2017—2021年陕西省男男同性性行为人群HIV感染状况及相关因素分析

Analysis of HIV infection status and its related factors among men who have sex with men in Shaanxi Province,2017—2021

目的 了解2017—2021年陕西省男男同性性行为人群(men who have sex with men,MSM)的人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染情况及其相关因素,为开展MSM艾滋病综合防治和干预工作提供科学依据。方法 2017—2021年对陕西省MSM开展哨点监测,收集MSM的人口学特征、艾滋病知识知晓情况、干预服务、既往HIV检测比例、高危性行为史等信息,采集静脉血进行HIV、梅毒及丙型肝炎病毒(hepatitis C virus,HCV)抗体检测。采用logistic回归模型对HIV感染相关因素分析。结果 2017—2021年HIV抗体阳性率依次为5.50%(44例)、 4.12%(33例)、 4.25%(34/800)、4.75%(38例)和3.38%(27例),新发感染率依次为3.44%、1.64%、4.62%、2.37%和5.37%,趋势检验差异无统计学意义(χ^(2)_(趋势)=2.499,P=0.114;P=0.423);各年份艾滋病知识知晓率均>90%;与同性肛交的比例从2017年的88.25%(706例)上升至2021年的95.12%(761例),与同性坚持使用安全套的比例从2017年的67.42%(476/706)上升至2021年的80.55%(613/761),差异有统计学意义(χ^(2)_(趋势)=49.375、94.915,P<0.01)。多因素logistic回归分析显示,本地居住时间>2年[aOR=1.52,95%置信区间(confidence interval, CI):1.04-2.22]、在互联网/交友软件找寻男性性伴(aOR=3.54, 95%CI:1.64-7.66)、不知晓艾滋病防治知识(aOR=3.13, 95%CI:2.03-4.82)、梅毒阳性(aOR=5.66,95%CI:3.52-9.11)及最近1年内未做过HIV检测(aOR=2.88,95%CI:2.10-3.96)均是HIV感染的相关因素。结论 陕西省MSM哨点人群HIV抗体阳性率和HIV新发感染率未持续上升,但相关危险行为仍持续存在,应创新干预和检测方式,促进主动检测,降低HIV感染风险。

Objective To understand the human immunodeficiency virus(HIV)infection status and its related factors among men who have sex with men(MSM)in Shaanxi Province from 2017 to 2021,so as to provide scientific evidence for the comprehensive prevention and intervention of acquired immunodeficiency syndrome(AIDS)among MSM.Methods Consecutive sentinel surveillance in MSM were conducted from 2017 to 2021 in Shaanxi Province,in which questionnaire survey was conducted to collect information including demographic characteristics,AIDS knowledge awareness,intervention services,previous HIV testing,and high-risk sexual behavior history,etc.Venous blood samples were collected for HIV,syphilis and hepatitis C virus(HCV)antibody testing.Logistics regression analysis was used to identify the related factors of HIV infection.Results In each year during the period from 2017 to 2021,the HIV antibody positive rate was 5.50%(44/800),4.12%(33/800),4.25%(34/800),4.75%(38/800)and 3.38%(27/800),respectively,and the rate of incident HIV infection was 3.44%,1.64%,4.62%,2.37%and 5.37%,respectively,with no statistically significant trend(χ^2_(trend)=2.499,P=0.114;P=0.423).The rates of AIDS knowledge awareness were over 90.0%in each year.From 2017 to 2021,the percentage of MSM having anal sex with males increased significantly from 88.25%(706/800)to 95.12%(761/800),the percentage of those who consistently use condoms when having sex with males increased significantly from 67.42%(476/706)to 80.55%(613/761),with statistically significant trend(χ^2_(trend)=49.375,94.915,P<0.01).Multivariable logistic regression analysis indicated that having lived in local residence for>2 years(aOR=1.52,95%CI:1.03-2.22),searching for male sexual partners through internet/dating software(aOR=3.54,95%CI:1.64-7.66),not having knowledge of AIDS prevention and treatment(aOR=3.13,95%CI:2.03-4.82),tested positive for syphilis antibody(aOR=5.66,95%CI:3.52-9.11)and not having done HIV testing in the last year(aOR=2.88,95%CI:2.10-3.96)were the related factors for HIV infection.Conclusions In recent years,the HIV antibody positive rate and and incident HIV infection rate among MSM sentinel population in Shaanxi Province have not increased continuously,but AIDS-related risk behaviors still exists.We should innovate intervention and testing methods,promote active testing,and reduce the risk of HIV infection.