南宁市男男性行为人群HIV-1新发感染率及感染危险因素分析
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摘要
目的了解南宁市男男性行为人群(men who have sex with men,MSM)人类免疫缺陷病毒(HIV)新发感染情况及感染危险因素。方法对南宁市2013-2015年连续4轮MSM人群2 524名进行横断面调查,并采集3～5 ml静脉血进行HIV抗体和梅毒检测。应用BED捕获酶联免疫法(BED-CEIA)对HIV抗体确证阳性样本进行HIV-1新发感染检测,估算HIV-1新发感染率,对调查资料进行χ2检验和Logistic回归分析。结果 4轮调查中HIV阳性率分别为6. 98%、11. 65%、11. 98%、11. 40%,新发感染率分别为2. 48%、6. 34%、7. 10%、7. 64%。多因素Logistic回归分析提示本地居住时间(OR=0. 583～0. 897),艾滋病防治知晓率(OR=0. 336～0. 978),性角色(OR=1. 334～1. 710),最近6个月与同性肛交使用安全套频率(OR=0. 501～0. 750),现症梅毒感染(OR=2. 561～4. 091)是HIV感染的危险因素。结论南宁市MSM人群HIV感染率处于较高水平,新发感染率有上升趋势。应该加强主动监测,加大干预力度。
Objective To undrestand recent HIV infection and associated factors among men who have sex with men in Nanning City. Methods A cross-sectional survey of 2 524 consecutive MSM populations in Nanning from 2013 to 2015 was conducted,and 3 to 5 ml of venous blood was collected for HIV antibody and syphilis testing. BED-enzyme-linked immunosorbent assay( BED-CEIA) was used to detect HIV-1 new infections in HIV-positive positive samples,and the new HIV-1 infection rate was estimated. The survey data were analyzed by χ2 test and logistic regression analysis. Results For the four rounds investigation,the HIV positive rates were 6. 98%,11. 65%,11. 98% and 11. 40% respectively and recent infection rates were2. 48%,6. 34%,7. 10%,7. 64% respectively during 2013-2015. The result of Logistic regression analysis showed that local residence time( OR = 0. 583 ～ 0. 897),HIV/AIDS knowledge awareness( OR = 0. 336 ～ 0. 978),sex role( OR = 1. 334 ～1. 710),nearly 6 months each sex were using condoms( OR = 0. 501 ～ 0. 750) and concurrent syphilis infection( OR = 2. 561 ～4. 091) were factors associated with HIV infection. Conclusion The HIV-1 infection rate among MSM was at a high level in Nanning,and the recent HIV-1 infection rate was upward trend. It is necessary to strengthen the active monitoring,and increase the intensity of intervention.
Objective To undrestand recent HIV infection and associated factors among men who have sex with men in Nanning City. Methods A cross-sectional survey of 2 524 consecutive MSM populations in Nanning from 2013 to 2015 was conducted,and 3 to 5 ml of venous blood was collected for HIV antibody and syphilis testing. BED-enzyme-linked immunosorbent assay( BED-CEIA) was used to detect HIV-1 new infections in HIV-positive positive samples,and the new HIV-1 infection rate was estimated. The survey data were analyzed by χ2 test and logistic regression analysis. Results For the four rounds investigation,the HIV positive rates were 6. 98%,11. 65%,11. 98% and 11. 40% respectively and recent infection rates were2. 48%,6. 34%,7. 10%,7. 64% respectively during 2013-2015. The result of Logistic regression analysis showed that local residence time( OR = 0. 583 ～ 0. 897),HIV/AIDS knowledge awareness( OR = 0. 336 ～ 0. 978),sex role( OR = 1. 334 ～1. 710),nearly 6 months each sex were using condoms( OR = 0. 501 ～ 0. 750) and concurrent syphilis infection( OR = 2. 561 ～4. 091) were factors associated with HIV infection. Conclusion The HIV-1 infection rate among MSM was at a high level in Nanning,and the recent HIV-1 infection rate was upward trend. It is necessary to strengthen the active monitoring,and increase the intensity of intervention.
引文
[1]中国疾病预防控制中心.全国艾滋病检测技术规范(2015年修订版)[Z]. 2015-12.
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[5]任强,邢爱华,常文辉,等.应用BED-CEIA方法估算陕西省2011年三类高危人群HIV-1新发感染率[J].现代检验医学杂志,2012,27(4):15-18.
