2011～2015年中国银川地区男男性行为人群HIV-1感染率和新发感染率趋势研究  

Infection Status of HIV in Men Who Have Sex With Men in Yinchuan,China,2011～2015

作　　者：吴忠兰[1] 宋玲[1] 鱼小红[1] 关光玉[1] 王雪敏[1] 赵伟明[2] 

机构地区：[1]宁夏疾病预防控制中心,银川750004 [2]宁夏医科大学,银川750001

出　　处：《病毒学报》2017年第3期367-371,共5页Chinese Journal of Virology

基　　金：宁夏自然科学基金(项目号:NZ13217);题目:宁夏静脉吸毒人群HCV发病率新方法的建立及应用;宁夏科技攻关计划项目国际合作专项(项目号:2013ZYH193);题目:宁夏丙型肝炎分子流行病学调查及干预模式的建立~~

摘　　要：调查2011~2015年中国宁夏银川地区男男性行为人群MSM(Men who have sex with men,MSM)HIV-1感染率和新发感染率的变化趋势,为高危特殊人群干预防治提供科学策略。2011~2015年在银川地区进行MSM哨点监测,调查MSM人群社会人口学信息、性行为情况、艾滋病预防服务覆盖和近1年HIV检测情况等,采用趋势χ2检验进行趋势分析;MSM确证结果为HIV-1阳性样本进行BED检测,计算新发感染率并进行χ2检验。2011~2015年在银川地区每年均调查MSM人群400例,HIV感染率分别为3.8%(95%Cl:2.3%~5.6%)、7.3%(95%CI:5.1%~12.3%)、5.5%(95%Cl:3.5%~8.0%)、6.0%(95%Cl:4.6%~8.6%)和8.3%(95%C1:6.4%~12.6%),未见有上升趋势(P=0.335);梅毒感染率分别为7.0%(95%CI:5.8%~10.2%)、6.3%(95%CI:4.1%~10.0%)、5.5%(95%CI:4.3%~7.9%)、6.8%(95%CI:5.3%~12.9%)和5.0%(95%Cl:4.0%~7.7%),未见有上升趋势(P=0.315);最近6个月与同性发生肛交行为的MSM中,安全套的使用率从2011年的40.8%下降至2015年的11.5%;最近6个月与同性发生商业性行为的比例从2011年的16.0%至2015年的15.0%,而在同性商业性行为中安全套的使用率从85.9%上升至90.0%,最近6个月与异性发生性行为的MSM中,从2011年41.5%至2015年24.3%,呈逐年减少趋势,与异性发现性行为安全套的使用率从38.0%下降至7.2%。2011~2015年新发感染率分别为2.88%(95%CI:0.36%~5.40%)、5.70%(95%CI:2.17%~9.23%)、5.19%(95%CI:1.97%~8.41%)、5.73%(95%CI:2.35%~9.12%)、5.28%(95%CI:2.01%~8.55%),卡方检验显示,P>0.05(χ2=2.478,P=0.629),差异无统计学意义。银川地区MSM人群HIV感染率和新发感染率保持稳定态势;MSM人群存在严重的认知行为分离现象,MSMW人群是艾滋病防治中的重点难点人群。To understand the current status of HIV infection in men who have sex with men （MSM） in Yinchuan, China, explore the associated factors with HIV infection, and provide information for the intervention in MSM. Data collected in the consecutive sentinel surveillances among MSM during 2011- 2015 includes MSM＇s social-demographic information, sexual behavior histories, access to HIV prevention services and HIV testing in the past year. The infection trend was analyzed with χ^2 test and the factors associated with HIV infection were identified through multivariate logistic regression analysis. From 2011 to 2015, a total of 2,000 MSM were surveyed respectively. The HIV infection rates were 3.8% （95%CI： 2.3%-5.6% ）, 7. 3%（95% CI. 5. 1%-12.3%）, 5.5% （95% CI：3.5%-8.0%）, 6.0% （ 95%CI： 4.6%-8. 6%） and 8.3%（95%CI：6.4%-12.6%） respectively, with no increasing trend（P=0. 335）. Syphilis prevalence rates were 7.0%（95%CI. 5. 8%-10. 2%） 6.3%（95%CI：4.1%-10.0%）, 5.5% （95%CI.4.3%-7.9%）, 6.8%（95%CI： 5.3%-12.9%） and 5.0%（95%CI.4.0%-7.7% ）respectively, with no increasing trend （P = 0. 315）. From 2011 to 2015, the percentage of MSM who failed to consistently use condoms for anal sex in the past 6 months decreased from 40. 8% to 11. 5%, the percentage of those having commercial sex with males are from 16.0% in 2011 to 15.0% in 2015, and in the act of civil commercial condom use increased from 85.9% to 90.0%. With opposite sexual behavior among MSM, from 41. 5% in 2011 to 24. 3% in 2015, sex condom utilization rate has decreased from 38.0% to 7.2%. For years 2011, 2012, 2013, 2014 and 2015, the prevalence of recent HIV infection was 2.88% （0.36%-5.40%）, 5.70% （2.17%-9.23%）, 5.19% （1. 97%-8.41%）, 5.73% （2.35%- 9.12%）, and 5.28% （2.01%-8.55%）, and the difference was not significant （ χ^2 = 2. 478, P=0. 629）. The stable situation of HIV infection and high risk sexual behavior in MSM in Yinchuan, There are serious separation phenomenon in the behavior an

关 键 词：艾滋病病毒 HIV-1 男男性行为者 趋势分析 

分 类 号：R373.9[医药卫生—病原生物学]