HIV阳性男男性行为者对偶然或商业性伴的传播危险分析  

Risks of HIV transmission to casual or commercial sexual partners and its correlates by HIV-positive MSM engaged in unprotected sex

作　　者：刘乃鹏[1] 张月[1] 王晓冬 周易 肖剑 刘晓宇[1] 王威[1] 朱晓芳 赵越 张洪波[1] 

机构地区：[1]安徽医科大学公共卫生学院流行病与卫生统计学系,合肥230032 [2]成都同乐健康咨询服务中心,成都610000 [3]上海美丽人生健康服务中心,上海200000 [4]上海爱的家园互助小组,上海200000

出　　处：《中国艾滋病性病》2018年第2期159-163,共5页Chinese Journal of Aids & STD

基　　金：中国全球基金艾滋病项目(CSO-2012-研-26)~~

摘　　要：目的了解艾滋病病毒（HIV）阳性男男性行为者（MSM）对偶然或商业性伴的传播危险,并探讨与其传播危险相关联的因素,为发展控制HIV在MSM中的继续传播的干预方法提供依据。方法采用滚雪球方法,在上海和成都市招募有高危性行为的HIV阳性MSM作为研究对象。以匿名方式进行一对一问卷调查,调查内容包括调查对象的社会人口学特征、性行为状况、CD4~＋T淋巴细胞（简称CD4细胞）计数、HIV病毒载量和物质使用等。结果共招募308名调查对象,最近6个月中,对偶然或商业性伴有性传播危险者（即：未接受抗病毒治疗者,或接受抗病毒治疗者体内HIV病毒载量≥50拷贝/mL者）占29.55%（91人）。非条体Logis.tic回归分析发现,感染HIV时间在1年以内的调查对象,其传播危险是感染HIV时间≥3年者的7.60倍;拥有HIV阴性或未知感染状况男性固定性伴者的传播危险,是没有此类性伴者的7.83倍;CD4细胞数在350~499个/μL和500个/μL及以上的调查对象,其传播危险是CD4细胞数〈350个/μL者的2.29倍和9.58倍。结论拥有无保护性行为的HIV阳性MSM中,对偶然或商业性伴的传播危险普遍存在,且高于一般人群。故该人群需要强化早发现和早治疗及性伴告知策略和措施,切实降低该人群继续传播危险。Objective To understand the risks of HIV transmission to casual or commercial partners among HIV-positive MSM engaged in unprotected sex and to determine the related factors for HIV transmission intervention.Methods Participants were recruited by MSM community-based organizations with ＂snowball＂sampling in Shanghai and Chengdu,China.The survey was conducted on face-to-face by well trained staff in a confidential room.Participants completed questionnaires anonymously to collect the information on demographics,sexual behaviors,viral load,CD4 cell count,substance use,et al.Results Of 308 participants,29.55% （91）had risks of HIV transmission（defined as HIV-positive MSM without receiving ART,or with ART but viral load〉50 copies/mL）to their casual or commercial sexual partners.Multivariate logistic analysis showed that the risks of HIV transmission was high among the participants diagnosed as HIV infection within 1 year,7.60 times of those diagnosed as HIV infection in 1-3 years.Participants who had HIV negative or unknown status male regular partners were more likely to have risks of HIV transmission to their casual or commercial partners（OR=7.83）.Participants with CD4 cell counts〉350/μL were less likely to have risks of HIV transmission to their casual or commercial partners than those with CD4 cell counts〈350/μL.Conclusion It is common that HIV-positive MSM have unprotected sexual behavior with casual or commercial partners.And the risks of transmission of HIV-positive MSM are higher than that of the general population.So HIV testing should be expanded among MSM,and ART for MSM diagnosed as HIV-infection should be early initiated,and sexual partner notification should be strengthened.

关 键 词：艾滋病病毒 性传播 男男性行为者 影响因素 

分 类 号：R512.91[医药卫生—内科学]