2017年襄阳市MSM人群HIV感染状况及影响因素分析
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摘要
目的了解襄阳市男男性行为人群(men who have sex with men,MSM)的艾滋病病毒(human immunodeficiency virus,HIV)感染状况及其影响因素,为制定防控措施提供依据。方法采用分类滚雪球法,召集过去一年内有过插入性口交或肛交同性性行为的MSM作为对象,开展问卷调查,采集血液标本进行HIV、梅毒和丙型肝炎三种抗体检测。数据采用SPSS 23.0软件进行描述性、单因素和多因素分析。结果共调查400名MSM,HIV感染率4.25%。单因素分析显示,婚姻状况、文化程度、艾滋病防治知识得分、最近1周同性行为次数、最近一次与同性发生肛交性行为时是否使用安全套、同性性行为时是否坚持使用安全套、是否接受过干预服务共7个因素影响HIV感染率(P≤0.10)。多因素分析显示,文化程度高中以上(aOR=0.25,95%CI:0.07～0.92)、艾滋病防治知识全对(aOR=0.24,95%CI:0.07～0.77),最近一次与同性肛交性行为时使用安全套(aOR=0.065,95%CI:0.01～0.47)、接受过干预服务(aOR=0.007,95%CI:0.001～0.092)是HIV感染率的保护性因素。结论 2017年襄阳市MSM人群HIV感染率较高,应采取有效措施,特别是针对文化程度初中以下的MSM,加大综合干预措施力度,提高艾滋病干预服务覆盖率,加强艾滋病防治知识宣传教育,切实提高同性肛交性行为时安全套使用率,从而遏制该人群的艾滋病传播。
Objective To investigate the status of human immunodeficiency virus(HIV) infection and relevant influencing factors among men who have sex with men(MSM) in Xiangyang City so as to provide a basis for formulating its prevention and control measures. Methods Classification snowball-rolling method was used to recruit MSM who had inserted oral or anal sex with male partners in the past year to serve as the surveyed subjects. A questionnaire survey was conducted, and blood samples were collected to detect antibodies against HIV, syphilis and hepatitis C virus(HCV). SPSS 23.0 software was used to perform data analyses, including descriptive statistics, univariate and multivariate regression analyses. Results A total of 400 MSM were surveyed, with the HIV positive rate of 4.25%. Single factor analysis showed that marital status, education background, score of HIV/AIDS-related knowledge, the times of homosexual behavior in the last week, whether using condom in the last homosexual anal sex, whether consistently using condom in homosexual behavior and whether receiving intervention services were the factors associated with HIV infection(P≤0.10). Multivariate regression analysis showed that having high school and above educational background(aOR=0.25, 95%CI:0.07-0.92), full score of HIV/AIDS-related knowledge(aOR=0.24, 95%CI:0.07-0.77), using condom in the last homosexual anal sex(aOR=0.065, 95%CI:0.01-0.47), receiving intervention services(aOR=0.007, 95%CI:0.001-0.092) were the protective factors for HIV infection. Conclusions The infection rate of HIV in MSM in Xiangyang City in 2017 was high. It is necessary to adopt effective measures, enhance comprehensive targeted intervention measures in MSM who have junior middle school and below educational background, improve the coverage rate of HIV/AIDS intervention services, intensify propaganda and education of HIV/AIDS prevention and treatment knowledge and increase the condom use rate at each homosexual anal intercourse so as to curb the spread of HIV/AIDS in MSM.
Objective To investigate the status of human immunodeficiency virus(HIV) infection and relevant influencing factors among men who have sex with men(MSM) in Xiangyang City so as to provide a basis for formulating its prevention and control measures. Methods Classification snowball-rolling method was used to recruit MSM who had inserted oral or anal sex with male partners in the past year to serve as the surveyed subjects. A questionnaire survey was conducted, and blood samples were collected to detect antibodies against HIV, syphilis and hepatitis C virus(HCV). SPSS 23.0 software was used to perform data analyses, including descriptive statistics, univariate and multivariate regression analyses. Results A total of 400 MSM were surveyed, with the HIV positive rate of 4.25%. Single factor analysis showed that marital status, education background, score of HIV/AIDS-related knowledge, the times of homosexual behavior in the last week, whether using condom in the last homosexual anal sex, whether consistently using condom in homosexual behavior and whether receiving intervention services were the factors associated with HIV infection(P≤0.10). Multivariate regression analysis showed that having high school and above educational background(aOR=0.25, 95%CI:0.07-0.92), full score of HIV/AIDS-related knowledge(aOR=0.24, 95%CI:0.07-0.77), using condom in the last homosexual anal sex(aOR=0.065, 95%CI:0.01-0.47), receiving intervention services(aOR=0.007, 95%CI:0.001-0.092) were the protective factors for HIV infection. Conclusions The infection rate of HIV in MSM in Xiangyang City in 2017 was high. It is necessary to adopt effective measures, enhance comprehensive targeted intervention measures in MSM who have junior middle school and below educational background, improve the coverage rate of HIV/AIDS intervention services, intensify propaganda and education of HIV/AIDS prevention and treatment knowledge and increase the condom use rate at each homosexual anal intercourse so as to curb the spread of HIV/AIDS in MSM.
引文
[1] Bai X, Xu J, Yang J, et al. HIV prevalence and high-risk sexual behaviours among MSM repeat and first-time testers in China:implications for HIV prevention[J]. J Int AIDS Soc, 2014,17(1):18848.
