四川和重庆地区大中学生男男性接触者HIV感染状况及其相关危险性行为调查
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摘要
目的:了解我国四川和重庆地区在校大中学生男男性接触者(men who have sex with men,MSM)的艾滋病病毒(human immunodeficiency virus,HIV)感染状态、艾滋病相关危险性行为、最近6个月多性伴(性伴数≥2个)行为的影响因素。方法:在重庆和四川采用非概率抽样,共招募200名在校大中学生参与问卷调查和现场HIV检测。采用频率描述HIV感染率,采用Logistic回归模型分析最近6个月多性伴行为(性伴数≥2个)的影响因素。结果:本研究共回收调查问卷200份,有效问卷193份(96.50%)。HIV抗体阳性检出率为8.29%,在读学校是中学(高中/中专/职高)、大专、大学本科及以上的HIV阳性检出率分别为17.95%、8.33%、5.08%;户口是农村的和在此之前未做过HIV检测阳性检出率分别为12.70%、11.11%。最近1个月内82.47%(127人)发生插入性行为时未每次使用安全套;最近6个月内51.81%(100人)有多性伴行为(性伴数≥2个)。多因素logistic回归显示最近6个月内多性伴行为(性伴数≥2个)的独立因素有:在读学校是大专(OR=4.270,P=0.0083)、在读学校是大学及以上(OR=3.523,P=0.0043)、最近6个月通过互联网寻找男性性伴(OR=5.622,P<0.0001)、最近1个月内无保护插入式性行为(OR=2.255,P=0.0201)。结论:我国四川和重庆地区大中学生MSM的HIV感染率高,尤其是中学生MSM和农村户口的学生MSM的HIV感染率高,同时四川和重庆地区大中学生MSM危险性行为发生率高,多性伴行为普遍,应及时开展科学适用的干预方式,遏制艾滋病毒在学生MSM中的流行。
Objective:To assess the prevalence of human immunodeficiency virus(HIV),risky sexual behaviors and the influencing factors of multiple sex partners(≥2 partners)in last 6 months among male students who have sex with men(MSM)in Chongqing and Sichuan. Methods:We adopted non-probability sampling method to recruited students MSM,and 200 students MSM were recruited to finish the survey and field HIV testing. Frequency was used to analyze the prevalence of HIV and logistic regression was used to analyze the influencing factors of multiple sex partners(≥2 partners)in last 6 months among student MSM. Results:There were 200 questionnaires and 193(96.50%)valid questionnaires.HIV antibody positive rate was 8.29%,the HIV antibody positive detection rate of student who studied at secondary school(including high school,technical secondary school and professional high school),junior college and university and above were17.95%,8.33% and 5.08%,respectively. The HIV antibody positive detection rate whose registered permanent residence was rural and not-receiving HIV testing were 12.70% and 11.11%,respectively. In the last month,82.47%(127 persons)did not use condom every time when they had sexual intercourse. In the last 6 months,51.81%(100 persons)had multiple sexual partners(≥2 partners).Logistic regression showed that contributing factors of multiple sex partners(≥2 partners)in last 6 months were student who studied at junior college(OR=4.270,P=0.0083),student who studied at University and above(OR=3.523,P=0.0043),having male sex partner via internet in last 6 months(OR=5.622,P<0.0001),and having unprotected sex intercourse in last 1 month(OR=2.255,P=0.0201).Conclusion:In Chongqing and Sichuan,the prevalence of HIV infection among secondary school and college students MSM is high,especially among secondary school students MSM and students whose registered permanent residence is rural. And also in Chongqing and Sichuan,high-risk sexual behavior and having had multiple sex partners are still commonly seen among students MSM students.Interventions are needed to prevent HIV transmission in this population.
