南宁市男男性行为者HIV感染确诊前后性行为变化及其影响因素分析  

Change of Risky Sexual Behaviors and Influencing Factors Before and After HIV Diagnosis Among HIV-Infected Men Who Have Sex with Men in Nanning City

作　　者：岑平[1] 徐红[1] 刘君辉 孙恒[1] 邓小芳[1] 钟永泉 刘楠楠[1] CEN Ping;XU Hong;LIU Junhui;SUN Heng;DENG Xiaofang;ZHONG Yongquan;LIU Nannan(Nanning Center for Disease Control and Prevention,Nanning 530021,China)

机构地区：[1]南宁市疾病预防控制中心,广西南宁530021

出　　处：《中国皮肤性病学杂志》2020年第6期659-664,共6页The Chinese Journal of Dermatovenereology

基　　金：广西自然科学基金(2018GXNSFBA281047)。

摘　　要：目的了解南宁市男男性行为人群(MSM)艾滋病病毒(HIV)感染者/患者确诊前后与固定同性性伴发生性行为的变化特征及其影响因素。方法 2016年5月-12月间匿名调查的124例HIV阳性MSM病例作为研究对象,对其调查结果进行分析。结果 124例研究对象平均年龄(28.40±9.90)岁,以未婚(72.58%)、汉族(61.29%)、大专及以上学历(50.81%)为主,78.23%通过互联网寻找同性伴侣;确诊前与固定同性性伴的安全套坚持使用率仅为17.31%,而确诊后与固定同性性伴的无保护性行为均减少(P<0.001),且固定同性性伴数减少(P<0.001)。固定同性性伴为阳性的比例分别从确诊前的24.04%上升到50.85%。多因素Logistic回归分析显示,确诊HIV阳性后发生无保护性行为的危险因素有:确诊前与固定同性性伴是否发生无保护性行为(OR=2.906,95%CI:1.675~5.962,P=0.017)、确诊后固定同性性伴数(OR=1.511,95%CI:1.232~1.978,P=0.014)。结论 MSM人群HIV感染者在确诊后无保护性肛交和多性伴性行为明显减少,但部分仍保持高危性行为,应进一步开展扩大检测和抗病毒治疗等干预措施,尽早发现感染者,控制HIV在该人群中的流行及"二代传播"。Objective To investigate the characteristics of changes in sexual behavior before and after HIV diagnosis among HIV-infected men who have sex with men(MSM) in Nanning city,and to study the factors predicting sexual risk behaviors after diagnosis.Methods The HIV-positive MSM cases were anonymously investigated as subjects from May 2016 to December 2016 in Nanning and the results of the surrey were analyzed.Results Among 124 HIV-infected MSM surveyed,the average age was(28.4±9.9) years.Most were unmarried(72.58%),ethnically Han(61.29%),had college degree or above(50.81%).78.23% searched for male sex partners via the internet.Before diagnosis,the proportion of unprotected sex for the MSM with fixed male partner was 17.31%.After diagnosis,the proportion of unprotected sex(P<0.001) and multiple sexual partners(P<0.001) were significant decreased.The proportion of MSM who had HIV-positive male partners rose from 24.04% before diagnosis to 50.85% after diagnosis.Multivariate logistic regression analysis revealed that the risk factors for unprotected sex after the diagnosis of HIV included presence or absence of unprotected sex with fixed sex partner before diagnosis(OR=2.906,95%CI:1.675~5.962,P=0.017) and multiple sexual partners after diagnosis(OR=1.511,95%CI:1.232~1.978,P=0.014).Conclusion After diagnosis,HIV-infected MSM reduce their high-risk anal sexual behaviors and few has multiple sexual partners,but some continued to practice sexual risk behaviors.It is urgent to expand HIV testing and early ART,to detect the infected people as early as possible and control the prevalence of HIV/AIDS and "secondary HIV transmission" among the population.

关 键 词：男男同性行为者(MSM) HIV 性行为 

分 类 号：R512.91[医药卫生—内科学]