2016-2021年福州市娱乐场所男男性行为者艾滋病监测结果分析

Analysis of HIV/AIDS surveillance in men who have sex with men in entertainment places in Fuzhou from 2016 to 2021

目的 分析娱乐场所男男性行为者(MSM)的特征和HIV感染相关因素,为娱乐场所MSM艾滋病防治提供参考依据。方法 2016-2021年在福州市娱乐场所中招募年龄≥18岁、最近6个月与同性发生过肛交/口交的男性,收集人口学特征、性行为特征以及既往检测情况,采用χ^(2)检验和多因素logistic回归模型分析其HIV抗体阳性的影响因素。结果 本次招募MSM共4 603人,平均年龄为(32.93±9.92)岁,主要以省内户籍(82.90%)、未婚/离异/丧偶(68.24%)、大专及以上教育程度(48.23%)、本地居住时间≥2年(76.34%)、同性性取向(86.51%)以及通过网络寻找性伴者(69.61%)为主;MSM人群中年龄≥45岁、本省户籍、本地居住时间≥2年、同性性取向的构成比呈逐年上升趋势(P值均<0.05)。最近6个月肛交、最近1次肛交未使用安全套、发生商业性行为比例、最近1年接受艾滋病干预服务的比例呈上升趋势(P值均<0.05);最近6个月发生异性性行为、最近1次异性性行为使用安全套、吸毒、既往接受艾滋病抗体检测的比例呈下降趋势(P值均<0.05)。2016-2021年期间累计监测HIV阳性率为3.30%(152/4 603),历年监测HIV阳性率总体呈逐年下降趋势(χ^(2)=66.053,P<0.01)。多因素分析结果显示,年度、高中及以上学历、本地居住时间1年及以上、最近6个月肛交使用安全套、既往未患性病是MSM人群HIV抗体阳性的保护因素(OR值均<1),而年龄≥45岁和不知晓艾滋病知识是危险因素(OR值均>1)。结论 娱乐场所MSM年龄偏大,教育程度偏低,无保护肛交性行为呈现上升趋势,应加大娱乐场所中MSM艾滋病知识的宣传和安全性行为的健康教育,开发适合娱乐场所使用的宣传材料,加强以安全套推广使用为核心的干预措施,探索现场检测和自我检测相结合的HIV检测模式,有效控制HIV的传播流行。

Objective To analyze the characteristics and factors related to HIV infection of men who have sex with men(MSM)in entertainment places in Fuzhou,to provide reference for AIDS prevention and control among MSM in entertainment places.Methods From 2016 to 2021,men aged≥18 years who had oral or anal sex with men in the past 6 months were recruited in entertainment places in Fuzhou,and their demographic characteristics,sexual behavioral characteristics,and previous detections,were collected.The influencing factors of HIV antibody positivity were analyzed by x^(2)test and multivariable logistic regression model.Results A total of 4603 MSM were recruited this time.The average age was(32.93±9.92)years old.The majority were household registration in the province(82.90%),unmarried/divorced/widowed(68.24%),college education or above(48.23%),local residence time≥2 years(76.34%),homosexual orientation(86.51%),and seeking sexual partners through the Internet(69.61%).Among the MSM population,the proportions of aged 45 and above,household registration in the province,local residence time≥2 years,and homosexual orientation showed increasing trend year by year(all P<0.05).The proportion of anal sex in the last 6 months,no condom use in the last anal sex,commercial behavior,and receiving AIDS intervention services in the past year showed increasing trend(all P<0.05).The proportion of heterosexual sex in the past 6 months,condom use in the last heterosexual sex,drug use,and previous HIV antibody testing showed downward trend(all P<0.05).From 2016 to 2021,the cumulative HIV positivity rate monitored was 3.30%(152/4603),showing a downward trend year by year(χ^(2)=66.053,P<0.01).The results of multivariable analysis showed that year,high school and above education,local residence time of 1 year and above,condom use in anal sex in the last 6 months,and no previous sexually transmitted diseases were the protective factors for HIV antibody positivity among MSM(all OR<1).Age≥45 years old and lacking AIDS knowledge were the risk factors(all OR>1).Conclusions The MSM in entertainment places are older and have lower educational levels,and unprotected anal sex showed an upward trend.We should improve the publicity of HIV knowledge and safe sex among MSM in entertainment places,develop promotional materials suitable for entertainment places,strengthen intervention measures with condom promotion and use as the core,explore the HIV testing mode combining on-site testing and self-testing,control the spread of HIV epidemic effectively.