湖北省艾滋病感染男男性行为人群婚姻及配偶检测情况
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摘要
目的了解湖北省艾滋病感染者中男男性行为者(men who have sex with men,MSM)人群的婚姻影响因素及配偶检测情况。方法收集湖北省2013—2017年艾滋病感染途径为"同性传播"的病例,比较"已婚/离异"组和"未婚"组之间的差异,纳入Logistic回归分析。分析有婚姻组配偶HIV检测情况。结果湖北省2013—2017年累计报告7 005例MSM感染者,5 996例≥22岁法定结婚年龄,其中12例(0.20%)婚姻状况不详,2 772例(46.23%)有过婚姻(已婚、离异),3 212例(53.57%)未婚。有婚姻组与未婚组在年龄、职业、文化程度、性病史和样本来源上的差异有统计学意义(Ρ均<0.05)。Logistic回归分析:MSM人群大于40岁有婚姻的可能性增大(OR=91.348,95%CI:72.653～114.854);职业中政府/企事业单位(OR=1.571,95%CI:1.192～2.071)和农民/民工(OR=1.454,95%CI:1.158～1.825)有婚姻的可能性较大;初中文化程度有婚姻的可能性最大(OR=2.971,95%CI:2.425～3.639)。有婚姻组配偶HIV检测率为28.90%(801/2 772),阳性率18.73%(150/801)。结论对于MSM人群的异性伴侣和妻子,也应纳入干预和关怀。建议加强针对MSM人群本身特点的干预内容,对医务人员和社会大众进行反歧视教育,促进MSM人群的配偶告知和检测工作。
Objective To understand the marital status, influencing factors, and spouse′s HIV detection of HIV positive men who have sex with men(MSM) in Hubei Province. Methods Collected cases of HIV/AIDS infected by "homosexual transmission" in Hubei during 2013-2017, and compared the differences between the "married/divorced" group and the "unmarried" group by Logistic Regression analysis. Analyzed HIV detection of spouses in the "married/divorced" group.Results A total of 7 005 MSM with HIV/AIDS were reported, including 5 996 persons reaching the legal marriage age of 22 years, with 12 persons(0.20%) whose marital status was unknown, 2 772(46.23%) who had been married/divorced, and 3 212(53.57%) who were unmarried. The logistic regression analysis indicated that the influencing factors of marriage(more possible of marriage) were the age above 40 years(OR=91.348, 95%CI: 72.653-114.854), those working in government/enterprises/public institutions(OR=1.571, 95%CI: 1.192-2.071), farmers/migrant workers(OR=1.454, 95%CI: 1.158-1.825), and people with junior middle school education level(OR=2.971, 95%CI: 2.425-3.639). Totally 28.90%(801/2 772) of married/divorced spouses had HIV testing, and 18.73%(150/801) of them was positive. Conclusion It is necessary to strengthen the intervention and care for MSM female spouses and promote the notification and HIV testing.
Objective To understand the marital status, influencing factors, and spouse′s HIV detection of HIV positive men who have sex with men(MSM) in Hubei Province. Methods Collected cases of HIV/AIDS infected by "homosexual transmission" in Hubei during 2013-2017, and compared the differences between the "married/divorced" group and the "unmarried" group by Logistic Regression analysis. Analyzed HIV detection of spouses in the "married/divorced" group.Results A total of 7 005 MSM with HIV/AIDS were reported, including 5 996 persons reaching the legal marriage age of 22 years, with 12 persons(0.20%) whose marital status was unknown, 2 772(46.23%) who had been married/divorced, and 3 212(53.57%) who were unmarried. The logistic regression analysis indicated that the influencing factors of marriage(more possible of marriage) were the age above 40 years(OR=91.348, 95%CI: 72.653-114.854), those working in government/enterprises/public institutions(OR=1.571, 95%CI: 1.192-2.071), farmers/migrant workers(OR=1.454, 95%CI: 1.158-1.825), and people with junior middle school education level(OR=2.971, 95%CI: 2.425-3.639). Totally 28.90%(801/2 772) of married/divorced spouses had HIV testing, and 18.73%(150/801) of them was positive. Conclusion It is necessary to strengthen the intervention and care for MSM female spouses and promote the notification and HIV testing.
引文
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[13]陆怀初,周碧波,王斌,等.宁波市鄞州区2009-2011年艾滋病自愿咨询检测情况分析[J].国际流行病学传染病学杂志,2013(1):17-19.
[14]汤后林,吕繁.桥梁人群在艾滋病病毒传播中的作用[J].中华流行病学杂志,2007,28(2):192-194.
[15]王毅,李六林,周万明,等.年轻男男性行为者艾滋病预防服务覆盖现状及信息获取渠道关联因素分析[J].华南预防医学,2018,44(6):506-512.2018-08-15
[2]吴尊友.中国防治艾滋病30年主要成就与挑战[J].中华流行病学杂志,2015,36(12):1329-1331.
[3]RUAN S M,YANG H,ZHU Y W,et al.Rising HIV prevalence among married and unmarried among men who have sex with men:Jinan,China[J].AIDS and Behavior,2009,13(4):671-676.
[4]曹臻,张洪波,佘敏,等.在婚男男性行为人群HIV感染及其双性性行为状况调查[J].中华流行病学杂志,2012,33(5):488-491.
[5]陆珍珍,蓝光华,朱秋映,等.HIV-1感染男男性行为人群婚姻的相关因素及配偶HIV-1状况[J].中国健康教育,2017,33(8):698-701.
[6]白广义,王伟,赵宏儒,等.河北省2004-2013年性传播艾滋病男性患者流行特征分析[J].中华疾病控制杂志,2014,18(12):1170-1172,1176.
[7]SETIA M S,SIVASUBRAMANIAN M,ANAND V,et al.Married men who have sex with men:the bridge to HIV prevention in Mumbai,India[J].International Journal of Public Health,2010,55(6):687-691.
[8]王毅,徐杰,李志军,等.男男性行为者女性性行为现状及影响因素分析[J].中国公共卫生,2012,28(9):1162-1165.
[9]曹越,李十月,路亮,等.已婚与未婚MSM特征及与同伴交往状况比较[J].中国公共卫生,2014,30(10):1333-1336.
[10]王毅,李六林,张光贵,等.男男性行为者婚姻状况及其艾滋病相关行为特征调查[J].实用预防医学,2012,19(12):1772-1775.
[11]CHEN G Z,LI Y,ZHANG B C,et al.Psychological characteristics in high-risk MSM in China[J].BMC Public Health,2012,12:58.
[12]TAO J,RUAN Y H,YIN L,et al.Sex with women among men who have sex with men in China:prevalence and sexual practices[J].AIDS Patient Care and STDs,2013,27(9):524-528.
[13]陆怀初,周碧波,王斌,等.宁波市鄞州区2009-2011年艾滋病自愿咨询检测情况分析[J].国际流行病学传染病学杂志,2013(1):17-19.
[14]汤后林,吕繁.桥梁人群在艾滋病病毒传播中的作用[J].中华流行病学杂志,2007,28(2):192-194.
[15]王毅,李六林,周万明,等.年轻男男性行为者艾滋病预防服务覆盖现状及信息获取渠道关联因素分析[J].华南预防医学,2018,44(6):506-512.2018-08-15