江苏省跨性别女性人群危险行为特征和HIV检测影响因素分析  

Characteristics of risk behaviors and analysis of the correlates with HIV testing among transgender women in Jiangsu province

作　　者：肖文静 闫红静[2] 陈莉萍[2] 陈沄渟 傅更锋[2] 羊海涛[1,3] XIAO Wenjing;YAN Hongjing;CHEN Liping;CHEN Yunting;FU Gengfeng;YANG Haitao(School of Public Health,Nanjing Medical University,Nanjing 211166,China;Jiangsu Provincial Center for Disease Control and Prevention,Nanjing210009;Jiangsu Institute of Parasitic Diseases,Wuxi 214064)

机构地区：[1]南京医科大学公共卫生学院,南京211166 [2]江苏省疾病预防控制中心,南京210009 [3]江苏省血吸虫病防治研究所,江苏无锡214064

出　　处：《中国艾滋病性病》2020年第4期381-385,415,共6页Chinese Journal of Aids & STD

基　　金：美国国立卫生研究院项目(NIH:1R01MD010678-01)。

摘　　要：目的了解江苏省跨性别女性人群(MTF)危险行为特征、艾滋病病毒(HIV)检测率及其影响因素,为相关干预的实施提供依据。方法采用同伴推动抽样法(RDS)在江苏省内招募MTF,用匿名自填问卷收集社会人口学、行为学以及心理健康等方面信息,并采集指尖血进行HIV和梅毒快速检测。结果共招募符合条件MTF250人,44.00%年龄分布在18~24岁,高中及以下学历占36.80%;47.60%报告服用过激素,18.00%接受过性别重塑手术,34.40%曾被诊断患有抑郁症;调查对象20.80%自述曾从事过性工作;过去一年在与他人发生性行为时或性行为之前饮酒率和毒品使用率分别为37.60%和4.00%;最近6个月多性伴数(≥2个)占35.60%,性行为中无保护性肛交和阴道交发生率为25.60%和5.20%;调查样本HIV感染者占比为14.80%;去除一年前已知HIV阳性者,最近一年HIV检测率为51.72%(120/232),检测阳性者37例,均确诊为阳性。多因素分析显示,从事过性工作[调整比值比(AOR)=2.36, 95%可信区间(CI):1.02~5.46]、未服用激素(AOR=2.34, 95%CI:1.24~4.41)、未患有抑郁症(AOR=2.10, 95%CI:1.11~4.02)是促进MTF最近一年接受HIV检测的影响因素。结论首次在江苏省开展针对MTF人群的调查,显示跨性别女性人群具有感染HIV高风险但较低HIV检测率特征,亟需采取有效干预措施控制艾滋病在该人群中的流行。Objective To understand the characteristics of risk behaviors, HIV testing rate and influencing factors of transgender women(male-to-female, MTF) in Jiangsu province, and provide a theoretical basis for implementation of intervention measures. Methods Transgender women were recruited by respondent driven sampling method. Anonymous self-reported questionnaires were used to collect information on the social demography, behaviors and mental health, and fingertip blood was collected for rapid testing of HIV and syphilis. Results Among the 250 eligible MTF recruited, 44.00% were aged between 18-24 years, and 36.80% had high school education or below. 47.60% were reported taking hormones and 18.00% underwent gender confirmation surgery. 34.40% had been diagnosed depression, and 20.80% engaged in sex work. The rate of alcohol consumption and drug use before or during sexual intercourse were 37.60% and 4.00%, respectively over the past year. 35.60% had 2 or more sexual partners;25.60% had anal sex and 5.20% had vaginal sex without condom use in the last 6 months. HIV infections accounted for 14.80%. Apart from those diagnosed HIV positive one year ago, among 232 MTF with HIV negative or unknown status of HIV infection, the HIV test rate in the last year was 51.72%(120/232)and 37 HIV positive cases were confirmed. Multivariate analysis showed that having sex work(AOR=2.46, 95% CI:1.08,5.61), no hormones taken(AOR =2.43,95% CI :1.30,4.54) and no depression(AOR =2.10,95% CI :1.05,4.20) were influence factors for HIV testing among MTF in the last year. Conclusion The first investigation of MTF in Jiangsu indicates that MTF bear a high risk of HIV infection but a low HIV detection rate. It is urgent to take effective measures to control the HIV epidemic in this population.

关 键 词：跨性别女性 危险行为 艾滋病病毒检测 影响因素 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]