丽水市MSM人群HIV定期检测及暴露后预防调查

Regular HIV testing and post-exposure prophylaxis among men who have sex with men in Lishui City

目的了解浙江省丽水市男男性行为人群(MSM)HIV定期检测和暴露后预防(PEP)行为,为制定针对性干预策略提供参考。方法于2022年4—8月,采用方便抽样方法抽取丽水市MSM 389人进行调查,通过问卷调查收集社会人口学信息、性行为、HIV检测和PEP行为等资料;采用二阶聚类分析比较不同聚类MSM的HIV定期检测和PEP接受情况。采用多因素logistic回归模型分析HIV定期检测和接受PEP的影响因素。结果调查对象年龄M(QR)为31.00(16.00)岁。HIV定期检测146人,占37.53%;接受过PEP 47人,占12.08%。二阶聚类分析将MSM聚成两类,第一类HIV定期检测占28.05%,低于第二类的44.44%;接受过PEP占22.56%,高于第二类的4.44%(均P<0.05)。多因素logistic回归分析结果显示,年龄(OR=1.030,95%CI:1.011~1.050)、性行为角色(两者皆有,OR=2.999,95%CI:1.732~5.194)和近6个月男男性行为情况(有且每次使用安全套,OR=4.567,95%CI:2.593~8.044)是MSM人群HIV定期检测的影响因素;年龄(OR=0.970,95%CI:0.942~0.999)、性取向(OR=0.292,95%CI:0.139~0.612)和近6个月男男性行为情况(有且不使用安全套,OR=0.135,95%CI:0.040~0.460;有且每次使用安全套,OR=0.076,95%CI:0.018~0.326)是MSM人群接受PEP的影响因素。结论不同性行为特征的MSM人群对HIV定期检测和PEP的接受程度不同,近6个月男男性行为情况、性行为角色和性取向是主要的影响因素。

Objective To investigate the status of regular HIV testing and post exposure prophylaxis(PEP)behaviors among men who have sex with men(MSM)in Lishui City,Zhejiang Province,so as to provide the reference for developing targeted intervention strategies.Methods A total of 389 MSM were selected from Lishui City by convenient sampling method from April to August 2022,and demographic information,sexual behaviors,HIV testing and PEP behaviors were collected through questionnaire surveys.MSM were clustered using two step clustering analysis,and regular HIV testing and PEP behaviors among different groups of MSM were compared.Factors affecting regular HIV testing and PEP behaviors were evaluated using a multivariable logistic regression model.Results The MSM surveyed had a median age of 31.00(interquartile range,16.00)years.There were 146 MSM undergoing regular HIV testing,accounting for 37.53%,and 47 MSM receiving PEP,accounting for 12.08%.MSM were divided into two groups.There were 28.05%of MSM with regular HIV testing in group 1,which was lower than the 44.44%in group 2;and 22.56%receiving PEP,which was higher than the 4.44%in group 2(both P<0.05).Multivariable logistic regression analysis identified age(OR=1.030,95%CI:1.011-1.050),sexual roles(both receptive and insertive,OR=2.999,95%CI:1.732-5.194)and homosexual behaviors in the past 6 months(use condoms every time,OR=4.567,95%CI:2.593-8.044)as factors affecting regular HIV testing among MSM;age(OR=0.970,95%CI:0.942-0.999),sexual orientation(OR=0.292,95%CI:0.139-0.612)and homosexual behaviors in the past 6 months(not use condoms,OR=0.135,95%CI:0.040-0.460;use condoms every time,OR=0.076,95%CI:0.018-0.326)as factors affecting PEP behaviors among MSM.Conclusion MSM with different characteristics of sexual behaviors have different preferences for HIV regular testing and PEP,with homosexual behaviors in the past 6 months,sexual roles and sexual orientation being the main influencing factors.