广西年轻男男性行为人群HIV/梅毒感染和高危性行为状况及其影响因素分析

Prevalence status and influencing factor of HIV,syphilis and high-risk sexual behaviors among young men who have sex with men in Guangxi

目的了解广西年轻男男同性性行为人群HIV和梅毒感染情况,探讨该人群HIV/梅毒感染和高危性行为的影响因素,为制定相应干预措施提供参考。方法 2010—2015年对居住在广西南宁市、柳州市和桂林市的MSM人群,通过滚雪球方法招募其中的18～24岁者进行人口学和行为学调查,并采集5 mL静脉血进行HIV和梅毒抗体检测。不同人口学和行为学特征的HIV和梅毒阳性率比较采用卡方(x^2)检验进行分析,用logistics回归分析影响高危性行为、 HIV和梅毒感染的相关危险因素。结果共招募了年轻MSM 2 148人,平均年龄为(21.63±1.85)岁,未婚占97.5%,大专及以上学历占51.2%,艾滋病知识知晓率为95.4%,同性肛交安全套坚持使用率为55.7%, HIV抗体阳性率为6.8%(147/2 148),梅毒阳性率为6.5%(139/2 148)。多因素logistics回归分析结果显示,感染HIV的危险因素是大专以下学历、同性肛交未坚持使用安全套以及最近一年患过性病, OR值(95%CI)分别为1.637 (1.125-2.382)、1.693 (1.167-2.457)、 2.446 (1.311-4.572);感染梅毒的危险因素是不知晓艾滋病知识以及最近一年患过性病, OR值(95%CI)分别为9.149 (1.240-67.498)、 8.553 (5.141-14.229);发生同性肛交未坚持使用安全套的危险因素是民族为壮族、艾滋病知识知晓情况以及最近一年患过性病, OR值(95%CI)分别为1.510 (1.009-2.261)、 1.544 (1.018-2.340)、 0.357 (0.228-0.559)。结论广西年轻MSM人群的HIV、梅毒感染率处于较高水平,且发生高危性行为的比例较高,亟需针对YMSM群体采取有效的艾滋病性病干预策略和措施。

Objective To understand the current status of HIV and syphilis infection among young men who have sex with men(YMSM)in Guangxi,explore the associated factors of HIV/syphilis infection and sexual risk behaviors,and provide the information for the intervention in YMSM.Methods Individuals who were 18 to 24-year-olds YMSM population and lived in Nanning,Liuzhou,and Guilin between 2010 to 2015 were recruited though the method of snowball,and the demographic and behavioral survey were conducted.Meanwhile,5 mL venous blood was collected for HIV and syphilis antibody detection.The information collection included YMSM’s social-demographic information,sexual behavior histories,and the knowledge about HIV/AIDS.To compare the HIV and syphilis infection between different demographic and behavioral characteristics,chi-square was adopted in the analysis.Multivariate logistic regression was used to analyze the factors that affected the high-risk sexual behavior,HIV infection,and syphilis infection.Results A total of 2 148 YMSM were enrolled in this study,the average age of samples was(21.63±1.85)years old,51.2%of them received high education,and the unmarried individuals were accounted for 97.5%.The HIV/AIDS knowledge awareness rate was 95.4%,and the condom use rate among same-sex anal sex was 55.7%.The HIV infection rate and syphilis prevalence were 6.8%and 6.5%,respectively.Based on the multivariate logistic regression analysis:education level(P=0.01,OR=1.637),condom use for anal sex in the past 6 months(P=0.006,OR=1.693),and SDTs infection in the past year(P=0.005,OR=2.446)were associated with HIV infection.Acknowledging HIV/AIDS(P=0.03,OR=9.149)and SDTs infection in the past year(P<0.001,OR=8.553)were associated with syphilis infection.Zhuang ethnicity(P=0.045,OR=1.51),knowledge about HIV/AIDS(P=0.041,OR=1.544),and SDTs infection in the past year(P<0.001,OR=0.357)were associated with sexual risk behaviors.Conclusion HIV and syphilis infection was high among YMSM in Guangxi,and they had higher chance of conducting high-risk sexual behavior.It is necessary to strengthen the comprehensive for the intervention in YMSM.