Epidemiological Profile of Men Who Have Sex with Men: First Data about Male Sex Workers in Central African Republic (CAR)

Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex workers (SW) among them, as well as the proportion of MSM who have been victims of gender-based violence (GBV). Material and Methods: A cross-sectional study coordinated by the Direction de la Médecine du Travail was carried out at the headquarters of the association ALTERNATIVES in Bangui Bangui from July 1 to October 31, 2021. Consenting MSM present during the study period were systematically included. Sociodemographic variables, those relating to the future vision of the activity and to GBV were collected and analyzed using Epi-Info version 7 software. Results: Forty MSM with an average age of 23 years and mainly secondary education (75.0%) were included. The vast majority of MSM were unemployed (85.0%). 45.0% had been victims of GBV and wanted to stop working as an MSM (47.5%), and almost 2/3 (65.0%) would accept another income-generating activity in exchange for the MSM. Violence was sexual (32.5%), economic (22.5%), physical (20.0%), verbal (12.5%) and psychological (12.5%). Conclusion: The MSM were mainly young, poorly educated, unemployed, and almost half were victims of GBV. The desire to change MSM activity to another income-generating activity alongside that of MSM shows that many of them are SW, workers in the informal sector. This must be taken into account in prevention activities, even if the data needs to be confirmed on a much larger sample.

Demographic and Sexual Behavior Characteristics of Men Who Have Sex with Men (MSM) Registered in a Targeted Intervention (TI) Program in India

Background: Men who have sex with men (MSM) contribute substantially to HIV prevalence in India. The targeted intervention (TI) program is the most important link between MSM and the public health system. Hence, we studied the demographic and sexual behavior characteristics of MSM registered in TI program in India. Methods: We used information maintained at TI sites under the program catering exclusively to MSM in India. Demographic characteristics and sexual behavior of MSM over the past two decades were also studied. Risk behaviors included type of partners, alcohol use, sexual acts per week, years of sex work and age at initiation of sex work. Bivariate analysis was carried out to understand the demographic determinants of sexual behavior. Results: In total, data of 6037 MSMs from 14 TI sites were analyzed. Of these 4655 (73.8%) were young adults (<35 years) and 2565 (40.8%) had completed their matriculation. More than half (55.4%) were married. Double-decker was identified as the most common sub-typology among MSM. Average age of initiation of sex was 23.0 years and average number of sexual acts per week was 6.8 (95% CI: 6.8 - 7.0). Irregular partners and alcohol use were observed in 30.5% and 52.8% of MSM respectively. Cohort analysis revealed a statistically significant declining trend in average age of initiation of sex over the past two decades. The sexual behavior of MSM varied significantly by employment status, education, marital status, state of residence, alcohol use and type of sex partner. Conclusion: MSMs registered with the TI program in India were mostly young, educated, and employed. Many MSM also had a history of heterosexual relationships, and thus had the potential of transmitting HIV infection to the otherwise low risk general population. This analysis supports the use of TI program data for understanding the demographic and sexual behavior characteristics of hard to reach and stigmatized population in society.

Factors influencing HIV infection in men who have sex with men in China

To identify risk factors for HIV infection among men who have sex with men （MSM） and to provide a theoretical basis for prevention interventions. Between December 2011 and August 2012, a case-control study was conducted among MSM who underwent voluntary counselling and testing for HIV. Confirmed HIV-positive MSM were included in the case group, and HIV-negative MSM were included in the control group. Information on possible risk factors was collected by a survey questionnaire and a qualitative interview. The results of a conditional logistic regression showed that the following were influencing factors for HIV infection： average monthly income between 2001 and 3000 Yuan （odds ratio （0R）=6.341, 95% Ch 1.714-12.544）, only sometimes using condoms when having anal sex with men in the last 6 months （0R=7.601, 95% Ch 1.359-23.083）, having HIV-positive sex partners （0R=5.273, 95% Ch 1.572- 17.691）, rectal trauma with bleeding in the last 6 months （0R=2.947, 95% Ch 1.308-6.638）, not using condoms at last sexual encounter （OR-- 1.278, 95% Ch 1.012-5.595）, engaging in commercial sex （0R=5.925, 95% Ch 1.923-13.890） and having more than 16 sex partners in the last 6 months （0R=1.175, 95% Ch 1.021-1.353）. These seven factors were the risk factors of HIV infection （OR〉l）. However, having anal sex less than 10 times in the previous 1 month （OR=O.O02, 95% CI： 0.000-0.287） was a protective factor against HIV infection among MSM （OR〈l）, and insertive （0R=0.116, 95% Ch 0.000-0.236） （OR〈l） anal intercourse influenced HIV infection. Interventions should be targeted at MSM whose average monthly income is between 2001 and 3000 Yuan, and who engage in commercial sex. In addition, the importance of using condoms at every sexual encounter should be emphasised in health education, as should the treatment of rectal trauma with bleeding. Finally, MSM should decrease the number of sex partners and frequency of anal sex to decrease the rate of HIV infection.

