男男性行为人群主要性伴类型特征及其未检测HIV相关因素分析

Analysis of characteristics of types of primary sexual partners and related factors of not being tested for HIV among men who have sex with men

目的比较主要性伴类型不同的MSM特征,分析MSM最近6个月未检测HIV的相关因素。方法2021年4-7月在山东省9个城市招募MSM,开展面对面问卷调查,收集其社会人口学特征、高危行为和HIV检测等信息,采集血样用于HIV抗体和梅毒抗体检测。结果最近6个月发生同性肛交性行为的MSM共3008人,将MSM根据最近6个月主要性伴类型分为固定性伴组(36.83%,1108/3008)、商业性伴组(3.06%,92/3008)和临时性伴组(60.11%,1808/3008)。不同组别MSM的年龄、本地居住时间、文化程度、寻找男性性伴的主要场所、最近6个月新型毒品使用、肛交每次坚持使用安全套、发生群交行为、未检测HIV和最近1年患过性病、接受同伴教育、梅毒检测频率的分布差异有统计学意义(均P<0.05)。多因素logistic回归分析结果显示,MSM最近6个月未检测HIV的相关因素包括年龄<30岁(aOR=1.39,95%CI:1.06~1.83)、已婚/同居(aOR=1.74,95%CI:1.39~2.16)、高中及以下文化程度(aOR=1.39,95%CI:1.15~1.67)、最近6个月未使用新型毒品(aOR=2.27,95%CI:1.89~2.71)、最近1年未接受同伴教育(aOR=1.59,95%CI:1.28~1.98)、从未做过梅毒检测(aOR=11.30,95%CI:8.15~15.66)、最近1年未做但以前做过梅毒检测(aOR=5.65,95%CI:4.19~7.62)、最近6个月主要性伴类型是商业性伴(aOR=1.80,95%CI:1.01~3.20)和最近6个月主要性伴类型是临时性伴(aOR=1.50,95%CI:1.26~1.80)。结论主要性伴类型不同的MSM特征有所差异,HIV检测比例仍有待提高。今后应针对主要性伴类型不同的MSM特征,充分利用网络和同伴教育等方法扩大MSM HIV检测覆盖率。

Objective To compare the characteristics of MSM with different types of primary sexual partners and to analyze the factors associated with MSM not being tested for HIV in the last six months.Methods MSM were recruited in nine cities of Shandong Province from April to July 2021,and face-to-face questionnaires were conducted to collect information on sociodemographic characteristics,high-risk behaviors,and HIV testing of MSM.Blood samples were taken for serological tests of HIV and syphilis antibodies.Results A total of 3008 men who had anal sex with men in the last six months were divided into three groups according to the type of primary sexual partner in the last six months:the fixed sexual partner group(36.83%,1108/3008),the commercial sexual partner group(3.06%,92/3008),and casual sexual partner group(60.11%,1808/3008).There were statistically significant differences in the distribution of age,local residence time,education level,the primary place to find male sexual partners,use of new-type drugs in the last six months,consistent condom use every time during same-sex anal sex in the last six months,group sex in the last six months,no HIV testing in the last six months,having had a sexually transmitted disease in the last year,receiving peer education in the last year,and frequency of syphilis testing in the last year among different groups(P<0.05).Multivariable logistic regression analysis showed that related factors of not being tested for HIV in the last six months in MSM were those aged less than 30 years old(aOR=1.39,95%CI:1.06-1.83),married/cohabiting(aOR=1.74,95%CI:1.39-2.16),high school education or less(aOR=1.39,95%CI:1.15-1.67),had not used new-type drugs in the last six months(aOR=2.27,95%CI:1.89-2.71),had not received peer education in the last year(aOR=1.59,95%CI:1.28-1.98),had never been tested for syphilis(aOR=11.30,95%CI:8.15-15.66),had not been tested in the last year but had been previously tested for syphilis(aOR=5.65,95%CI:4.19-7.62),the type of primary sexual partner in the last six months being a commercial sexual partner(aOR=1.80,95%CI:1.01-3.20),and the type of primary sexual partner in the last six months being a casual sexual partner(aOR=1.50,95%CI:1.26-1.80).Conclusions The characteristics of MSM with different types of primary sexual partners are different,and the proportion of HIV testing still needs to be improved.In the future,we should make full use of the Internet and peer education to expand the coverage of HIV testing for MSM,targeting the characteristics of MSM with different types of primary sexual partners.