Objective:To assess the prevalence of human immunodeficiency virus(HIV),risky sexual behaviors and the influencing factors of multiple sex partners(≥2 partners)in last 6 months among male students who have sex with men(MSM)in Chongqing and Sichuan. Methods:We adopted non-probability sampling method to recruited students MSM,and 200 students MSM were recruited to finish the survey and field HIV testing. Frequency was used to analyze the prevalence of HIV and logistic regression was used to analyze the influencing factors of multiple sex partners(≥2 partners)in last 6 months among student MSM. Results:There were 200 questionnaires and 193(96.50%)valid questionnaires.HIV antibody positive rate was 8.29%,the HIV antibody positive detection rate of student who studied at secondary school(including high school,technical secondary school and professional high school),junior college and university and above were17.95%,8.33% and 5.08%,respectively. The HIV antibody positive detection rate whose registered permanent residence was rural and not-receiving HIV testing were 12.70% and 11.11%,respectively. In the last month,82.47%(127 persons)did not use condom every time when they had sexual intercourse. In the last 6 months,51.81%(100 persons)had multiple sexual partners(≥2 partners).Logistic regression showed that contributing factors of multiple sex partners(≥2 partners)in last 6 months were student who studied at junior college(OR=4.270,P=0.0083),student who studied at University and above(OR=3.523,P=0.0043),having male sex partner via internet in last 6 months(OR=5.622,P<0.0001),and having unprotected sex intercourse in last 1 month(OR=2.255,P=0.0201).Conclusion:In Chongqing and Sichuan,the prevalence of HIV infection among secondary school and college students MSM is high,especially among secondary school students MSM and students whose registered permanent residence is rural. And also in Chongqing and Sichuan,high-risk sexual behavior and having had multiple sex partners are still commonly seen among students MSM students.Interventions are needed to prevent HIV transmission in this population.
引文
[1]杨中荣,金玫华,董正全,等.中国内地大、中学生中男男性行为者HIV感染率的Meta分析[J].卫生研究,2013,42(4):689-692.
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[5]广州日报.调查称7%男性大学生有过男男性行为经历[EB/OL].(2013-11-29)[2016-12-12].http://news.xinhuanet.com/politics/2013-11/29/c_125781825.htm.
[6]王丽欣,陈官芝,张北川,等.男男性行为者中大学生与同龄非大学生艾滋病高危行为对比研究[J].中华流行病学杂志,2010,31(1):113-114.
[7]Li X,Wu G,Lu R,et al.HIV-testing behavior and associated factors among MSM in Chongqing,China:results of 2 consecutive crosssectional surveys from 2009 to 2010[J].Medicine(Baltimore),2014,93(27):e124.
[8]Zeng G,Feng L,Ouyang L,et al.The dynamic trends of HIV prevalence,risks,and prevention among men who have sex with men in Chongqing,China[J].Biomed Res Int,2014,2014:602719.
[9]Zeng Y,Zhang L,Li T,et al.Risk factors for HIV/syphilis infection and male circumcision practices and preferences among men who have sex with men in China[J].Biomed Res Int,2014,2014:498987.
[10]宋逸,季成叶,星一,等.中国大学生性行为现况分析[J].中国学校卫生,2009,30(2):116-117.
[11]Zheng J,Wu Z,Poundstone KE,et al.HIV,syphilis infection,and risky sexual behaviors among male university students who have sex with men in Beijing,China:a cross-sectional study[J].AIDS Educ Prev,2012,24(1):78-88.
[12]柏建芸,于茂河,柳忠泉,等.天津市730名青年学生MSM的HIV感染状况及影响因素[J].中国艾滋病性病,2015,21(12):1048-1051.
[13]朱军礼,张洪波,吴红花.学生中122名男男性行为者HIV/STD高危行为及其感染状况分析[J].中国艾滋病性病,2007,13(4):350-352.
[14]冯连贵,丁贤彬,卢戎戎,等.青年学生中男男性行为人群HIV、梅毒感染率及估计HIV发病率的趋势分析[J].第三军医大学学报,2010,32(24):2644-2646.
[15]陈梦清,程伟彬,徐慧芳,等.广东省825名学生男男性行为人群rush poppers使用情况及其影响因素[J].中华预防医学杂志,2016,64(11):949-953.
[16]Carey JW,Mejia R,Bingham T,et al.Drug use,high-risk sex behaviors,and increased risk for recent HIV infection among men who have sex with men in Chicago and Los Angeles[J].AIDS Behav,2009,13(6):1084-1096.
[17]Ostrow DG,Plankey MW,Cox C,et al.Specific sex drug combinations contribute to the majority of recent HIV seroconversions among MSM in the MACS[J].J Acquir Immune Defic Syndr,2009,51(3):349-355.
[18]UNAIDS.How AIDS changed everything[R/OL].(2015-07-14)[2016-07-10].http://www.unaids.org/sites/default/files/media_asset/MDG6Report_en.pdf.
[19]Qin Y,Liu FY,Tang WM,et al.HIV self-testing among high-risk men who have sex with men in China:a cross-sectional study[J].Lancet,2016,388:S76.
[20]何益新,郑迎军,汪道发,等.1例男男性行为者因口交而感染HIV的调查报告[J].中国艾滋病性病,2008,14(5):521.
[21]邹华春,庞琳,吴尊友.使用互联网的男男性行为人群艾滋病/性传播疾病高危行为特征研究现状[J].中华流行病学杂志,2008,29(6):622-624.