Uptake of HIV Self-testing among Men Who have Sex with Men in Beijing, China： a Cross-sectional Study

Objective To examine HIV self-testing uptake and its determinates among men who have sex with men （MSM） in Beijing, China. Methods A cross-sectional online survey was conducted in Beijing, China in 2016. Participants were users of a popular Chinese gay networking application and had an unknown or negative HIV status. Univariate and multivariate logistic regression analyses were conducted to examine factors associated with HIV self-testing based on adjusted odds ratio （AOR） and 95% confidence interval （CI）. Results Among the 5,996 MSM included in the study, 2,383 （39.7%） reported to have used HIV self-testing kits. Willingness to use an HIV self-test kit in the future was expressed by 92% of the participants. High monthly income （AOR = 1.49; CI = 1.10-2.02; P = 0.010）, large number of male sex partners （≥2： AOR = 1.24; CI = 2.09-1.43; P = 0.002）, sexual activity with commercial male sex partners （〉 2： AOR = 1.94; CI = 1.34 -2.82; P = 0.001）, long-term drug use （AOR = 1.42; CI = 1.23-1.62; P 〈 0.001）, and long-term HIV voluntary counseling and testing （VCT） attendance （AOR = 3.62; CI = 3.11-4.22; P 〈 0.001） were all associated with increased odds of HIV self-testing uptake. Conclusion The nearly 40% rate of HIV self-testing uptake among MSM in our sample was high. In addition, an over 90% willingness to use kits in the future was encouraging. HIV self-testing could be an important solution to help China achieve the global target of having 90% of all people living with HIV diagnosed by 2020.

A survey of HIV infection and related high-risk factors among men who have sex with men in Suzhou,Jiangsu,China

A cross-sectional study using the snowball sampling method was conducted in May 2008 to investigate human immunodeficiency virus （HIV） infection status and related high risk factors among men who have sex with men （MSM） in Suzhou city of Jiangsu province. The researchers carried out a face-to-face questionnaire interview among MSM, and collected their blood samples to test for HIV and other sexually transmitted diseases （STDs）. Among the 280 respondents, 91.1% had homosexual acts in the past 6 months and 87.5% had multiple homosex- ual partners; 46.4% had heterosexual sex in the past 6 months and 33.1% had multiple heterosexual partners. The rate of continued condom use was 44.3% in homosexual sex in the past 6 months, while the rate in heterosexual sex was 33.9%. Laboratory test results showed that the prevalences of HIV and syphilis were 7.1% （20/280） and 15.0% （42/280）, respectively, but no HCV-positive person was found. In the multivariate logistic regression model, subjects with a monthly income of more than RMB $ 1,000 （OR=4.83,95% CI=1.44-16.22）, subjects who often went to bars for sexual partners （OR=2.25, 95%CI=1.21-4.20）, and subjects who had more than one sexual partner in the past 6 months （OR=0.49, 95%CI=0.25-0.97） and had sex with fixed sexual partners in the past 6 months （OR=0.42, 95%CI=0.25-0.75） were significantly associated with the rate of continued condom use in homosexual sex in the past 6 months. Unprotected sex and multiple sexual partners were more common among MSM in Suzhou city; furthermore, the prevalences of HIV infection and syphilis were relatively high. HIV preventive measures should be designed to address these risk factors and control the spread of HIV among MSM.

