HIV阳性MSM人群梅毒感染状况及影响因素调查  

Syphilis infection and its influencing factors among HIV positive MSM population

作　　者：刘增艳[1] 王欣心[1] 洪佳佳 段义 史文雅[1] 李彦奇[1] 刘超[1] 田丽娜[1] 任航 谢彧洋[1] 

机构地区：[1]北京市丰台区疾病预防控制中心,北京100071

出　　处：《现代预防医学》2018年第3期520-523,528,共5页Modern Preventive Medicine

摘　　要：目的了解男男性途径的HIV感染者/病人合并梅毒感染的情况,分析其影响因素。方法经知情同意,对2017年1月至4月期间,在北京市某医院内由社区组织随访的男男性途径的HIV感染者/病人进行问卷调查,并采血进行梅毒血浆反应素快速试验(RPR)和梅毒螺旋体明胶颗粒凝集试验(TPPA),分析方法为检验,单因素logistic回归。结果 385例HIV阳性MSM完成问卷调查和血清学检查,RPR和TPPA阳性111例,梅毒感染率为28.8%,其中RPR滴度≥1∶8的梅毒感染者为14.0%(54/385)。报告近3个月有过性行为比例为63.1%(243/385),其中性伴数>2的占32.9%(80/243),37.4%(91/243)近3个月内有过1~5次男男群交性行为,37.9%(92/243)自述近3个月使用过rush。近3个月,发生过肛交性行为(OR=1.66,P=0.037)、性伴数多(OR=1.94,P=0.020)、性行为时无法坚持每次使用安全套(OR=22.14,P<0.001)、最近一次发生肛交性行为时未使用安全套(OR=19.73,P=0.002)是合并梅毒感染的危险因素。结论男男性途径的HIV感染者/病人梅毒感染率较高、高危性行为发生较多。Objective To understand the prevalence of syphilis among HIV infected men who have sex with men （MSM） and to analyze its influencing factors. Methods From January to April 2017, a questionnaire interview with informed consent was conducted on MSM known HIV positive who were followed up by community - based organizations in a hospital in Beijing. Their blood samples were collected for rapid syphilis plasma test （RPR） and treponema pallidum gelatin particle agglutination test （TPPA）. Data were analyzed by chi - square test and univariate logistic regression. Results Among the 385 HIV - positive MSM who completed the questionnaire and serological tests, 111 were positive for RPR and TPPA, with a syphilis infection rate of 28.8% ,and 14.0% （54/385）of those infected with RPR titer ≥ 1： 8. The proportion of sexual behaviors in the past three months was 63.1% （ 243/385 ） , of which 32.9% （ 80/243 ） had sexual partners 〉 2 and 37.4% （91/243） had 1 - 5 times men and men group sex, and 37.9% （92/243）reported rush using in the past three months. In the past three months, anal sex（ OR = 1.66, P = 0.037 ）, multi - sexual partner（ OR = 1.94, P = 0.020） , not sticking to a condom every time when having sex （ OR = 22.14 ,P 〈 0. 001 ） and not using condoms during the last anal sex （ OR = 19.73, P = 0. 002 ） were risk factors for syphilis infection. Conclusion MSM known HIV positive have higher rates of syphilis infection and unsafe sexual behaviors.

关 键 词：艾滋病 男男性行为者 活跃期梅毒 感染率 影响因素 

分 类 号：R195[医药卫生—卫生统计学]