北京市男男性行为者"互联网+"干血斑HIV核酸检测可行性及HIV感染危险因素研究  

Feasibility on the Internet-based HIV nucleic acid testing with dry blood spots and risk factors associated with HIV infection in men having sex with men in Beijing

作　　者：夏冬艳[1] 陈凯[2] 苏雪丽[1] 王月华 刘国武[1] 郝尹虓[1] 王娟[1] 陈婧[1] 李桂英[1] 蒋岩[2] 卢红艳[1] Xia Dongyan;Chen Kai;Su Xueli;Wang Yuehua;Liu Guowu;Hao Yinxiao;Wang Juan;Chen Jing;Li Guiying;Jiang Yan;Lu Hongyan(Beijing Center for Diseases Prevention and Control,Beijing Research Center for Preventive Medicine,Beijing 100013,China;Chinese Center for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]北京市疾病预防控制中心,北京市预防医学研究中心,100013 [2]中国疾病预防控制中心,北京102206

出　　处：《中华流行病学杂志》2020年第6期913-918,共6页Chinese Journal of Epidemiology

基　　金：北京市科学技术委员会资助课题研究(D17110700670000)。

摘　　要：目的应用"互联网+"干血斑HIV核酸检测策略了解MSM的HIV核酸阳性率及MSM感染HIV的影响因素。方法采用方便抽样的方法招募1375位MSM,采集干血斑样本并邮寄到实验室进行HIV核酸检测。调查对象凭检测条码到指定网站查询检测结果。采用非条件logistic回归分析MSM感染HIV的影响因素。结果MSM中新发现HIV感染者的HIV核酸阳性率为9.7%(131/1349),HIV抗体阳性率为8.3%(112/1349)。HIV早期感染者占新发现的HIV核酸阳性者的14.5%(19/131),检测核酸阳性距最后1次高危行为时间间隔为6~120 d。多因素logistic回归分析结果显示,MSM感染HIV的影响因素包括30~39岁(与<30岁者比较,OR=1.88,95%CI:1.07~3.29)、月收入≥8000元(与无收入者比较,OR=0.42,95%CI:0.19~0.96)、最近6个月肛交行为中未坚持使用安全套(与最近6个月未发生肛交行为或肛交时坚持使用安全套者相比,OR=2.22,95%CI:1.45~3.40)、使用过Rush Poppers(与未使用过Rush Poppers者相比,OR=2.33,95%CI:1.49~3.64)、使用过毒品(与未使用过毒品者相比,OR=5.43,95%CI:2.32~12.69)、没有固定性伴(与有固定性伴者相比,OR=1.74,95%CI:1.13~2.68)。结论北京市MSM的早期感染者占有较大比例,开展"互联网+"干血斑HIV核酸检测能够在更短的时间内发现早期HIV感染者,有助于减少二代传播。有必要在MSM中开展禁毒、禁用Rush Poppers、推广使用安全套、倡导稳定性关系等措施。Objectives To understand the prevalence of HIV nucleic acid using internet-based dry blood spots HIV testing strategy in men who had sex with men(MSM)and to probe the factors associated with HIV infection.Methods Using convenient sampling method,1375 MSM were recruited and their dry blood spots samples were collected before being mailed to the laboratories for HIV nucleic acid testing.Results were showed to these MSM on a specific website by inputting their codes to it.Non-conditional binary logistic regression method was used to identify the associated factors on HIV infection.Results The overall proportions of HIV nucleic acid positives appeared as 9.7%(131/1349)and HIV antibody positives as 8.3%(112/1349).Fresh infections accounted for 14.5%(19/131)among the newly-identified HIV nucleic acid positives,and the interval was ranging from 6 to 120 days,between the laboratory testings and the closest date that experiencing high risk behavior.Risk factors that related to HIV infection would include:30 to 39 years of age(comparing to those under the age of 30,OR=1.88,95%CI:1.07-3.29),≥8000 Yuan of monthly income(comparing to those without income,OR=0.42,95%CI:0.19-0.96),inconsistent condom use during anal sexual contacts in the last six months(compared with those who had not anal sex or used condoms consistently in anal sex in the past six months,OR=2.22,95%CI:1.45-3.40),ever use of Rush Poppers(compared with those who never used Rush Poppers,OR=2.33,95%CI:1.49-3.64),addictive drug abuse(compared with those who never abused addictive drugs,OR=5.43,95%CI:2.32-12.69),and not having regular sexual partners(compared with having regular sexual partners,OR=1.74,95%CI:1.13-2.68)etc..Conclusions Dry blood spots HIV nucleic acid testing could help to identify the fresh HIV infections at an early stage,so as to prevent further transmission in the MSM population,among which fresh HIV infections accounted for a fairly large proportion.It is necessary to set up programs in reducing the abuse of drugs or Rush Poppers,and to prom

关 键 词：男男性行为者 HIV感染 干血斑 "互联网+"HIV检测 危险因素 

分 类 号：R512.91[医药卫生—内科学] R440[医药卫生—临床医学]