Prevalence and risk factors of HIV and syphilis,and knowledge and risk behaviors related to HIV/AIDS among men who have sex with men in Chongqing,China

High HIV prevalence and incidence burdens have been reported in men who have sex with men（MSM）in Chongqing,China.We aimed to estimate the prevalence of HIV and other sexually transmitted infections（STIs）,to appraise the knowledge and risk behaviors related to HIV/AIDS among MSM,and to analyze the possible causes of deviation between behavior and knowledge to make better strategies.We recruited 617 MSM from February to July in 2008 by using a respondent-driven sampling（RDS） method in Chongqing,China.Through the collection of questionnaire-based data and biological testing results from all objects,we launched a crosssectional survey.STATA/SE was used for data analysis by frequency,ANOVA,rank sum test and logistic regression models.MSM with syphilis（OR=4.16,95%CI：2.35-7.33,P〈0.0001） were more likely to be HIV infected.Being a company employee（OR=3.64,95%CI：1.22-10.08,P〈0.0001） and having bought male for sex（OR=3.52,95%CI：1.10-11.32,P〈0.034） were associated with a higher probability of syphilis.MSM with younger age,higher education and greater monthly income had a higher mean knowledge score.MSM who had HIV testing had a higher mean knowledge score than those who never had.Students,venues for finding sex partners by Internet and homosexuals in MSM had a higher mean knowledge score compared to other occupations,venues for finding sex partners and sexual orientation.There is an urgent need for delivery of barrier and biomedical interventions with coordinated behavioral and structural strategies to improve the effect of HIV interventions among MSM.

Perceptions of Reducing HIV-Preventive Behaviors among Men Who Have Sex with Men Living with HIV in Japan

Sexual health and behavior among HIV-positive men who have sex with men (MSM) have attracted attention in Japan and elsewhere. It has been reported that perceptions about sex are one factor leading to a reduction in HIV-preventive behaviors. This study investigated types of perceptions, termed self-talk, which allow HIV-positive Japanese MSM to permit themselves to participate in unprotected anal intercourse (UAI). A package of internet surveys for MSM including 20 items assessing self-talk on UAI and condom usage in anal intercourse was administered in 2014. Data from 479 HIV-positive Japanese MSM were analyzed. Exploratory factor analysis was conducted to reveal the factor structure of the self-talk. In addition, using the Kruskal-Wallis test, we examined the relationship between the types of self-talk and the tendency to have UAI. Factor analysis of 20 items assessing self-talk on UAI produced four dimensions: “Diversion/Desire for Stimulation,” “Optimism/Defiant Attitude,” “Denial of Concern of Transmitting,” and “Concern about Relationships.” The score of the subscale “Diversion/Desire for Stimulation” was significantly higher than the other three subscales. It was shown that there was a tendency for the self-talk assessed to be associated with the UAI frequency. The types of perceptions permitting UAI and the psychological stress of being an HIV-positive MSM in Japan were discussed. This study was the first to reveal the factorial structure of perceptions in reducing HIV-preventive behaviors among HIV-positive MSM in Japan. We found positive associations between certain types of self-talk and risky sexual behaviors. We provided recommendations for psychosocial support and HIV risk-reduction intervention for HIV-positive MSM.

Acceptance to Use Daily Oral Pre-Exposure Prophylaxis (PrEP) as an HIV Prevention Method and Ability to Pay for PrEP among Men Who Have Sex with Men in Ho Chi Minh City, Vietnam

Background: Men who have sex with men (MSM) are disproportionately affected by HIV in Vietnam. Regardless of international and national agencies’ efforts, the HIV epidemic in MSM has been increasing in recent years. Novel and evidence-based HIV antiretroviral pre-exposure prophylaxis (PrEP) maybe needed to combat the HIV epidemic among this population in Vietnam. This study aims to identify how MSM accept the use of PrEP as an HIV prevention method and their ability to pay for it. Method: This is a cross-sectional study of 373 MSM seeking HIV testing in a community-based HIV clinic in Ho Chi Minh City, Vietnam from January to April 2016. Potential participants were briefly informed about ethical considerations, screened for eligibility, and signed an informed consent form when selected. Face-to-face interviews were conducted by the clinic’s staff. Descriptive and analytical analysis was performed by STATA 13.0. Results: Of 373 participants, only 92 men (24.7%) reported having known about PrEP. Out of 360 men who were questioned about their acceptance of PrEP as an HIV prevention method, 274 (76.1%) embraced the use of PrEP. The median maximum affordable monthly PrEP cost was one million Vietnam Dong (VND) (equivalent to US$43) and the median average affordable monthly PrEP cost was 0.5 million VND (approximately $21.7). The majority of men (68.8%) could afford an average of less than $43 a month for PrEP. Conclusion: There is a relatively high level of PrEP acceptance among MSM in Ho Chi Minh City, Vietnam. To increase PrEP acceptance, raising awareness and understanding of PrEP is recommended. To expand PrEP interventions in Vietnam, the target population’s ability to pay should be a key focus.