[22]Crosby RA,Mena L,Ricks JM.Correlates of sexual-risk behaviors among young black MSM:implications for clinic-based counseling programs[J].AIDS Care,2017,29(6):718-723.
[2]UNAIDS.2015 China AIDS response progress report[R/OL].(2015-03)[2016-07-10].http://www.unaids.org/sites/default/files/country/documents/CHN_narrative_report_2015.pdf.
[3]中国疾病预防控制中心性病艾滋病预防控制中心.我国染艾学生年均净增35%[EB/OL].(2016-12-16)[2016-12-20].http://ncaids.chinacdc.cn/fzdt/mtbd/201612/t20161216_136642.htm.
[4]中华人民共和国中央人民政府.2015年全国教育事业发展统计公报[EB/OL].(2016-07-06)[2016-12-12].http://www.gov.cn/xinwen/2016-07/06/content_5088866.htm.
[5]广州日报.调查称7%男性大学生有过男男性行为经历[EB/OL].(2013-11-29)[2016-12-12].http://news.xinhuanet.com/politics/2013-11/29/c_125781825.htm.
[6]王丽欣,陈官芝,张北川,等.男男性行为者中大学生与同龄非大学生艾滋病高危行为对比研究[J].中华流行病学杂志,2010,31(1):113-114.
[7]Li X,Wu G,Lu R,et al.HIV-testing behavior and associated factors among MSM in Chongqing,China:results of 2 consecutive crosssectional surveys from 2009 to 2010[J].Medicine(Baltimore),2014,93(27):e124.
[8]Zeng G,Feng L,Ouyang L,et al.The dynamic trends of HIV prevalence,risks,and prevention among men who have sex with men in Chongqing,China[J].Biomed Res Int,2014,2014:602719.
[9]Zeng Y,Zhang L,Li T,et al.Risk factors for HIV/syphilis infection and male circumcision practices and preferences among men who have sex with men in China[J].Biomed Res Int,2014,2014:498987.
[10]宋逸,季成叶,星一,等.中国大学生性行为现况分析[J].中国学校卫生,2009,30(2):116-117.
[11]Zheng J,Wu Z,Poundstone KE,et al.HIV,syphilis infection,and risky sexual behaviors among male university students who have sex with men in Beijing,China:a cross-sectional study[J].AIDS Educ Prev,2012,24(1):78-88.
[12]柏建芸,于茂河,柳忠泉,等.天津市730名青年学生MSM的HIV感染状况及影响因素[J].中国艾滋病性病,2015,21(12):1048-1051.
[13]朱军礼,张洪波,吴红花.学生中122名男男性行为者HIV/STD高危行为及其感染状况分析[J].中国艾滋病性病,2007,13(4):350-352.
[14]冯连贵,丁贤彬,卢戎戎,等.青年学生中男男性行为人群HIV、梅毒感染率及估计HIV发病率的趋势分析[J].第三军医大学学报,2010,32(24):2644-2646.
[15]陈梦清,程伟彬,徐慧芳,等.广东省825名学生男男性行为人群rush poppers使用情况及其影响因素[J].中华预防医学杂志,2016,64(11):949-953.
[16]Carey JW,Mejia R,Bingham T,et al.Drug use,high-risk sex behaviors,and increased risk for recent HIV infection among men who have sex with men in Chicago and Los Angeles[J].AIDS Behav,2009,13(6):1084-1096.
[17]Ostrow DG,Plankey MW,Cox C,et al.Specific sex drug combinations contribute to the majority of recent HIV seroconversions among MSM in the MACS[J].J Acquir Immune Defic Syndr,2009,51(3):349-355.
[18]UNAIDS.How AIDS changed everything[R/OL].(2015-07-14)[2016-07-10].http://www.unaids.org/sites/default/files/media_asset/MDG6Report_en.pdf.
[19]Qin Y,Liu FY,Tang WM,et al.HIV self-testing among high-risk men who have sex with men in China:a cross-sectional study[J].Lancet,2016,388:S76.
[20]何益新,郑迎军,汪道发,等.1例男男性行为者因口交而感染HIV的调查报告[J].中国艾滋病性病,2008,14(5):521.
[21]邹华春,庞琳,吴尊友.使用互联网的男男性行为人群艾滋病/性传播疾病高危行为特征研究现状[J].中华流行病学杂志,2008,29(6):622-624.
[22]Crosby RA,Mena L,Ricks JM.Correlates of sexual-risk behaviors among young black MSM:implications for clinic-based counseling programs[J].AIDS Care,2017,29(6):718-723.