青年男男性行为人群艾滋病、梅毒感染的流行病学调查  

The epedemiological survey of HIV and syphilis infection among young men who have sex with men

作　　者：朱正平[1] 徐园园[1] 吴苏姝[1] 刘黎[1] 李昕[1] 许文炯[2] 董晓庆[2] 董潇潇[2] 李小杉[3] 卫平民[3] ZHU Zheng-ping;XU Yuan-yuan;WU Su-shu;LIU Li;LI Xin;XU Wen-jiong;DONG Xiao-qing;DONG Xiao-xiao;LI Xiao-shan;WEI Ping-min(Section of AIDS Control and Prevention,Nanjing Municipal Center for Disease Control and Prevention,Nanjing 210003,China;Section of Microbiological Examination,Nanjing Municipal Center for Disease Control and Prevention,Nanjing 210003,China;School of Public Health,Southeast University,Nanjing 210009,China)

机构地区：[1]南京市疾病预防控制中心艾滋病防制科,江苏南京210003 [2]南京市疾病预防控制中心微生物检验科,江苏南京210003 [3]东南大学公共卫生学院,江苏南京210009

出　　处：《中华疾病控制杂志》2018年第12期1265-1269,共5页Chinese Journal of Disease Control & Prevention

基　　金：2016年度教育部人文社科研究规划基金项目(6YJA840014);南京市第一期现场流行病学培训班(NJFETP-1);第三轮艾滋病综合防治示范区“一地一策”项目

摘　　要：目的掌握南京地区近5年青年男男性行为人群(young men who have sex with men,YMSM)艾滋病和梅毒感染率,分析YMSM感染人类免疫缺陷病毒(human immunodeficiency virus,HIV)危险因素。方法利用2013-2017年南京市MSM人群横断面调查研究,筛选其中16~24周岁YMSM调查资料进行分析。结果纳入调查的YMSM共1029名。以未婚、汉族和自我认同为同性恋为主,文化程度大专及以上占73.66%。HIV、现症梅毒和既往梅毒总感染率分别为8.65%、4.18%和8.84%,5年间变化趋势均无统计学意义(均有P>0.05)。YMSM通过网络寻找性伴的比例从63.96%上升至73.86%;最近半年发生无保护性肛交(unprotected anal intercourse,UAI)比例从55.86%下降至36.93%,最近一次肛交安全套使用比例从62.00%上升至80.71%,差异均有统计学意义(均有P<0.05)。多因素Logistic回归分析显示,最近半年发生过UAI、YMSM性角色为被插入方和双重角色、现症梅毒感染是YMSM感染HIV的危险因素。结论南京市YMSM人群HIV和梅毒感染率均处于较高水平,大部分YMSM接受过高等教育,今后应长期持续学校艾滋病性病预防控制综合措施的落实。应积极开发针对YMSM的网络干预措施和方法。坚持使用安全套和及时规范诊疗性病是降低YMSM人群感染HIV的关键措施。Objective To master the prevalence of human immunodeficiency virus (HIV) and syphilis and to analyze the risk factors associated with HIV infection among men who have sex with men(YMSM) in Nanjing during recent 5 years. Methods We used the data of consecutive cross-sectional surveys among MSM conducted in Nanjing from 2013 to 2017. We analyzed the data of participants of age from 16 to 24 years old. Results 1 029 YMSM were included,with the majority of YMSM being single,and also included Han ethnic people and self-identified homosexuals. Over 73. 66% of YMSM had at least a college education. The total prevalence of HIV,current syphilis and previous syphilis was 8. 65%, 4. 18% and 8. 84%,respectively. The changing trends of the prevalence were not statistically different (all P > 0. 05). The proportion of the participants seeking sexual partners through the internet rose from 63. 96% to 73. 86%,while the rate of the participants who had UAI in the past six months decreased from 55. 86% to 36. 93%,and condom use rate in the last act of anal sex rose from 62. 00% to 80. 71%,with all of the differences being statistically significant (all P <0. 05). Multivariate logistic analysis showed that the variables of had UAI in the past six months,receptive and dual sexual role, and currently syphilis infection were independently associated with HIV infection. Conclusions HIV and syphilis preva- lence among YMSM in Nanjing were high. As the majority of YMSM were students or college above educated,measures of AIDS and sexual transmitted diseases control and prevention in schools and universities should be implemented in a long term. It is necessary to develop internet based intervention methods tailor to YMSM. The key measures for HIV prevention among YMSM were consistent condom use and sexual transmitted diseases prevention and standardized treatment.

关 键 词：青年男男性行为人群 人类免疫缺陷病毒 梅毒 感染率 

分 类 号：R373.51[医药卫生—病原生物学] R759.1[医药卫生—基础医学]