长沙市男男性行为者性病艾滋病综合干预模式研究  

Comprehensive intervention model of sexually transmitted disease and acquired immune-deficiency syndrome in men who have sex with men of Changsha

作　　者：杜方智 郑志菊[1] 张栩 梁国钧[1] 陈祥生[1] 陈曦[2] 贺健梅[2] 郑军[2] 高守芝[2] 李承西 袁瑛 黄敖 王千秋[1] DU Fang-zhi;ZHENG Zhi-ju;ZHANG Xu;LIANC Guo-jun;CHEN Xiang-sheng;CHEN Xi;HE Jian-mei;ZHENG Jun;GAO Shou-zhi;LI Cheng-xi;YUAN Ying;HUANG Ao;WANG Qian-qiu(National Center for Sexually Transmitted Disease Control,Chinese Center for Disease Control and Prevention,Nanjing,Jiangsu Province 210042,China;不详)

机构地区：[1]中国疾病预防控制中心性病控制中心,江苏省南京210042 [2]湖南省疾病预防控制中心性病艾滋病预防控制科 [3]中大阳光工作小组 [4]左岸彩虹工作小组 [5]长沙市第一医院皮肤科

出　　处：《中国慢性病预防与控制》2021年第7期495-498,504,共5页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：中国医学科学院联合创新团队项目(2016-I2M-3021)。

摘　　要：目的探讨长沙市男男性行为人群(men who have sex with men,MSM)中以梅毒和艾滋病筛查及转介为主的性病艾滋病综合干预模式的有效性,为制定提高性病艾滋病干预水平的策略提供依据。方法于2018年10月至2019年6月,委托两个非政府组织(non-governmental organizations,NGOs)应用滚雪球的方法分别招募628和600名MSM,共1 228人,并建立以疾病预防控制中心、性病艾滋病防治协会、NGOs和医疗机构"四位一体"的干预模式。干预内容包括宣传教育,性病艾滋病咨询、检测、转介、诊疗和性伴通知等,其中小组1采用转介单转介方式,小组2采用陪同转介方式。采用SPSS 21.0统计软件进行χ2检验。结果 1 228名MSM年龄中位数为26岁(P25~P75:22~30岁)。艾滋病筛查阳性者101人,转介率为100%,转介成功率为90.1%,感染率为7.4%,治疗率为92.3%;梅毒筛查阳性者83人,转介率为68.7%,转介成功率为91.2%,感染率为6.2%,规范治疗率为96.0%。小组1艾滋病筛查阳性者转介成功率(81.8%)显著低于小组2(100%),差异有统计学意义(P<0.01);小组1未对既往梅毒感染的患者进行转介,转介率(46.9%)显著低于小组2(100%),差异有统计学意义(P<0.01)。小组2采取了陪同转介的方式,梅毒感染患者转介成功率(100%)显著高于小组1(78.3%),差异有统计学意义(P<0.05)。干预后,小组1和小组2招募的MSM近1个月性行为时每次都使用安全套的比例(分别为68.8%,76.2%)均高于干预前(分别为58.5%,38.6%),差异均有统计学意义(P<0.05,P<0.01)。小组1招募的MSM梅毒预防知识知晓率干预前后比较(分别为90.3%、94.7%),差异无统计学意义(P>0.05)。干预后,小组2招募的MSM梅毒预防知识知晓率(96.7%)高于干预前(41.0%),差异有统计学意义(P<0.01)。结论 "四位一体"以性病艾滋病筛查和转介为主的干预模式有效提高了MSM性病的干预水平,同时也促进了艾滋病的干预,有进一步推广的价值。Objective To explore the effectivity of comprehensive intervention model on sexually transmitted disease(STD)and acquired immune-deficiency syndrome(AIDS) in men who have sex with men(MSM) based on the screening and referral of Human Immuno-deficiency Virus(HIV) and syphilis in Changsha,and to provide the basis for developing strategies of improving the intervention level of AIDS. Methods From October 2018 to June 2019,two non-governmental organizations(NGOs) were commissioned to recruit 1 228 MSM by snowball sampling method,and the intervention model of "four in one" was established based on Center for Disease Control and Prevention(CDC),Association of STD & AIDS Prevention and Control(AIH),NGOs and medical institutions. The intervention content included the publicity and education,consultation of AIDS,HIV and syphilis tests,referral,treatment and sexual partner notification,etc. Group 1 only adopted the referral form,while group 2 adopted the escort referral. The χ2 test was used to analyze the data,the used software was SPSS 21.0. Results A total of 1 228 MSM(median age:26 years old,P25-P75:22-30 years old) were recruited. The screening results indicated 101 cases with positive HIV,the referral rate was 100%,the referral success rate was 90.1%,the infectious rate was 7.4%,the treatment rate was 92.3%;the syphilis screening results indicated 83 cases with syphilis,the referral rate was 68.7%,the referral success rate was 91.2%,the infectious rate was6.2%,the recommended treatment rate was 96.0%. The referral success rate of HIV-positive patients in group 1 was 81.8%,which was significantly lower than that(100%) in group 2,P<0.01;patients with history of syphilis infection were not be referred in group 1,the referred rate was 46.9%,which was significantly lower than that(100%) in group 2,P<0.01. The escort referral form in group 2 was used,the referral success rate(100%) of patients with syphilis in group 2 was significantly higher than that(78.3%)in group 1,P<0.05. After intervention, the proportion(68.8% and

关 键 词：梅毒 艾滋病 男男性行为者 筛查 转介 

分 类 号：R512.91[医药卫生—内科学]