上海和苏州两地男男性行为者HIV自我检测行为、检测模式及影响因素研究

HIV self-testing,testing strategy and related factors among men who have sex with men in two cities in Shanghai and Suzhou

目的评估上海和苏州两地MSM的HIV自我检测行为、检测模式及影响因素。方法2021年2―5月间通过社交软件招募上海市、苏州市两地≥18岁且未被诊断为HIV/AIDS的MSM开展网络问卷现况调查,用频率描述自检行为及检测模式,用χ^(2)检验和Logistic回归分析模型分析影响因素。结果759名研究对象中,542例有HIV自检史,占比71.4%。其中148例报告既往自检出现过阳性结果,140人经复测确认为假阳性。检测模式包括不检测、传统检测和自检/自检+传统检测三种,各占20.6%、10.0%、69.4%。与含自检模式相比,长居苏州(OR=1.85,95%CI:1.08~3.17)、性角色插入方(OR=0.34,95%CI:0.14~0.80)、近1年性伴数2~4人(OR=0.51,95%CI:0.32~0.81)或5~9人(OR=0.31,95%CI:0.14~0.68)、线下(OR=0.44,95%CI:0.23~0.86)或“线下+线上”(OR=0.51,95%CI:0.31~0.84)寻找性伴、近1年使用毒品/兴奋剂(OR=0.54,95%CI:0.36~0.83)、有性病史(OR=0.41,95%CI:0.24~0.69)、试剂获取困难(OR=2.52,95%CI:1.53~4.15)、试剂使用困难(OR=1.93,95%CI:1.22~3.07)是MSM选择未检测模式的影响因素;年龄18~<25岁(OR=0.26,95%CI:0.10~0.71)或25~<45岁(OR=0.38,95%CI:0.15~0.95)、近1年性伴数2~4人(OR=0.42,95%CI:0.23~0.78)、试剂获取困难(OR=2.58,95%CI:1.33~4.99)是MSM选择传统检测模式的影响因素(均有P<0.05)。结论上海和苏州两地的MSM具有较高的自检使用率和支持服务需求,年龄、居住地、性行为特征、药物滥用、自检试剂可及性和可操作性影响MSM对检测模式的选择。

Objective To understand HIV self-testing behaviors,test strategies and related factors among men who have sex with men(MSM)in Shanghai and Suzhou.Methods MSM aged≥18 with no HIV/AIDS history in Shanghai and Suzhou were recruited and investigated online from February to May,2021.Frequencies were used to describe self-testing behaviors and test strategies,andχ^(2)test and Logistic regression were used in analyses of related factors.Results A total of 759 MSM were recruited.71.4%(542/759)had self-testing history.Among them,148 reported having observed a positive result of whom 140 identified it false positive through another test.The rate of adopting test strategy including self-testing,strategy with only facility-based test and no-testing strategy in the last year was 69.4%、10.0%and 20.6%,respectively.Compared to strategy including self-testing,living in Suzhou(OR=1.85,95%CI:1.08-3.17),inserting sexual role(OR=0.34,95%CI:0.14-0.80),having 2-4(OR=0.51,95%CI:0.32-0.81)or 5-9(OR=0.31,95%CI:0.14-0.68)sexual partners in the last year,seeking partners offline(OR=0.44,95%CI:0.23-0.86)or offline&online(OR=0.51,95%CI:0.31-0.84),drug abuse(OR=0.54,95%CI:0.36-0.83),STD history(OR=0.41,95%CI:0.24-0.69),having difficulties in accessing or using kits(OR=2.52,95%CI:1.53-4.15;OR=1.93,95%CI:1.22-3.07)were factors relating to choice of no-testing strategy;aged 18-<25(OR=0.26,95%CI:0.10-0.71)or 25-<45(OR=0.38,95%CI:0.15-0.95),having 2-4 sexual partners in the last year(OR=0.42,95%CI:0.23-0.78)and having difficulties in accessing kits(OR=2.58,95%CI:1.33-4.99)were factors relating to choice of only facility-testing strategy(all P<0.05).Conclusions MSM in Shanghai and Suzhou have a relatively high uptake of HIV self-testing and an imperative demand for specific health care.Choice of test strategy among MSM relates to age,residence,sexual behaviors,drug abuse,accessibility and operability of self-testing kits.