[2] 岑平,王永.男男性行为人群艾滋病感染的影响因素研究进展[J].中国热带医学,2018,18(12):1269-1272.
[3] 秦倩倩,郭巍,王丽艳,等.2008-2015年中国经男男性行为感染HIV者流动情况及其影响因素[J].中华预防医学杂志,2016,50(11):938-942.
[4] 邱兴庆,龚文胜,孟丽丽,等. 2015年襄阳市MSM人群HIV感染状况及影响因素分析[J].中国初级卫生保健,2016,30(1):37-40.
[5] 邱兴庆,赵云岩,孟丽丽,等.湖北省襄阳市男男性行为人群艾滋病干预效果分析[J].中国健康教育,2016,32(12):1082-1085,1102.
[6] 苏秋菊,金大庆,袁月,等.鞍山市MSM艾滋病综合干预效果评价[J].中国艾滋病性病,2015,21(10):865-867.
[7] 王卓,龙清泉,冯雷,等.2010-2014年达州市MSM艾滋病哨点监测分析[J].中国艾滋病性病,2015,21(11):957-960.
[8] 彭庭海,彭国平,阳凯,等.湖北省2010-2013年男男性行为者HIV新发感染分析[J].中华流行病杂志,2015,36(2):162-166.
[9] 王毅,李六林,樊静,等.绵阳市不同寻找性伴场所MSM的性行为特征及HIV感染现状[J].实用预防医学,2018,25(9):1029-1034.
[10] WHO. Lack of HIV/AIDS services for men having sex with men imperils Asia[EB/OL]. (2011-11-12)[2018-07-05].http://www.wpro.who.int/mediacentre/releases/2009/20090217/en/index.html.
[11] 张万宏,石萍,石卫东,等. 男性双性性行为者性取向及群体性行为特征分析[J].华中科技大学学报(医学版),2014,41(3):375-378.
[12] 李玉风,许建,李鹏. 一般男男性行为者和男男性工作者艾滋病感染情况及相关知识行为调查[J].中华行为医学与脑科学杂志,2012,21(4):346-348.
[13] 谭文倩,赵俊仕,刘志胜,等. 长沙市2012-2014年男男性接触人群HIV感染趋势分析[J].实用预防医学,2015,22(8):912-914.
[14] 邱兴庆,张静,谢爱齐,等.男男性接触人群的自我效能对艾滋病知识行为影响分析[J].实用预防医学,2013,20(11):1297-1300.
[15] 姜袁,窦亚兰,蔡爱杰,等.基于结构方程模型构建男男性行为人群预防艾滋病知识-动机-心理模型的研究[J].中华流行病学杂志,2016,37(2):281-285.
[2] 岑平,王永.男男性行为人群艾滋病感染的影响因素研究进展[J].中国热带医学,2018,18(12):1269-1272.
[3] 秦倩倩,郭巍,王丽艳,等.2008-2015年中国经男男性行为感染HIV者流动情况及其影响因素[J].中华预防医学杂志,2016,50(11):938-942.
[4] 邱兴庆,龚文胜,孟丽丽,等. 2015年襄阳市MSM人群HIV感染状况及影响因素分析[J].中国初级卫生保健,2016,30(1):37-40.
[5] 邱兴庆,赵云岩,孟丽丽,等.湖北省襄阳市男男性行为人群艾滋病干预效果分析[J].中国健康教育,2016,32(12):1082-1085,1102.
[6] 苏秋菊,金大庆,袁月,等.鞍山市MSM艾滋病综合干预效果评价[J].中国艾滋病性病,2015,21(10):865-867.
[7] 王卓,龙清泉,冯雷,等.2010-2014年达州市MSM艾滋病哨点监测分析[J].中国艾滋病性病,2015,21(11):957-960.
[8] 彭庭海,彭国平,阳凯,等.湖北省2010-2013年男男性行为者HIV新发感染分析[J].中华流行病杂志,2015,36(2):162-166.
[9] 王毅,李六林,樊静,等.绵阳市不同寻找性伴场所MSM的性行为特征及HIV感染现状[J].实用预防医学,2018,25(9):1029-1034.
[10] WHO. Lack of HIV/AIDS services for men having sex with men imperils Asia[EB/OL]. (2011-11-12)[2018-07-05].http://www.wpro.who.int/mediacentre/releases/2009/20090217/en/index.html.
[11] 张万宏,石萍,石卫东,等. 男性双性性行为者性取向及群体性行为特征分析[J].华中科技大学学报(医学版),2014,41(3):375-378.
[12] 李玉风,许建,李鹏. 一般男男性行为者和男男性工作者艾滋病感染情况及相关知识行为调查[J].中华行为医学与脑科学杂志,2012,21(4):346-348.
[13] 谭文倩,赵俊仕,刘志胜,等. 长沙市2012-2014年男男性接触人群HIV感染趋势分析[J].实用预防医学,2015,22(8):912-914.
[14] 邱兴庆,张静,谢爱齐,等.男男性接触人群的自我效能对艾滋病知识行为影响分析[J].实用预防医学,2013,20(11):1297-1300.
[15] 姜袁,窦亚兰,蔡爱杰,等.基于结构方程模型构建男男性行为人群预防艾滋病知识-动机-心理模型的研究[J].中华流行病学杂志,2016,37(2):281-285.