福州市2016―2021年发生异性性行为的MSM人群特征及HIV感染因素

Characteristics of MSM with heterosexual behavior and analysis on related factors of their HIV infection in Fuzhou from 2016 to 2021

目的了解福州市发生异性性行为的男男性行为者(men who have sex with men,MSM)人群特征及HIV感染相关因素,为开展有效的干预措施提供参考依据。方法2016―2021年通过互联网招募≥15岁,近1年与男性发生过口交或肛交性行为的MSM至现场检测点,筛选最近6个月与异性发生性行为的MSM,分析其社会人口学和行为学特征、HIV感染状况。结果共调查13829名MSM,其中2016―2021年各年度发生异性性行为的MSM人群分别为156、207、314、352、338、241人。MSM人群发生异性性行为的多因素logistic回归分析模型分析显示:>25岁年龄组(OR=1.298,95%CI:1.091~1.544)、在婚/同居(OR=9.283,95%CI:8.025~10.739)、高中/中专(OR=1.259,95%CI:1.021~1.552)、异性恋(OR=37.311,95%CI:25.204~53.126)、双性恋(OR=7.266,95%CI:6.325~8.347)、性取向未确定(OR=4.394,95%CI:3.001~6.433)、场所寻找男性伴(OR=1.370,95%CI:1.080~1.738)是发生异性性行为的危险因素(均P<0.05);本地居住时间1~2年(OR=0.733,95%CI:0.553~0.971)、本地居住时间>2年(OR=0.809,95%CI:0.670~0.977)、未吸毒(OR=0.459,95%CI:0.228~0.924)是发生异性性行为的保护因素(均P<0.05)。监测发生异性性行为的MSM人群HIV抗体阳性率为4.17%(67/1608),历年HIV抗体阳性率呈下降趋势(趋势χ^(2)=6.959,P=0.008)。发生异性性行为的MSM HIV感染的多因素logistic回归分析模型结果显示:性取向不确定(OR=3.133,95%CI:1.112~8.826)是危险因素;高中/中专(OR=0.469,95%CI:0.247~0.889)、大专及以上(OR=0.330,95%CI:0.178~0.613)、未发生肛交或每次都使用安全套(OR=0.184,95%CI:0.063~0.539)、肛交有时使用安全套(OR=0.304,95%CI:0.103~0.897)、未吸毒(OR=0.228,95%CI:0.059~0.883)是保护因素。结论福州市发生异性性行为的MSM人群坚持使用安全套比例低,应加强干预宣传,提高安全套使用率,减少AIDS向普通女性传播流行的风险。

Objective To understand the characteristics of MSM with heterosexual behavior and related factors of their HIV infection in Fuzhou,and to provide reference basis for effective intervention measures.Methods From 2016 to 2021,MSM aged 15 and over who had oral or anal sex with men in the last year were recruited.MSM who had sex with the female in the past 6 months were selected,and their sociolect-demographic,behavioral characteristics and HIV infection status were analyzed.Results 13829 MSM were investigated,of which the respondents with heterosexual behavior from 2016 to 2021 was 156,207,314,352,338 and 241 respectively.Multivariate logistic regression analysis of heterosexual behavior showed that>25 age group(OR=1.298,95%CI:1.091-1.544),married/cohabiting(OR=9.283,95%CI:8.025-10.739),education level of high school or technical secondary school(OR=1.259,95%CI:1.021-1.552),heterosexuality(OR=37.311,95%CI:25.204-53.126),bisexuality(OR=7.266,95%CI:6.325-8.347),undetermined sexual orientation(OR=4.394,95%CI:3.001-6.433),finding male sex partners through places(OR=1.370,95%CI:1.080-1.738)were risk factors(all P<0.05);MSM who lived in Fuzhou for 1-2 years(OR=0.733,95%CI:0.553-0.971),MSM who lived in Fuzhou for more than two years(OR=0.809,95%CI:0.670-0.977),non-drug users(OR=0.459,95%CI:0.228-0.924)were protective factors(all P<0.05).The HIV antibody positive rate of MSM with heterosexual behavior was 4.17%(67/1608).The HIV antibody positive rate of MSM showed a downward trend(trendχ^(2)=6.959,P=0.008).The results of multivariate logistic regression analysis showed that undetermined sexual orientation(OR=3.133,95%CI:1.112-8.826)was risk factors;education level of high school or technical secondary school(OR=0.469,95%CI:0.247-0.889),education level of junior college or below(OR=0.330,95%CI:0.178-0.613),never having anal sex or using condom every time(OR=0.184,95%CI:0.063-0.539),sometimes using condom(OR=0.304,95%CI:0.103-0.897),non-drug users(OR=0.228,95%CI:0.059-0.883)were protective factors(all P<0.05).Conclusions The proportion of insisting condom use among MSM with heterosexual behavior is low.The intervention of MSM with heterosexual behavior should be strengthened to enhance the utilization rate of condoms and reduce the risk of AIDS spreading to women.