福州市2016—2020年网络招募男男性行为人群艾滋病监测结果分析

Analysis of the results of HIV survey among men who have sex with men by online recruitment from 2016 to 2020 in Fuzhou City

目的了解福州市2016―2020年MSM人群HIV感染状况及其相关因素,为制定艾滋病干预策略提供依据。方法2016―2020年通过网络招募方式在福州市开展MSM调查,调查内容参照《全国艾滋病哨点监测实施方案操作手册》,包括人口学、行为学和抗体筛查情况等,采用趋势χ^(2)检验和多因素Logistic回归分析模型进行影响因素分析。结果2016―2020年共计调查11864人,MSM人群HIV感染率为3.82%(453/11864),各年份分别为4.48%、4.24%、3.27%、5.01%和2.36%,历年监测MSM人群HIV感染率呈现下降趋势(χ^(2)=9.802,P<0.001)。最近6个月最近1次肛交性行为使用安全套比例由89.45%下降到79.21%,与同性发生商业性行为比例由0.38%上升到2.05%,艾滋病知识知晓率由97.51%下降到94.53%,趋势χ^(2)检验均有统计学意义(均有P<0.05)。多因素Logistic回归分析模型分析显示,高中及以上学历、在本地居住时间≥1年、最近6个月未发生肛交性行为或最近1次肛交性行为使用安全套、最近6个月肛交性行为每次都用安全套、最近1年接受艾滋病干预服务、知晓艾滋病知识均为MSM人群HIV感染的保护因素;吸毒和最近1年患过性病则会增加MSM人群HIV感染的风险。结论福州市MSM人群的HIV感染状况呈现下降态势,但艾滋病知识知晓率和同性肛交使用安全套比例均呈现下降态势,应重点针对低文化程度和流动性大的MSM人群,加强以安全套推广使用和HIV检测的综合干预措施,有效控制MSM人群HIV疫情。

Objective To understand the HIV infection status and its related factors of men who have sex with men(MSM)in Fuzhou City from 2016 to 2020,and to provide a basis for formulating intervention strategies.Methods The MSM survey in Fuzhou City from 2016 to 2020 was carried out by online recruitment.The content of the survey was conducted according to the Requirements of the National AIDS Sentinel Monitoring Program,which including demographic information,behavioral characteristics and antibody screening.Trendχ^(2)test and multivariate Logistic regression were used to analyze influencing factors.Results A total of 11864 people were surveyed from 2016 to 2020.The cumulative HIV infection rate of the MSM population monitored was 3.82%(453/11864).And the HIV infection rates in 2016-2020 were 4.48%,4.24%,3.27%,5.01%and 2.36%,respectively.The HIV infection rate of the MSM population monitored every year showed a downward trend(χ^(2)=9.802,P<0.001).In the last 6 months,the rate of condom use in the most recent anal sex decreased from 89.45%to 79.21%,the rate of commercial sex with the same sex increased from 0.38%to 2.05%,and the awareness rate of AIDS knowledge decreased from 97.51%to 94.53%,with statistically significant results of trendχ^(2)tests(all P<0.05).Multivariate Logistic regression analysis showed that having high school degree or above,living in the local area for more than 1 year,no anal sex or condom use in the last 6 months,persistent using condoms for anal sex,receiving AIDS intervention services in one year and having AIDS knowledge were all protective factors for the HIV infection in MSM population;While drug addiction and having sexually transmitted diseases in recent one year would increase the risk of the HIV infection in MSM population.Conclusions There is a downward trend in the HIV epidemic among MSM population in Fuzhou City.However,the AIDS awareness rate and the rate of condom use for anal sex with the same sex both show downward trends.We should focus on MSM population with low education and high mobility on strengthening the comprehensive intervention measures to promote the condom use and HIV testing,for which can effectively control the HIV epidemic in MSM population.