摘要
目的了解重庆市某郊区男男性行为者(MSM)艾滋病病毒(HIV)新发感染状况,探讨其相关影响因素。方法对2013—2017年重庆市某郊区MSM哨点监测样本中,HIV抗体确证阳性样本采用捕获酶联免疫法(BED)或限制性抗原亲和力酶联免疫吸附法(LAg)进行新发感染检测,估算该人群新发感染率,多因素Logistic回归分析HIV新发感染的影响因素。结果该区2013—2017年MSM哨点监测的1 250例样本中1 061人(84.88%)来自网络招募,平均年龄(26.33±7.39)岁,未婚1 095人(87.60%),文化程度大专及以上者912人(72.96%);艾滋病知识知晓率和接受过干预服务的均>92.00%;最近6个月肛交每次都使用安全套的比例为56.83%;最近一年进行过HIV抗体筛查的比例为39.44%。每年的HIV阳性检出率均在10.00%～10.80%之间,每年的新发感染率分别为10.78%[95%可信区间(CI):2.94%～18.62%],12.18%(95%CI:4.22%～20.15%),5.65%(95%CI:0.09%～11.21%),1.84%(95%CI:-1.68%～5.35%),6.93%(95%CI:0.85%～13.01%)。5年总的新发感染率为7.98%(95%CI:4.95%～11.01%)。多因素Logistic回归分析显示,最近1年未参与过HIV抗体筛查[比值比(OR)=3.589,95%CI:1.210～10.645],最近6个月同性肛交未每次使用安全套MSM(OR=9.098,95%CI:3.116～26.569)是HIV新发感染的危险因素。结论重庆市某郊区MSM大多通过互联网社交,HIV感染率和新发感染率均较高,提示对MSM应通过互联网传递有效的HIV预防策略的信息,继续扩大检测和落实安全套使用等多种干预措施,从而降低新发感染。
Objective To understand the HIV infection rate and incidence among men who have sex with men(MSM)in a suburb of Chongqing from 2013 to 2017,and to explore the influence factors.Methods A total of 1250 MSM were surveyed via sentinel surveillance during 2013-2017.BED HIV capture enzyme immunoassay(BED)or limiting antigen avidity enzyme immunoassay(Lag-Avidity EIA)were used to detect HIV antibody as well as recent infections,to estimate the HIV incidence in MSM,and analyze the influence factors.Results Among the 1 250 MSM,84.88%(1 061)were recruited online.The average age was(26.33±7.39);87.60%(1 095)were unmar-ried;72.96%(912)had a junior college degree of education and above;more than 92.00% were aware of HIV/AIDS knowledge and received intervention services;56.83% had condom use in anal sex during the last 6 months;39.44% had HIV testing in the past year.The annual HIV positive detection rate was between 10.00% and 10.80% with the annual incidenceof 10.78%(95% CI:2.94%-18.62%),12.18%(95% CI:4.22%-20.15%),5.65%(95% CI:0.09%-11.21%),1.84%(95%CI:-1.68%-5.35%),and 6.93%(95%CI:0.85%-13.01%)respectively.The total 5-year incidence was 7.98%(95%CI:4.95%-11.01%).Multivariate logistic regression analysis showed that the risk factors for HIV infection were no HIV testing in the recent year(OR=3.589,95%CI:1.210-10.645)and no consistent condom use in anal intercourse in the past 6 months(OR=9.098,95%CI:3.116-26.569).Conclusion Most of the MSM in the suburb of Chongqing has social contacts through the internet.The HIV infection rate and incidence among MSM are high.It is suggested that effective HIV prevention measures should be disseminated through the internet,and HIV testing should be expanded in combination with behavior intervention such as condom use so as to reduce HIV infection among MSM.
作者
杨蓓
卢戎戎
秦毅
杨恩泽
廖书
柏兴建
吴国辉
陈于
YANG Bei;LU Rongrong;QIN Yi;YANG Enze;LIAO Shu;BAI Xingjian;WU Guohui;CHEN Yu(School of Public Health and Management,Research Center for Medicine and Social Development,Innovation Center for Social Risk Governance in Health,Chongqing Medical University,Chongqing 400016,China;STD/AIDS Prevention and Control Institute,Chongqing Center for Disease Control and Prevention,Chongqing 400042;Hechuan District Center for Disease Control and Prevention,Chongqing 401519)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2019年第2期153-157,共5页
Chinese Journal of Aids & STD
基金
重庆市医学科研计划项目(2017ZDXM001)~~
