中国四座城市男男性行为人群HIV感染状况及其危险因素  

The prevalence of HIV infection and the risk factors among MSM in 4 cities, China

作　　者：许娟[1] 韩德琳[2] 刘征[3] 马小燕[4] 王莉莉[5] 徐杰[1] 庞琳[1] 张洪波[6] 吴尊友[1] 

机构地区：[1]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206 [2]成都市疾病预防控制中心性病艾滋病防治科 [3]郑州市疾病预防控制中心性病艾滋病防治科 [4]北京市疾病预防控制中心性病艾滋病防治研究所 [5]哈尔滨市疾病预防控制中心性病艾滋病预防控制所 [6]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系

出　　处：《中华预防医学杂志》2010年第11期975-980,共6页Chinese Journal of Preventive Medicine

基　　金：基金项目：国家自然科学基金（30771850）;美国国立卫生研究院（NIH）福格迪国际中心（Fogarty International Center）项目（2U2RTW006918-06）;卫生部男男性行为人群艾滋病综合防治试点项目（2008年3月）

摘　　要：目的了解男男性行为人群（MSM）HIV感染状况，探索感染的危险因素。方法采用同伴驱动抽样和滚雪球方法在北京市、哈尔滨市、郑州市与成都市招募MSM研究对象（1950名），以面对面问卷调查（共调查1950份，有效问卷1950份）获得相关人口学及行为学资料，抽取1950名调查对象各5ml静脉血进行HIV抗体血清学检测（用胶体金法、乳胶层析法与双抗原夹心酶联免疫法进行初筛，用免疫印迹试验进行确证检测），描述HIV感染特征，分析其危险因素。对不同组别间的率或构成比进行）（2检验，感染危险因素进行多因素logistic回归分析。结果共调查MSM1864名，HIV感染率为6．7％（125／1864）。≥40岁者HIV感染率为9．5％（24／252），≤19岁者为1．9％（2／105）；大学文化程度者HIV感染率为4．8％（41／858），初中及以下文化程度者为8．4％（31／371）；性伴与之年龄差小于10岁者为5．0％（58／1168），性伴比之大10岁者为10．3％（35／340）；无无保护被动肛交者HIV感染率为5．5％（64／1169），有无保护被动肛交者为8．9％（61／695）。年龄≥40岁（OR=6．5，95％CI：1．5～28．7）、初中及以下文化程度（OR=1．8，95％CI：1．1～2．7）、拥有比自己年龄大10岁及以上性伴（OR=2．1，95％CI：1．3～3．3）、有无保护被动肛交（OR=1．6，95％CI：1．1～2．4）是HIV感染的独立危险因素。结论MSM人群HIV感染率较高，年龄大、文化程度低、拥有较大年龄的性伴及无保护被动肛交与HIV感染相关。Objectives To access the prevalence of HIV infection and the associated factors among urban MSM in China. Methods Participants were recruited using respondent driven sampling and snowball sampling method in Beijing, Harbin, Zhengzhou and Chengdu city. A face-to-face questionnaire was administrated to collect relevant demographic and ethological data;5 ml venous blood sample was taken from each subject to measure HIV antibody in serum （samples were first screened by colloidal gold, latex chromatographic and double-antigen sandwich ELISA method, positive samples were further confirmed by immunoblotting method ）. The characteristics of HIV infection was described and the risk factors were analyzed. Results A total of 1864 MSM were recruited and the prevalence of HIV was 6. 7% （125/1864）. It was 9. 5% （24/252） among MSM older than 39 years and it was 1.9% （2/105） among those less than 20 years old. The prevalence was 8.4% （31/371） among MSM with junior level education and was 4. 8% （41/858） among those with college level education. It was 10. 3% （35/340） among MSM with sexual partner old than him for over 10 years while it was 5.0% （58/1168） among those having sexual partner within 10 years older. The prevalence of HIV infection was 8. 9% （61/695） among MSM with unprotected receptive anal sex and it was 5.5% （64/1169 ） among those without unprotected receptive anal sex. The risk factors independently associated with HfV infection included being older than 39 years（ OR = 6. 5,95% CI： 1.5 - 28. 7 ） ,with junior or lower level education（ OR = 1.8,95% CI： 1.2 - 2. 7 ）, having sexual partner older than himself for over 10 years （ OR = 2. 1,95% CI： 1.3 - 3.3 ） and having unprotected receptive anal intercourse （ OR = 1.6,95 % CI： 1.1 -2.4 ）. Conclusion MSM had a high rate of HIV infection. Older age, lower level education, having older sexual partner and unprotected receptive anal intercourse were related to HIV infection.

关 键 词：获得性免疫缺陷病毒 感染 同性恋 男性 危险因素 

分 类 号：R686[医药卫生—骨科学]