天津市浴池男男性行为人群HIV新发感染队列研究  

HIV infection incidence among men who have sex with men in common bathing pool in Tianjin： a cohort study

作　　者：于茂河[1] 江国虹[1] 斗智[2] 李志军[3] 郭燕[1] 徐鹏[1] 杨杰 徐杰[2] 

机构地区：[1]天津市疾病预防控制中心,300011 [2]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206 [3]美国疾病预防控制中心全球艾滋病项目中国办事处,北京100600 [4]深蓝公共卫生咨询服务中心,天津300121

出　　处：《中华流行病学杂志》2016年第3期362-366,共5页Chinese Journal of Epidemiology

基　　金：中美艾滋病防治合作项目-天津同志浴池男男性行为者艾滋病预防综合干预试点;天津市卫生局科技基金项目（2013KZ052）;天津市卫生行业重点攻关项目（12KG129） 志谢 感谢天津深蓝公共卫生咨询服务中心为项目调查作出的贡献

摘　　要：目的 通过队列研究分析天津市浴池MSM人群HIV新发感染状况及影响因素,为在MSM人群中开展HIV感染的预防和干预提供依据。方法 以经常光顾天津市某同性恋浴池、曾发生过男男性行为的MSM为研究对象,于2011年4月至2013年9月采用同伴推动法招募研究对象,建立MSM人群开放性队列,完成HIV检测和基线调查,并进行跟踪随访检测。调查内容包括人口学特征、艾滋病相关知识知晓情况、艾滋病相关行为情况等信息。以随访过程中＂HIV阳转＂为结局因变量,同时,将从研究对象进入队列到出现HIV阳转的时间为时间因变量,应用Cox比例风险模型进行浴池型MSM人群HIV新发感染影响因素的分析。结果 调查期间符合条件的研究对象733例,共新发HIV感染59例,队列随访累积观察时间为7 384.9人月,HIV新发感染率为9.59/100人年（95%CI：7.3/100人年～11.92/100人年）。多因素 Cox 回归分析显示,天津市浴池型MSM人群的危险因素包括：年龄较低者相比较年长者艾滋病知识知晓率低者（HR=1.82,95%CI：1.03～2.66）相比较知晓率高者,多性伴者（HR=1.74,95%CI：1.26～2.58）相比较固定性伴者,正在感染梅毒者（HR=2.36,95%CI：1.31～3.27）,均易发生HIV的新发感染。结论 同性恋浴池MSM人群中年龄较低、艾滋病知识知晓率低、多性伴、梅毒感染为该人群HIV新发感染的危险因素,应针对危险因素加强浴池型MSM人群HIV新发感染的监测和干预。Objective To investigate incidence of HIV infection and identify associated risk factors among men who have sex with men （MSM） in common bathing pools in Tianjin. Methods A prospective cohort study was conducted among the MSM recruited in a common bathing pool in Tianjin from 2011 to 2013. A total of 733 MSM were surveyed to obtain the information about their sociodemographic characteristics, HIV-related knowledge awareness and sexual behaviors, and subsequent follow-up surveys were carried out every four months. Cox regression analysis was conducted to identify the risk factors for HIV infection. Results A total of 59 HIV infection cases were found in the 2.5-years follow-up survey. The cumulative follow-up time was 7 384.9 person- months. The incidence rate of HIV infection was 9.59/100 person-year. The multivariate Cox regression analysis showed that young age, low score of HIV/AIDS knowledge awareness （HR=1.82, 95%CI：1.03-2.66）, having two and more sexual partners during past 6 months （HR=1.74, 95%CI： 1.26-2.58） and syphilis （HR=2.36, 95%CI：1.31-3.27） were significantly associated with HIV infection in this MSM cohort. Conclusions Low score of HIV/AIDS knowledge awareness, young age, having two and more sexual partners during past 6 months and syphilis were the risk factors for HIV infection in MSM in common bathing pools. It is necessary to strengthen the HIV surveillance and intervention in this population.

关 键 词：同性恋浴池 男男性行为人群 HIV新发感染 队列 

分 类 号：R512.91[医药卫生—内科学]