唐山市男男性行为人群HIV和梅毒感染状况及相关危险因素研究

Analysis on infection status and risk factors of HIV and syphilis among MSM in Tangshan

目的对唐山市男男性行为(men who have sex with men,MSM)人群专题调查数据进行分析,了解MSM人群艾滋病病毒(human immunodeficiency virus,HIV)和梅毒感染状况,分析该人群HIV和梅毒感染危险因素,为制定有效防治措施提供科学依据。方法2009—2016年,通过MSM社会组织和VCT门诊招募MSM人群进行问卷调查和血清学检测,通过单因素和多因素Logistic回归分析HIV和梅毒感染危险因素。结果唐山市MSM人群年龄主要为20~<30岁(65.9%),未婚(75.8%)居多,大专及以上学历者(57.1%)为主;艾滋病知晓率为90.4%;同性恋取向者占67.1%;互联网交友占62.2%;同性性伴总数2~4人者占51.9%;近6个月有肛交性行为者占87.1%;近6个月肛交性行为每次都用安全套者占42.2%。HIV感染率为8.4%,梅毒感染率为2.0%。经多因素Logistic回归分析,同性性伴数多、近6个月多性伴、单纯同性性行为是MSM人群感染HIV的危险因素;在婚/与同性同居是MSM人群感染梅毒的危险因素。结论唐山市MSM人群HIV感染状况较为严峻且存在知-行分离现象,应加强该人群警示性教育,在唐山地区积极推广暴露前(pre-exposure prophylaxis,PrEP)和暴露后(post-exposure prophylaxis,PEP)预防,完善性病诊疗服务,降低MSM人群HIV感染风险。

Objective To analyze the data of thematic survey of men who have sex with men(MSM)in Tangshan,to understand the infection status of human immunodeficiency virus(HIV)and syphilis among MSM,to analyze the risk factors,and thereby to provide scientific basis for making effective prevention and treatment measures.Methods From 2009 to 2016,questionnaires and serological tests were conducted on MSM populations recruited by MSM social organizations and Voluntary Counseling and Testing(VCT)clinics,and the risk factors of HIV and syphilis infection were analyzed by univariate and multivariate Logistic regression respectively.Results Major MSM populations in Tangshan were aged between 20 and<30 years old,unmarried populations(75.8%)dominated,and the populations receiving junior college degree or above(57.1%)ranked top place;the awareness rate for AIDS knowledge was 90.4%.In the MSM populations,67.1%were homosexual orientation,62.2%populations made friends through Internet,51.9%populations had 2-4 homosexual partners.In the last 6 months,87.1%populations anal sex,and 42.2%populations used condoms during each sexual intercourse.The infection rate for HIV and syphilis infection was 8.4%and 2.0%respectively.Multiple Logistic regression analysis showed that the number of homosexual partners dominated,multiple homosexual partners during the first 6 months,and simple homosexual sex were risk factors for HIV infection in MSM.Marital/cohabitation with homosexual partners was a risk factor for syphilis infection in MSM.Conclusion The HIV infection status of MSM in Tangshan is severe,and the phenomenon of cognitive-behavioral dissociation emerges.It is required to tighten warning education,actively promote pre-exposure prophylaxis(PrEP)and post-exposure prophylaxis(PEP)prevention,improve STD diagnosis and treatment services in Tangshan region,and reduce the risk of HIV infection in MSM population.