Casual Sex, Sex Work and Unprotected Sex among Men Who Have Sex with Men in the Human Papilloma Virus (HPV) Clinical Trial —North-West Region of Tshwane, South Africa

Background: The gap in the understanding of the context of the sexually transmitted infections (STIs) and risky behaviours among men who have sex with men (MSM) could lead to the development and implementation of inappropriate interventions, which could exacerbate the rapid spread of STIs, especially HIV, among MSM. The aim of the study was to qualitatively assess the understanding of the STIs and the risky sexual behaviours of men who have sex with men in the North-West region of Tshwane. Methods: An exploratory qualitative design was employed to assess the STIs and the risky sexual behaviour of the MSM population. The study participants were enrolled in an HPV clinical trial at MECRU, which is a clinical research unit at the Sefako Makgatho Health Sciences University. Data collection occurred from September 2016 to May 2017. A convenience sampling method was used and n = 30 participants were selected. Face-to-face in-depth interviews were conducted on MSM 18 years and older, using a semi-structured interview guide. Thematic content analysis was used for data analysis, using NVivo version 10 software. Results: The mean age of the sample was 26 years, and the age range was 18 to 44 years. All were unmarried, and all of them came from townships, rural villages and informal settlements in the vicinity of the clinical research unit. The high-risk behaviours noted among the majority of the MSM in this study were having multiple sexual partners and exchanging partners, alcohol abuse, inconsistent condom-use, having unprotected anal sex, and having transactional sex. There was a high level of knowledge of STIs in the heterosexual population with poor understanding of STIs affecting MSM through anal sex. Most of the MSM played a female or bottom role, which made them vulnerable because they could not successfully negotiate condom use, and they reported that they sometimes accepted gifts or money in exchange for anal sex. Conclusion: The study concludes that the MSM in this study had casual sex, and are involved in sex work without practising safe sex. There is a need for health promotion on STIs and risky behaviours among MSM in communities as well as in health facilities for MSM in the North-West region of Tshwane.

Effectiveness of a Training Program for Improving Public Health Nurses’ Attitudes and Confidence in Dealing with Men Who Have Sex with Men

Objective: This study examined the effect of an educational intervention on public health nurses’ attitudes and confidence in dealing with men who have sex with men (MSM). In Japan, HIV is primarily transmitted through sexual contact between men, and free HIV testing and counseling are provided by public health nurses. However, because of a lack of education, public health nurses do not often recognize the existence of MSM in daily life. Thus, improving public health nurses’ understanding of MSM is crucial. Methods: This study used a quasi-experimental design to examine public health nurses’ homophobia, confidence in dealing with MSM, and low awareness of MSM in daily life at pre-test, post-test, and 1 and 3 months follow-ups. The intervention comprised a 3-hour training session conducted between November 2012 and September 2013 in the Kinki region. Results: A total of 124 public health nurses participated in the training, 117 of which were allocated to the intervention group;182 public health nurses who did not participate in the training session were allocated to a control group. Homophobia scores had significantly decreased at post-test, and remained at that low level by the follow-up at 3 months (pre-test to post-test;p = 0.00, post-test to 1 month;p = 0.83, 1 month to 3 months;p = 0.64, pre-test to 3 months;p = 0.00). Confidence in dealing with MSM and recognition of MSM had significantly increased by post-test;these were also maintained by the follow-up at 3 months (pre-test to post-test;p = 0.0, post-test to 1month;p = 0.18, 1 to 3 months;p = 0.44, pre-test to 3 months;p = 0.0). Discussion: While the three-hour training session was short, it was effective for improving attitudes toward MSM and building confidence in dealing with them.

