上海市男男性行为者HIV自检情况及其影响因素

Analysis of the HIV self-testing and its influencing factors among men who have sex with men in Shanghai

目的探索上海市MSM的HIV自检(HIVST)情况的影响因素,以及对HIVST的认知,为制定HIVST服务流程提供科学依据。方法2018年6月至2019年8月,以社会组织通过网络和外展等途径招募的已知HIV阴性或感染状况未知的MSM为研究对象。采用自行设计的调查问卷,在知情同意前提下,以问卷星网站在线调查的方式开展调查,收集其人口学特征、性行为特征、对HIVST的认知、本次HIVST情况以及未来HIVST使用意向等信息。研究对象同时接受自检。结果既往使用过HIVST者占48.2%(619/1285)。多因素Logistic回归分析显示,既往使用HIVST情况在近6个月有无男性伴、近6个月有无固定男性伴、最近一次到检测点接受过HIV检测的时间、以及最近一次HIV检测地点方面的差异具有统计学意义(P<0.05)。本次HIV快检阳性率为4.6%(59/1285),其中94.9%(56/59)愿意接受后续确证检测,67.8%(40/59)愿意主动到CDC确证,18.6%(11/59)希望社区组织帮助转介。57.0%(732/1285)的MSM认为HIVST与到HIV检测点检测相比各有优劣,相互补充;92.1%(1184/1285)愿意在未来使用HIVST。结论上海市MSM既往HIVST率相对较低,应加强社区组织+互联网模式推广使用HIVST服务,进一步促进上海市对MSM的HIVST服务的提供和利用,完善以CDC为主导、社区组织充分参与的HIVST阳性者的后续转介流程。

Objective To Analyze the HIV self-testing(HIVST)and its influencing factors among men who have sex with men(MSM)in Shanghai.The knowledge of the HIVST provides scientific evidence for the development of HIVST service processes.Methods From Jun 2018 to Aug 2019,the MSM with known HIV negative or unknown HIV status were recruited by Communities Organization as research objects.The self-designed questionnaire was conducted using the questionnaire star website.We collected general demographic information,sexual behavior characteristic,knowledge of the HIVST,current HIVST status,and the use of HIVST in the future,etc.The subjects also received HIVST.Results 48.2%(619/1285)of those used the HIVST in the past.Multivariate logistic regression analysis showed statistically significant differences appeared in the following situations:the previous use of HIVST,presence or absence of a male partner in the past six months,with or without a fixed male partner in the past six months,the time to the last HIV test at the HIV detection point,and the location of the latest HIV test(P<0.05),etc.The positive rate was 4.6%(59/1285).Among them,94.9%(56/59)were willing to accept confirmation testing,67.8%(40/59)were willing to take confirmation testing in CDC,18.6%(11/59)hope that Communities Organization will help with referral.57.0%(732/1285)of the objects believed that HIVST had advantages and disadvantages compared with the HIV detection point.92.1%(1184/1285)were willing to use HIVST in future.Conclusion The rate of HIVST was relatively low among MSM people in Shanghai.The Communities Organization+internet model should be strengthened to promote the provision and utilization of HIVST services.Referral process of HIVST-positive with CDC-led and Communities Organization participation should also be targeted.