HIV阳性男男性行为人群特征及其死亡相关影响因素分析
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摘要
目的了解广西壮族自治区艾滋病病毒(HIV)抗体阳性男男性行为人群(MSM)人群的基本特征,并分析影响其死亡的因素,为制定相关艾滋病防治政策提供科学依据。方法收集2005—2017年12月31日广西壮族自治区累计报告感染HIV途径为同性传播的3058例确诊病例,对其行为特征及影响其死亡的因素进行描述性和logistic回归分析。结果共有3058例病例符合纳入标准,年龄<40岁为主,占76.3%,文化程度以高中或中专及以上为主,占67.1%;同性性伴数≥3个占52.7%,非婚性行为性伴数≥3个占42.0%;多因素分析表明,患者的文化程度、同性性伴个数、接受抗病毒治疗和既往接受HIV检测是HIV阳性MSM死亡的影响因素。结论广西壮族自治区感染HIV的MSM者普遍存在高危行为接触史,应加强对该人群开展宣传教育活动,有效开展HIV检测,早发现早治疗,以阻断艾滋病的传播,减少病死率。
Objective To examine general characteristics of human immunodeficiency virus(HIV)-positive men who have sex with men(MSM) in Guangxi Zhuang Autonomous Region(Guangxi) and influencing factors of mortality among the MSM for providing evidences to develop AIDS prevention and control strategies. Methods We collected information on all male HIV/AIDS cases infected via homosexual pathway and reported in Guangxi from 2005 till 31 December 2017 from National Information Management System for Comprehensive AIDS Prevention and Control in China. Descriptive epidemiology and logistic regression analysis were adopted to analyze general characteristics and mortality-related factors of the HIV-positive MSM. Results Of the 3 058 MSM included in the study, 76.3% were less than 40 years old; 67.1% were with the education of senior high school or technical secondary school and above; 52.7% reported having three or more homosexual sex partners; and 42% reported having three or more unmarried sex partners. Multivariate logistic regression analysis revealed that education level, the number of homosexual sex partners, receiving antiretroviral therapy(ART) and undergoing HIV testing previously were independent factors of mortality among the HIV-positive MSM. Conclusion Highrisk behaviors are prevalent among the HIV-positive MSM in Guangxi, suggesting that health education on AIDS/HIV prevention and HIV testing should be promote among the population to control HIV infection and to reduce the fatality of AIDS.
Objective To examine general characteristics of human immunodeficiency virus(HIV)-positive men who have sex with men(MSM) in Guangxi Zhuang Autonomous Region(Guangxi) and influencing factors of mortality among the MSM for providing evidences to develop AIDS prevention and control strategies. Methods We collected information on all male HIV/AIDS cases infected via homosexual pathway and reported in Guangxi from 2005 till 31 December 2017 from National Information Management System for Comprehensive AIDS Prevention and Control in China. Descriptive epidemiology and logistic regression analysis were adopted to analyze general characteristics and mortality-related factors of the HIV-positive MSM. Results Of the 3 058 MSM included in the study, 76.3% were less than 40 years old; 67.1% were with the education of senior high school or technical secondary school and above; 52.7% reported having three or more homosexual sex partners; and 42% reported having three or more unmarried sex partners. Multivariate logistic regression analysis revealed that education level, the number of homosexual sex partners, receiving antiretroviral therapy(ART) and undergoing HIV testing previously were independent factors of mortality among the HIV-positive MSM. Conclusion Highrisk behaviors are prevalent among the HIV-positive MSM in Guangxi, suggesting that health education on AIDS/HIV prevention and HIV testing should be promote among the population to control HIV infection and to reduce the fatality of AIDS.
引文
[1]The Joint United Nations Programme on HIV/AIDS.The UNAIDSreport on the global AIDS epidemic.2011 edition[EB/OL].http://www.unaids.org/global_report.htm.
[2]齐啸,徐杰,张政,等.北京市男男性行为人群HIV和梅毒本底感染及新发感染调查研究[J].中国预防医学杂志,2013,6(14):407-412.