Spread of human immunodeficiency virus 1 among men who have sex with men is emerging as a genuine social concern and affecting the general populace- case reports from Eastern India

Human immunodeficiency virus(HIV) infection among men who have sex with men(MSM) has increased to a drastic proportion throughout India in the last couple of years due to a lack of productive identification and management framework. In apprehension of social disgrace these men attempt to live a normal hetero conjugal life and, in the process, act as a bridge in spreading the virus to their women partners. In this case report we have highlighted two cases which clearly distinguished the adequacy of HIV treatment among MSM when they are diagnosed during early or late phases of infection. An intensive and ample counseling to comprehend the psychology and sexual behavior of these men was found to be critically important in both the cases. Our study, which is actually the first of its kind, recorded and documented evidence of HIV infected MSM from Eastern India and renders a ray of hope among this marginally isolated group to comprehend the challenges and health risks faced by the MSM population. It also provides a format for the medical practitioners here in managing and treating related cases.

HIV阳性MSM的社会行为及首次同性性行为到阳性时间的影响因素分析

目的了解艾滋病病毒(HIV)阳性男男性行为者(MSM)的社会行为特征,分析首次同性性行为到阳性时间的影响因素。方法收集2007—2022年绵阳市疾病预防控制中心新确证并实施首次流行病学调查的阳性MSM资料,阳性时间的影响因素分析采用χ^(2)检验和Logistics回归模型。结果共收集有效资料457份,自认性取向成因属先天因素63.95%、后天因素36.05%,首次同性性行为性伴来源互联网60.54%、朋友等39.46%。首次同性性行为年龄平均23.95岁,发生阶段为在校学生44.64%、工作后55.36%。53.75%使用过rush poppers。阳性时间平均5.25年。多因素分析结果,职业学生/商业服务/无业(OR=1.868)、首次同性性行为发生在在校学生阶段(OR=1.555)者阳性时间短的可能更大,婚姻状况在婚及其他(OR=0.566)、固定性伴数≥3人(OR=0.553)、偶遇性伴数≥5人(OR=0.457)者阳性时间短的可能更小。结论阳性MSM多自认其性取向属先天因素,首次同性性行为的性伴来源互联网、发生在工作后和使用新型毒品较为普遍。阳性时间与婚姻状况、首次同性性行为发生阶段及性伴数量相关联。要针对性强化健康教育和行为干预。

Exploring the Perspectives of Healthcare Providers on Providing HIV Prevention and Treatment Services for Key Populations in Rwanda: A Qualitative Study

Background: The overall HIV prevalence and incidence in Rwanda have decreased significantly in the past decade. However, opposite trends are seen among key populations (KP). The HIV prevalence among sex workers is as high as 51% and continues to rise. While the HIV prevalence among KP remains high, their adherence to treatment is low. Healthcare providers play a vital role in KP’s access and adherence to HIV treatment. This study aimed to explore the perspectives of healthcare providers on providing HIV services to key populations in Rwanda. Methods: An exploratory qualitative study was conducted with nurses, doctors, social workers, and psychologists who provide HIV services to KP in public health facilities in Rwanda. In-depth interviews were conducted using a semi-structured interview guide. All data were analyzed thematically using Dedoose. Results: Interviews were conducted with 18 healthcare providers. Three overarching themes emerged from the interviews: healthcare providers’ intrinsic feelings affect the ways they provide HIV services to key populations, key populations face a multitude of challenges related to accessing treatment and preventing the spread of HIV, and a more comprehensive and sensitive approach should be used to improve HIV services for key populations. Conclusion: Healthcare providers expressed difficulties in providing services to key populations and identified a lack of adherence to treatment and prevention guidelines, structural barriers, KP’s lack of trust in the healthcare system, and the discrimination and abuse KP face as challenges to effective HIV prevention and treatment. More comprehensive services including clinical, financial, and psychosocial support from trusted sources are needed. Some important policy changes are essential to facilitate access to HIV services for KP.

