性伴感染状态知晓情况对本次HIV检测结果的影响。结果共纳入研究对象1094名,HIV检测阳性率5.9%(64例)。近6个月曾发生肛交者22.8%(220/965)知晓全部性伴的感染状况,知晓者HIV阳性率(2.3%)低于不知晓者(8.0%)。多因素Logistic回归显示知晓部分性伴感染状况[调整比值比(aOR)=0.33,95%可信区间(CI):0.14~0.80]、知晓全部性伴感染状况(aOR=0.25,95%CI:0.09~0.65)、未和不清楚感染状况的性伴发生无保护肛交(aOR=0.19,95%CI:0.10~0.40)、与固定性伴确立关系前互相告知检测结果(aOR=0.38,95%CI:0.16~0.91)的MSM,本次HIV检测阳性率更低。结论知晓性伴感染状态有助于MSM预防HIV感染,但广州市MSM的性伴感染状态知晓比例仍有待提高,需进一步探索兼顾准确性、隐私性、易用性、公平性的性伴感染状态知晓方式以促进人群实施。

Objective To understand the situation of knowledge of the sexual partners’HIV serostatus and its effect on HIV infection among men who have sex with men(MSM)in Guangzhou.Methods From May 2018 to July 2018,MSM were recruited from HIV voluntary counseling and testing clinics in Guangzhou.A structured questionnaire was used to collect the information before testing,including sexual behavior and the situation of knowledge of their partners’HIV serostatus in the past six months.Logistic regression model was used to analyze the relationship between the HIV serostatus awareness in the past six months and the HIV positive results.Results Among1094 MSM,5.9%(64/1094)was HIV seropositive.22.8%(220/965)of the MSM knew the serostatus of all their anal sexual partners in the past six months.Rate of HIV seropositive was lower for MSM who were aware of the serostatus of all partners(2.3%vs 8.0%).Multivariate logistic regression analysis showed that the HIV seropositive rate was lower among those who knew the serostatus of part of the partners(aOR:0.23,95%CI:0.14-0.80),those who knew the serostatus of all the partners(aOR:0.25,95%CI:0.09-0.65),those who rejected to have unprotected anal intercourse with unknown serostatus partners(aOR:0.19,95%CI:0.10-0.40),and those who used to confirm HIV serostatus with regular partners before establishing a relationship(aOR:0.38,95%CI:0.16-0.91).Conclusion Knowledge of the partners’HIV serostatus can help MSM prevent HIV infection.However,it is still necessary to take measures to upgrade the rate of knowledge of the parnters’HIV serostatus among MSM.