20162021年浙江省金华市男男性行为人群人类免疫缺陷病毒感染状况及相关因素分析

Human immunodeficiency virus infection status and related factors among men who have sex with men in Jinhua City, Zhejiang Province from 2016 to 2021

  • 摘要:
    目的 分析男男性行为(MSM)人群哨点监测数据,以了解浙江省金华市MSM人群的人类免疫缺陷病毒(HIV)感染状况及其相关因素。
    方法 于2016—2021年采用滚雪球抽样法招募研究对象并开展艾滋病哨点监测。纳入最近6个月内有过插入性肛交同性性行为、年龄≥18周岁的MSM人群。采用一对一问卷调查方法收集一般人口学特征、行为学特征等。采集调查对象静脉血5 mL,检测HIV和梅毒感染情况。用线性趋势χ2检验进行时间趋势分析,用多因素logistic回归模型分析影响HIV感染的相关因素。
    结果 HIV感染率为8.0%(127/1 597),历年呈下降趋势(P=0.002),但线性相关较弱(r=0.075);梅毒感染率为5.2%(83/1 597),历年变化无统计学意义(P=0.661)。调查对象通过互联网或交友软件寻找男性性伴侣、近1周发生同性肛交行为、近6个月肛交行为每次使用安全套、近1年接受过预防艾滋病服务、艾滋病知识已知晓的构成比呈上升趋势(P<0.05)。多因素logistic回归分析显示,少数民族(OR=2.27,95%CI:1.08~4.73)、外省户籍(OR=1.68,95%CI:1.08~2.62)、近6个月肛交行为未坚持每次使用安全套(OR=3.03,95%CI:2.02~4.54)、近1年未接受过预防艾滋病服务(OR=2.17,95%CI:1.44~3.27)、艾滋病知识未知晓(OR=1.86,95%CI:1.12~3.07)、梅毒感染(OR=2.35,95%CI:1.20~4.61)是HIV感染的相关因素(均P<0.05)。
    结论 金华市MSM人群HIV感染率维持在一定水平。需要重点关注梅毒感染、外省流入等高风险人群,建议进一步加强艾滋病和梅毒知识宣传、安全套的推广、警示性教育及综合干预服务。

     

    Abstract:
    Objective To understand the human immunodeficiency virus(HIV) infection status and related factors by using the HIV/AIDS sentinel surveillance data of men who have sex with men(MSM) in Jinhua City, Zhejiang Province.
    Methods Snowball sampling method was used to recruit MSM receiving HIV sentinel surveillance from 2016 to 2021.The inclusion criteria were aged 18 years old and above, reported having anal sex with man in recent 6 months. Questionnaire-based interviews were conducted on a one-on-one basis. Data including the characteristics of demography and ethology were collected. Five milliliter of blood samples were taken after the questionnaire. HIV and syphilis was screened. The time trend was analyzed with χ2 test. Multivariate logistic regression model was used to analyze the factors associated with HIV infection status among MSM.
    Results The positive rate of HIV was 8.0% (127/1 597), with an increasing trend (P=0.002), but the linear correlation was weak(r=0.075). The positive rate of syphilis was 5.2% (83/1 597), with no significant difference (P=0.661).The constituent ratios showed an increasing trend (P<0.05) in using condoms consistently, finding male sexual partners through Internet or dating software, having anal sex in the past week, using condoms every time during anal sex in the past 6 months, accepting prevention services of AIDS in the last year, and the overall awareness of AIDS related knowledge. Multivariate logistic regression analysis showed that who was from national minority (OR=2.27, 95%CI: 1.08‒4.73) and from other provinces (OR=1.68, 95%CI: 1.08‒2.62), who failed to consistently use condoms every time during anal sex in the past six months (OR=3.03, 95%CI: 2.02‒4.54), who never accepted prevention services of AIDS in the last year (OR=2.17,95%CI:1.44‒3.27), who don’t know the knowledge of AIDS (OR=1.86, 95%CI: 1.12‒3.07), and who was infected with syphilis (OR=2.35, 95%CI: 1.20‒4.61) were at higher risk for HIV infection among MSM.
    Conclusion The positive rate of HIV remains at a certain level among MSM in Jinhua. High-risk groups such as the patients with syphilis infections and floating population from other provinces need to be paid close attention. It is suggested to further strengthen the promotion of the use of condoms, awareness of AIDS and syphilis, warning education and comprehensive intervention services.

     

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