2016年济南市HIV阳性男男性行为人群性病流行状况及危险因素分析

Analysis on current status and risk factors of sexually transmitted diseases among the HIV-positive MSM, Jinan city,2016

目的了解济南市HIV阳性男男性行为者(MSM)性病流行状况及危险因素。方法采用方便抽样方法在济南市招募2016年7～9月就诊于艾滋病门诊且感染HIV的MSM,开展面对面问卷调查,并进行梅毒、淋病、沙眼衣原体、生殖器疱疹及尖锐湿疣5种性病筛查和临床诊断。采用χ~2检验和二分类多因素Logistic回归分析相关性病感染的危险因素。结果 198例调查对象平均年龄(32.96±8.20)岁;未婚、离异或丧偶占84.34%(167例);大专及以上文化程度占60.61%(120例);外地户籍占60.61%(120例);在本地居住时间≥1年占89.39%(177例)。艾滋病/性病知识知晓率79.80%(158例),最近6个月与男性发生过性行为占48.48%(96例);最近6个月与男性发生过肛交性行为占41.41%(82例);且每次使用安全套占68.29%(56例)。梅毒感染率为7.07%(14例),未发现淋病、沙眼衣原体、生殖器疱疹及尖锐湿疣等性病感染。多因素Logistic回归分析结果显示,完全知晓艾滋病/性病知识(OR=0.13,95%CI=0.04～0.49)是感染梅毒的保护因素;最近6个月发生男男性行为(OR=13.69,95%CI=1.65～113.72)和既往感染过性病(OR=4.37,95%CI=1.19～16.07)是危险因素。结论济南市HIV阳性MSM人群梅毒感染率略高。

Objective To understand the prevalence and risk factorsof sexually transmitted diseases(STDs) among the HIV-positive MSM in Jinan. Methods A convenience sampling method was used to recruit HIV-positive MSM who visitedthe AIDS clinic in Jinanduring July-September,2016.Face-to-face questionnaire interview wasconducted,and5 STDs including syphilis,gonorrhea,chlamydiatrachomatis,genital herpes and condyloma acuminatum were screenedandclinical diagnosed.Risk factors that associated with those diseases were analyzed by Chi-square test and binary logistic regression mode. Results The average age of 198 respondents was 32.96±8.20 years old;cases who wereunmarried,divorced or widowed accounted for 84.34%(167 people);the education level was junior college or above accounted for 60.61%(120 people);nonlocal census registers accounted for 60.61%(120 people);living in local area more than one year accounted for 89.39%(177 people);the AIDS/STDs awareness rate was 79.80%(158 people);in the last 6 months,48.48%(96 people)of the cases had sex behavior with their same-sex sexual partners,41.41%(82 people)had anal sex behaviorand 68.29%(56 people)of them used condoms every time.Syphilisinfected rate was 7.07%(14 people),gonorrhea,chlamydiatrachomatis,genitalherpes and condyloma acuminatum were not found.Multi-variate analysis showed one protective factor was the awareness of AIDS/STDsrelated knowledge,with odds ratio of 0.13(95%CI:0.04-0.49).The risk factors included homosexualbehavior and previouly infected with STDs, with odds ratioof 13.69(95%CI:1.65-113.72)and 4.37(95%CI:1.19-16.07)respectively. Conclusion The syphilis infected rate of HIV-positive MSM is slightly higher in Jinan.