天津市男男性行为人群中HIV-1阳性者的行为特征与基因亚型分析  

Analysis of behavior and HIV-1 subtypes among HIV-1 infected men who have sex with men in Tianjin

作　　者：于茂河[1] 郑敏娜[1] 左桐[1] 柳忠泉[1] 徐鹏[1] 郭燕[1] 许宁[1] 程绍辉[1] 

机构地区：[1]天津市疾病预防控制中心,天津300011

出　　处：《中国艾滋病性病》2011年第1期32-34,44,共4页Chinese Journal of Aids & STD

基　　金：天津市科技支撑计划重大项目(项目编号No.07SYSYSF05100);天津市疾病预防控制中心科技计划项目(项目编号No.CDCKY0803)~~

摘　　要：目的了解天津市男男性行为人群(MSM)中艾滋病病毒Ⅰ型(HIV-1)阳性人群社会行为特征及其传播危害特点,初步揭示天津市MSM人群中HIV-1亚型分布情况。方法选择来自2008年天津市MSM人群经常活动的酒吧、浴池、会所及网络推动的男男性行为者,采用统一问卷调查方式调查780份问卷,采集静脉血检测HIV-1抗体,同时检测首次CD4+T淋巴细胞计数,问卷录入Epi Data数据库,提取其中阳性样本问卷资料进行统计分析;确认阳性的血清样本应用反转录聚合酶链反应(RT-PCR)对HIV-1的gag基因区进行扩增、测定、亚型序列分析。结果共确认66名HIV-1抗体阳性者,平均年龄(28.6±8)岁,艾滋病知识总知晓率78.98%。调查中性取向为同性恋者41人,异性恋者1人,双性恋者19人,拒答1人,未确定4人;66人最近半年均与男性发生过肛交的性行为,平均性伴4.4个,与男性最近一次性行为安全套使用率为63.6%;与异性有性行为者19人,与异性发生性行为最近一次安全套使用率为36.8%;最近半年有20人发生过商业性行为。66例MSM阳性者中共获得50例亚型结果,主要HIV-1流行毒株分属3个亚型,分别为HIV-1 CRF01-AE重组亚型36例,占72%,B亚型8例,占16%,CRF07_BC重组亚型6例,占12%。结论天津市MSM阳性人群存在着认知与行为分离现象,对配偶或异性传播存在潜在风险,无保护性男男性行为和商业性行为现象严重,导致HIV在该人群传播风险大等特点。HIV-1基因型是以CRF01_AE为优势基因型的多态性分布,应加强对该类人群的干预和监测力度。Objective To investigate the characteristics of sexual behavior among HIV-positive MSM（men who have sex with men ） in Tianjin, and analyze their HIV-1 gene subtypes. Methods The study was conducted among 780 MSM from gay-bar, gay public bathroom, gay club houses and internet. Blood samples were taken to test HIV- 1 and CD＋ T count. The behavior information was obtained via questionnaires. The gag gene region of HIV-1 was amplified by RT-PCR and sequenced. Results The average age of the 66 HIV positive MSM was 28.6＋8y; the rate of AIDS awareness was 78.98~/00. As for the sexual orientation, of the 66 HIV positive MSM, 41 were self-confessed as homosexual, 1 was heterosexual , and 19 were self-confessed as bisexuals. One subject declined to answer the question. They all had anal sex with men in the past six months, with an average of 4. 4 sexual partners for each person. The rate of condom use in the recent sexual intercourse was 63. 6%. Among them, 19 had sex with females, and the rate of condom use was 36.8 %; 20 had commercial sex intercourse in the past half year. Three subtypes of HIV-1 were detected. Of the detected cases 36 belonged to CRF01-AE, accounting for 72%, 8 were of B subtype, accounting for 16% ; CRF07_BC was observed in 6 cases, accounting for 12%. Conclusions A separation of cognition from behavior is seen among HIV positive MSM in Tianjin, which may pose a risk of HIV transmission for their spouses or heterosexual partners. They are also at risk of HIV infection due to their unprotected sex and commercial sex behavior. Their HIV-1 genotype is CRF01_AE based polymorphism. Intervention and surveillance should be strengthened among this population group.

关 键 词：男男性行为人群 亚型 

分 类 号：R373.19[医药卫生—病原生物学]