基于男性社交平台男男性行为人群HIV检测率及HIV自我检测率变化趋势分析

Changing trends of HIV testing and HIV self-testing in men who have sex with men on a gay social networking app

目的了解我国MSM的HIV检测率尤其是HIV自我检测(自检)率的变化趋势,初步评估HIV自检在扩大MSM的HIV检测方面的作用。方法通过Blued男性社交平台在全国范围内招募研究对象,调查内容包括社会人口学特征、性行为、既往HIV检测与自检等,并对历年数据进行趋势性分析。结果2013-2016、2018年,分别招募1342、1424、1173、2105、699名MSM。2013年研究对象年龄(30.6±6.6)岁,之后年份的研究对象年龄较2013年更为年轻化。2013年MSM的HIV检测率为60.0%(805/1342),并于2018年增至77.3%(540/699),2013-2016年与2018年MSM的HIV检测率呈现增长趋势(趋势检验Z=19.3,P<0.001)。2013、2018年MSM的HIV自检率分别为19.3%(259/1342)和58.1%(406/699),2018年是2013年的3倍(χ^(2)=237.5,P<0.001),在HIV检测者中HIV自检比例由2013年的32.2%(259/805)增至2018年的75.2%(406/540)(趋势检验Z=14.3,P<0.001)。结论基于男性社交平台的MSM的HIV检测率、HIV自检率、HIV检测者中HIV自检比例,2013-2016、2018年均呈明显上升趋势。提示HIV自检可提高MSM的HIV检测覆盖面,对我国MSM艾滋病防控有重大公共卫生意义。

Objective To understand the changing trends of HIV testing rates,with a focus on HIV self-testing,and to evaluate the impact of HIV self-testing on expanding HIV testing among MSM in China in past few years.Methods MSM were recruited online nationwide via a gay social networking app(Blued)from 2013 to 2016 and 2018.The survey collected information about socio-demographic backgrounds,sexual behaviors,and prior HIV testing experiences,including HIV self-testing.Trend analyses were conducted.Results Respectively,1342,1424,1173,2105 and 699 MSM were recruited nationwide from 2013 to 2016,and in 2018.The mean age was(30.6±6.6)years in 2013 and showed a decreasing trend afterwards.The HIV testing rate was 60.0%(805/1342)in 2013 and there was a rising trend from 2013 to 2016,and 2018(trend Z=19.3,P<0.001),reaching a peak at 77.3%(540/699)in 2018.Further,the HIV self-testing rate increased from 19.3%(259/1342)in 2013 to 58.1%(406/699)in 2018(χ2=237.5,P<0.001).The proportion of MSM who had HIV self-testing among prior HIV testers significantly increased from 32.2%(259/805)to 75.2%(406/540)during the study period(trend Z=14.3,P<0.001).Conclusions The HIV testing rate,HIV self-testing rate and proportion of men who had HIV self-testing among former HIV testers among web-based Chinese MSM showed substantial increases from 2013 to 2016,and 2018.This suggests that HIV self-testing may have a significant effect on the expansion of HIV testing coverage in MSM,and has important public health implications for HIV/AIDS prevention in China.