[6]秦鸥,周健,袁飞,等.贵阳市MSM人群艾滋病感染危险因素分析和新发感染率调查[J].中国皮肤性病学杂志,2013,27(12):1261-1263.
[7]段振华,范双凤,施雅莹,等.成都市男男性行为人群既往检测与HIV新发感染调查分析[J].现代预防医学,2017,44(5):914-921.
[8]史同新,张北川,李秀芳,等.男男性行为者中流动人口艾滋病高危行为研究[J].中华流行病学杂志,2009,30(7):668-671.
[9]郭璐,张敏,刘黎,等.南京市不同性角色MSM的行为特征及HIV和梅毒感染现状[J].中国艾滋病性病,2017,23(3):232-236.
[10]郑文彬,朱秋映,朱金辉,等. 2011年广西男男性接触者艾滋病监测结果分析[J].中华疾病控制杂志,2013,17(3):239-242.
[11]卢耀状,农全兴,农丽萍,等.南宁市MSM性行为知行分离的影响因素研究[J].中华疾病控制杂志,2015,19(12):1231-1234,1239.
[12]王毅,徐杰,李志军,等.男男性行为者安全套使用及影响因素分析[J].中华疾病控制杂志,2012,16(2):133-136.
[13]刘磊,郑迎军,殷文渊,等. HIV抗体阳性MSM的性病感染状况及其影响因素[J].中国艾滋病性病,2017,23(7):616-619.
[14]王毅,李六林,樊静,等.绵阳市男男性行为人群压力感受状况及影响因素分析[J].华南预防医学,2017,43(3):201-205.
[15]单士馨,廖玫珍,訾桂玲,等. 2010-2014年山东省网络型男男性行为者HIV感染及其影响因素[J].现代预防医学,2017,44(13):2457-2461.
[2]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].中华流行病学杂志,2015,36(2):162-166.
[3]赵涛,施建春,陈方方,等.南阳市MSM人群HIV新发感染情况研究[J].中国艾滋病性病,2013,19(1):39-42.
[4]崔为国,刘佳,聂玉刚,等.应用BED-CEIA方法估算河南省多类高危人群2009年的HIV-1新近感染率[J].中国病毒病杂志,2011,13(2):116-118.
[5]任强,邢爱华,常文辉,等.应用BED-CEIA方法估算陕西省2011年三类高危人群HIV-1新发感染率[J].现代检验医学杂志,2012,27(4):15-18.
[6]秦鸥,周健,袁飞,等.贵阳市MSM人群艾滋病感染危险因素分析和新发感染率调查[J].中国皮肤性病学杂志,2013,27(12):1261-1263.
[7]段振华,范双凤,施雅莹,等.成都市男男性行为人群既往检测与HIV新发感染调查分析[J].现代预防医学,2017,44(5):914-921.
[8]史同新,张北川,李秀芳,等.男男性行为者中流动人口艾滋病高危行为研究[J].中华流行病学杂志,2009,30(7):668-671.
[9]郭璐,张敏,刘黎,等.南京市不同性角色MSM的行为特征及HIV和梅毒感染现状[J].中国艾滋病性病,2017,23(3):232-236.
[10]郑文彬,朱秋映,朱金辉,等. 2011年广西男男性接触者艾滋病监测结果分析[J].中华疾病控制杂志,2013,17(3):239-242.
[11]卢耀状,农全兴,农丽萍,等.南宁市MSM性行为知行分离的影响因素研究[J].中华疾病控制杂志,2015,19(12):1231-1234,1239.
[12]王毅,徐杰,李志军,等.男男性行为者安全套使用及影响因素分析[J].中华疾病控制杂志,2012,16(2):133-136.
[13]刘磊,郑迎军,殷文渊,等. HIV抗体阳性MSM的性病感染状况及其影响因素[J].中国艾滋病性病,2017,23(7):616-619.
[14]王毅,李六林,樊静,等.绵阳市男男性行为人群压力感受状况及影响因素分析[J].华南预防医学,2017,43(3):201-205.
[15]单士馨,廖玫珍,訾桂玲,等. 2010-2014年山东省网络型男男性行为者HIV感染及其影响因素[J].现代预防医学,2017,44(13):2457-2461.