苏州市MSM人群艾滋病高危行为特征、感染状况及影响因素分析

目的了解苏州市男男性行为者(MSM)艾滋病高危行为特征、感染情况及其影响因素。方法采用横断面调查,采取分类滚雪球抽样的方法于2008年5月起,对苏州市范围内的MSM人群就艾滋病(AIDS)知识态度、高危行为特征的面对面问卷调查结果 ,以及血样的艾滋病病毒(HIV)及其他性传播疾病(STD)感染的实验室检测数据进行统计分析。结果所调查280名MSM中,82.7%最近六个月发生过同性性行为,其中79.4%有多个同性性伴;48.7%曾与异性发生过性行为,其中21.2%有多个异性性伴;最近六个月与同性发生肛交性行为时坚持使用安全套的比例为52.0%,与异性发生性行为时该比例为21.2%。300名被调查者均采集血样进行了血清学检测,确证HIV阳性人数22人,阳性率为7.3%;确证梅毒抗体阳性人数为66人,阳性率为22.0%。在多因素logistic回归模型中,常通过互联网寻找性伴(OR=1.93,95%CI=1.01～3.67)、最近六个月曾与固定性伴发生性行为(OR=0.45,95%CI=0.25～0.79)与最近六个月同性性行为时安全套坚持使用率的关系有统计学意义;梅毒感染(OR=3.17,95%CI=1.25～7.99)与HIV感染的关系具有统计学意义。结论苏州市MSM人群无保护性性行为及多性伴现象较为普遍,HIV和梅毒感染率较高,需要进一步加强对该人群的行为干预以防止艾滋病在该人群中的蔓延以及传播至一般人群。

在MSM人群中开展性病知识的同伴教育效果研究

目的探讨同伴教育在男男性行为者(MSM)人群中的知识认知和行为转变的效果.方法2004年3～11月,在昆明、成都两市的MSM人群中开展有组织的同伴教育活动;在4月和11月,分别进行性病、艾滋病知识和个人性行为情况的人群抽样调查,对调查结果进行比较分析.结果基线调查184人,终期调查175人.两次调查发生首次性行为的年龄中值均为18岁,发生首次同性性行为年龄的中值均为19岁.基线和终期调查发现,调查对象对性病、艾滋病知识的认知发生了有意义的全面提高,但在近3个月内异性性行为和同性性行为的发生率和性伴数没有改变,并且平均性伴数都超过1人.各种方式性行为的发生率没有改变,安全套的使用率也没有发生有意义的提高,只是对性对象的健康状况关注增加了.结论同伴教育能够很快提高MSM群体的性病、艾滋病知识认知,但是存在'认知与行为分离'的现象,加速安全性行为的促进是面临的重要问题,同时安全套促进也需要人性化措施.

快速检测、抗原-抗体联合酶联检测和集合核酸检测在MSM人群HIV-1检测中的应用研究

目的比较快速检测(胶体硒)和抗原-抗体联合酶联检测(4代酶联检测)以及集合核酸检测对男男同性恋人群(MSM)HIV急性感染的检验效能。方法结合该市2008年男男同性恋人群HIV感染专项调查工作,应用快速检测、4代酶联检测对接受调查的2 165例MSM进行HIV抗体初筛,对结果阴性者进行集合核酸检测,直至找到急性期感染者;对不同方法的检测成本进行估算,比较发现1例感染者的性价比。结果快速检测和4代酶联检测应用于MSM人群HIV筛查时,分别存在7.6%和2.9%的漏检率。本次调查使用集合核酸检测共发现10例急性期感染者。使用快速检测、4代酶联检测发现1例感染者的成本分别为48.8、50.5元,使用集合核酸检测发现1例急性期感染者的成本为7 380.2元。结论 4代酶联检测与快速检测成本接近,但前者功效更高,应该成为目前针对MSM人群HIV检测策略的组成部分,集合核酸检测应成为必要的补充,在该市MSM人群中使用上述方法的成本低于国外同类报道。

贵阳市2010～2014年MSM人群HIV感染者性行为情况

目的：了解2010-2014年贵阳市MSM人群（men who have sex with men,MSM）HIV感染者性行为特征,为预防控制MSM人群HIV感染者二代传播提供依据。方法：本研究以2010-2014年的4-7月份在贵阳市MSM人群监测哨点检测出的HIV感染者为研究对象,以一对一的方式进行问卷调查,并采集静脉血进行HIV和梅毒检测。结果：2010-2014年贵阳市MSM人群监测哨点共检测出的333名HIV感染者,年龄在18-24岁,所占的比例由2010年的55.4%下降到2014年的26.7%,在婚或同居所占的比例在5.0%-15.8%之间;文化程度大专及以上者由2010年的45.7%上升到2014年的70.0%。2010-2014年MSM人群感染者的梅毒感染检出率在6.7%-23.9%之间;最近6个月与同性发生肛交性行为所占的比例分别为79.7%-98.9%,与异性发生性行为所占的比例在7.8%-11.7%之间。73.6%-91.4%的MSM最近6个月同性肛交未坚持使用安全套;异性行为坚持使用安全套所占的比例仅为33.3%。结论：MSM人群HIV感染者年龄较小,主要处于性活跃阶段,梅毒的感染检出率较高,同性性行为及异性性行为时坚持使用安全套的比例均较低,将加速HIV和梅毒在MSM人群间及向异性人群传播。

