云南省男男性行为人群沙眼衣原体、淋球菌和梅毒感染现状及影响因素分析

Prevalence and influencing factors of Chlamydia trachomatis,Neisseria gonorrhoeae and Treponema pallidum infection among men who have sex with men in Yunnan province,2020:a cross-sectional survey

目的了解云南省男男性行为人群(MSM)沙眼衣原体(CT)、淋球菌(NG)和梅毒感染现状,探索云南省MSM人群CT、NG和梅毒感染的影响因素,为制定性传播感染防治策略提供依据。方法2020年1-12月,通过滚雪球抽样在云南省14个州(市)招募男男性行为者,共招募1298名MSM。采集尿液、咽拭子和直肠拭子以及血液标本进行CT/NG核酸扩增检测和梅毒检测。使用logistic回归模型分析CT、NG和梅毒感染影响因素。结果1298名MSM调查者中,CT、NG、梅毒的感染率分别为9.9%、3.1%、3.2%。直肠拭子CT的阳性率最高(6.0%,61/1023),咽拭子NG的阳性率最高(1.8%,22/1190)。多因素分析结果显示,滇中地区(OR=4.217,95%CI=1.611~11.04)和滇西北地区(OR=3.521,95%CI=1.357~9.136)、初中及以下文化程度(OR=2.333,95%CI=1.427~3.813)的MSM感染CT的风险更高,初中及以下文化程度(OR=2.935,95%CI=1.265~6.812)、通过互联网/交友软件寻找性伴(OR=2.64,95%CI=1.019~6.836)的MSM感染NG的风险更高,最近1年有性病史(OR=43.983,95%CI=19.31~100.182)的MSM感染梅毒的风险更高。结论云南省MSM人群CT、NG和梅毒感染率处于较高水平,应加强对MSM人群的综合干预,建议对存在高危性行为的MSM进行CT、NG和梅毒筛查。

Objective To investigate the prevalence and influencing factors of Chlamydia trachomatis(CT),Neisseria gonorrhoeae(NG)and Treponema pallidum(TP)infection among men who have sex with men(MSM)in Yunnan province for providing evidence to develop strategies on sexually transmitted infection prevention and control.Methods Totally 1400 MSM aged 15-65 years and with insertive oral or anal sex during past one year were recruited with snowball sampling in 14 prefectures/cities of Yunnan province in 2020.Face-to-face questionnaire interview,sampling of b1ood,urine,and pharyngeal/rectal swab specimens for tests of CT,NG and TP infection were carried out among the MSM.Logistic regression model was adopted in analyses on influencing factors of the infections.Results Among the 1298 MSM with valid information,the detection rates were 9.9%(number of positive cases:129),3.1%(40)and 3.2%(42)for CT,NG and TP infection,respectively,with the highest positive rate(6.0%,61/1023)of CT infection for rectal swab specimens and that(1.8%,22/1190)of NG infection for pharyngeal swab specimens.The results of multivariate logistic regression analysis showed that the MSM living in central region(odds ratio[OR]=4.217,95%confidence interval[95%CI]:1.611-11.04)or northwestern region(OR=3.521,95%CI:1.357-9.136)compared to living in northeastern of the province and the MSM with the education of junior high school and below(versus college and above:OR=2.333,95%CI:1.427-3.813)were more likely to have CT infection;the results also revealed that with the education of junior high school and below(versus college and above:OR=2.935,95%CI:1.265-6.812)and seeking sexual partners via internet/dating applications(versus through other routes:OR=2.64,95%CI:1.019-6.836)were risk factors for NG infection,and suffering from sexually transmitted diseases in past one year was a risk factor(OR=43.983,95%CI:19.31-100.182)for TP infection.Conclusion Among MSM in Yunnan province,the prevalence of CT,NG and TP infection were relatively high,suggesting that comprehensive intervention measures,including screening on the infections among high-risk individuals,should be strengthened in the MSM.