西安市男男性接触人群艾滋病感染状况及影响因素分析

Prevalence and risk factors of HIV infection among MSM in Xi’an

目的了解西安市男男性接触(men who have sex with men, MSM)人群HIV感染现况及危险因素,为制定艾滋病防控有效干预策略提供依据。方法通过横断面调查的方法,2016-2019年对1 600名MSM人群进行问卷调查及血清学检测。结果西安市MSM人群陕西省户籍占79.31%,未婚占79.06%,大专及以上学历占77.75%,自认为性取向为同性恋占75.25%,95.06%的MSM通过互联网及软件进行交友。艾滋病知识知晓率为91.38%。HIV、梅毒、丙肝阳性率分别为7.19%、2.94%、0.31%。最近一年患性病的MSM人群感染HIV的风险是未患性病的1.743倍,梅毒检测结果为阳性的MSM人群感染HIV的风险是梅毒阴性的4.233倍,文化程度高、艾滋病知识知晓、最近一次肛交使用安全套、最近6个月肛交坚持使用安全套为减少其感染HIV的保护因素。结论应继续扩大MSM人群防艾知识宣传覆盖面,推广安全套使用,加强完善性病诊疗服务,以控制HIV在该人群中的传播。

Objective To analyze HIV epidemic status and risk factors of men who have sex with men(MSM)in Xi′an,and to provide a basis for formulating effective intervention strategies for AIDS control and prevention.Methods A cross-sectional sentinel survey was conducted among 1600 MSM during 2016-2019 using behavior investigation and serological test.Results 79.31%of the MSM in Xi′an were registered permanent residents in Shaanxi Province,79.06%were unmarried,77.75%received a junior college degree and above education,and 75.25%sexual orientation was gay,up to 95.06%of the MSM made friends through the Internet and software.AIDS knowledge awareness rate was 91.38%.The positive rates of HIV,syphilis and hepatitis C were 7.19%,2.94%and 0.31%,respectively.In the last year,MSM who have venereal disease were 1.743 times more likely to have HIV than those who do not have a venereal disease,and those who tested positive for syphilis were 4.233 times more likely to have HIV than those who tested negative for syphilis.High educational level,AIDS knowledge,condom use during the last anal sex and condom use during the last 6 months of anal sex were the protective factors for reducing HIV infection among MSM.The results of multivariate analysis showed that high education level,AIDS knowledge awareness,condom use in the last anal sex,condom use per anal sex for the last six months were protective factors to reduce their HIV infection.Conclusion Expanding the coverage of AIDS prevention knowledge and condom promotion in the MSM population should be continued,and improvement of STD diagnosis and treatment services should be strengthened to control HIV prevalence in the MSM population.