江苏两市MSM抗病毒治疗效果及其影响因素的研究

目的:分析江苏男男性行为(men who have sex with men,MSM)人群的艾滋病抗病毒治疗效果及其影响因素,首次建立江苏省MSM抗病毒治疗评价方法。方法:通过整群抽样的方式选取江苏两市接受免费高效抗逆转病毒治疗(highly active antiretroviral therapy,HAART)的MSM作为研究对象,进行生活史和用药情况的问卷调查;从江苏省艾滋病治疗信息库中获知其CD4值,采用Epidata 3.0和SAS 9.0分别进行资料录入与统计分析。结果:157例MSM总体CD4值提高,服药依从性低。经单因素及多因素分析,确诊后安全套使用水平低、吸烟量大、确诊至治疗时间间隔长是影响治疗效果的危险因素;首次CD4值较高及服药天数较长是保护因素。结论:江苏目前男男性行为人群抗病毒治疗效果显著,建议对符合治疗条件的MSM进行早期治疗,并提高患者服药依从性。

300例中老年MSM人群艾滋病抗体检测及影响因素调查

目的了解重庆市中老年男男性接触者(MSM)艾滋病、梅毒流行情况及其影响因素。方法采用滚雪球与场所调查两种方式,现场问卷调查与指血快速检测人类免疫缺陷病毒(HIV)与梅毒。结果 300名中老年MSM人群艾滋病知识知晓率仅为67.7%,HIV指血快速检测结果阳性65人(21.67%),梅毒指血快速检测阳性27人(9.00%),最近一次发生肛交性行为时安全套使用率为74.3%,最近6个月内发生肛交性行为时每次坚持使用安全套的为29.2%。结论中老年MSM艾滋病知识知晓情况较差,安全套使用率也比较低,其HIV感染形势较为严峻,应及时采取有针对性的干预措施。

扬州市MSM人群艾滋病高危行为特征、感染状况及影响因素分析

目的:了解江苏省扬州市男男性行为者(men who have sex with men,MSM)艾滋病高危行为特征、感染情况及其影响因素。方法:采用横断面调查设计,采取分类滚雪球抽样的方法于2008年5月起,对扬州市范围内的MSM人群就艾滋病知识态度、高危行为特征的面对面问卷调查结果,以及血样的人类免疫缺陷病毒(human immunodeficiency virus,HIV)及其他性传播疾病(sexually transmitted disease,STD)感染的实验室检测数据进行统计分析。结果:所调查300例MSM中,82.7%最近6个月发生过同性性行为,其中79.4%有多个同性性伴;48.7%曾与异性发生过性行为,其中21.2%有多个异性性伴;最近6个月与同性发生肛交性行为时坚持使用安全套的比例为52.0%,与异性发生性行为时该比例为21.2%。均采集血样进行了血清学检测,确证HIV阳性22例,阳性率为7.3%;确证梅毒抗体阳性66例,阳性率为22.0%;未发现丙型肝炎病毒抗体阳性。在多因素Logistic回归模型中,常通过互联网寻找性伴(OR=1.93,95%CI:1.01～3.67)和最近6个月曾与固定性伴发生性行为(OR=0.45,95%CI:0.25～0.79)与最近6个月同性性行为时安全套坚持使用率的关系有统计学意义;梅毒感染(OR=3.17,95%CI:1.25～7.99)与HIV感染的关系具有统计学意义。结论:扬州市MSM人群无保护性性行为及多性伴现象较为普遍,HIV和梅毒感染率较高,需要进一步加强对该人群的行为干预以防止艾滋病在该人群中的蔓延以及传播至一般人群。