[3]闫红梅,王开利,高聪,等.探索应用常规数据估计MSM人群HIV新发感染率[J].中国艾滋病性病,2013,19(9):640-643.
[4]许娟,徐杰,米国栋,等.男男性行为者婚姻状况及其艾滋病高危行为比较[J].中华疾病控制杂志,2010,14(5):404-407.
[5]中国疾病预防控制中心性病艾滋病预防控制中心.2017年第四季度全国艾滋病/性病/丙肝综合防治数据信息季报[R].北京:中国疾病预防控制中心性病艾滋病预防控制中心,2017.
[6]古贤德,张宏伟,吴昊.506例艾滋病病人抗病毒治疗的临床分析[J].中国艾滋病性病,2013,19(6):390-392.
[7]李斯斯,农全兴,徐永芳,等.广西南宁1999-2014年艾滋病感染者/患者生存状况分析[J].中国公共卫生,2015,31(12):1569-1573.
[8]Hogan CM,Degruttola V,Sun X,et al.The set point study(ACTGA5217):effect of immediate versus deferred antiretroviral therapy on virologic set point in recently HIV-1-infected individuals[J].Journal of Infectious Diseases,2012,205(1):87-96.
[9]Pandori MW,Johe Hackett J,Louie B,et al.Assessment of the ability of a fourth-generation immunoassay for human immunodeficiency virus(HIV)antibody and p24 antigen to detect both acute and recent HIV infections in a high-risk setting[J].Journal of Clinical Microbiology,2009,47(8):2639-2642.
[10]周建波,郝超,还锡萍,等.男男性行为者艾滋病病毒及梅毒感染状况调查[J].中国公共卫生,2012,28(8):1031-1035.
[11]冯一冰,步凯,李萌,等.中国男男性行为人群HIV新发感染率和相关危险因素的Meta分析[J].中华流行病学志,2015,36(7):752-758.
[2]齐啸,徐杰,张政,等.北京市男男性行为人群HIV和梅毒本底感染及新发感染调查研究[J].中国预防医学杂志,2013,6(14):407-412.
[3]闫红梅,王开利,高聪,等.探索应用常规数据估计MSM人群HIV新发感染率[J].中国艾滋病性病,2013,19(9):640-643.
[4]许娟,徐杰,米国栋,等.男男性行为者婚姻状况及其艾滋病高危行为比较[J].中华疾病控制杂志,2010,14(5):404-407.
[5]中国疾病预防控制中心性病艾滋病预防控制中心.2017年第四季度全国艾滋病/性病/丙肝综合防治数据信息季报[R].北京:中国疾病预防控制中心性病艾滋病预防控制中心,2017.
[6]古贤德,张宏伟,吴昊.506例艾滋病病人抗病毒治疗的临床分析[J].中国艾滋病性病,2013,19(6):390-392.
[7]李斯斯,农全兴,徐永芳,等.广西南宁1999-2014年艾滋病感染者/患者生存状况分析[J].中国公共卫生,2015,31(12):1569-1573.
[8]Hogan CM,Degruttola V,Sun X,et al.The set point study(ACTGA5217):effect of immediate versus deferred antiretroviral therapy on virologic set point in recently HIV-1-infected individuals[J].Journal of Infectious Diseases,2012,205(1):87-96.
[9]Pandori MW,Johe Hackett J,Louie B,et al.Assessment of the ability of a fourth-generation immunoassay for human immunodeficiency virus(HIV)antibody and p24 antigen to detect both acute and recent HIV infections in a high-risk setting[J].Journal of Clinical Microbiology,2009,47(8):2639-2642.
[10]周建波,郝超,还锡萍,等.男男性行为者艾滋病病毒及梅毒感染状况调查[J].中国公共卫生,2012,28(8):1031-1035.
[11]冯一冰,步凯,李萌,等.中国男男性行为人群HIV新发感染率和相关危险因素的Meta分析[J].中华流行病学志,2015,36(7):752-758.