上海市男男性行为者知情交友的实施度及其与HIV感染的关系  

Prevalence of serosorting and HIV infection among MSM in Shanghai

作　　者：刘春馨 张泽彧 岳清[1] 傅洁[1] 郑煌 赵朝龙 宁镇[1] LIU Chunxin;ZHANG Zeyu;YUE Qing;FU Jie;ZHENG Huang;ZHAO Chaolong;NING Zhen(Shanghai municipal center for disease control and prevention,Shanghai 200336,China;Shanghai CSW&MSM Center,Shanghai 200023)

机构地区：[1]上海市疾病预防控制中心,上海200336 [2]上海心生,上海200023

出　　处：《中国艾滋病性病》2022年第1期82-86,共5页Chinese Journal of Aids & STD

基　　金：上海市卫生和计划生育委员会科研课题(20174Y0216)。

摘　　要：目的了解上海市MSM知情交友策略的实施度及其HIV感染情况,为是否在上海市MSM中普及知情交友措施提供参考依据。方法采用横断面调查,对2019年3-8月在艾滋病咨询检测点进行HIV咨询检测的MSM展开问卷调查。根据研究对象自述近3个月的性行为和安全套使用判断其对知情交友策略的实施情况,将仅与低HIV传播风险者(确定已过窗口期的HIV阴性者、正在使用暴露前预防的HIV阴性者或抗病毒治疗成功的HIV阳性者)发生过无套肛交(CAI)的MSM定义为"知情交友实施者",将曾与高HIV传播风险者(未治疗成功或不清楚治疗状态的HIV阳性者、未过或不确定是否已过窗口期的HIV阴性者、不确定HIV感染状态者)发生过CAI的MSM定义为"高危CAI者",比较知情交友实施者、高危CAI者和每次都用安全套者几类MSM的HIV感染率,并比较在性行为前了解、告知彼此的HIV感染状况的MSM的HIV感染率。结果共调查542名此前从未被确证为HIV感染者的MSM,知情交友实施率为16.05%。451名(83.21%)MSM最近3个月发生过同性肛交,其中知情交友实施者、高危CAI者、每次都用安全套者的占比分别为19.29%、30.16%、50.55%。相比于知情交友实施者,高危CAI者被新确证为HIV感染的概率显著较高(aOR=3.74,95%CI:1.04~13.41)。经常在发生性行为前了解性伴的HIV感染状态的MSM的HIV感染概率相对较低(aOR=0.18,95%CI:0.06~0.57)。结论上海市MSM中的知情交友实施率较低,如果能在发生性行为前了解双方近期的、有效的HIV检测结果以及药物预防措施采用情况并据此采取HIV感染保护措施,此种类型的知情交友可能会降低HIV感染风险,可尝试在上海MSM社区中试点,并展开队列研究进一步论证。Objective To understand the prevalence of serosorting and HIV infection among MSM who had never been confirmed as HIV infectors in Shanghai and provide evidence for serosorting generalization in Shanghai MSM.Methods A cross-sectional study was conducted among MSM who sought HIV counseling and testing service in Shanghai Municipal Center for Disease Control and Prevention from March to August 2019 by questionnaire.The conception of"Pre-Exposure prophylaxis"(PrEP)and"Undetectable=Untransmittable"(U=U)was combined into the concept of"serosorting."The prevalence of serosorting was evaluated according to the self-reported sexual behaviors and condom use in the past three months."Serosortor"was identified as MSM who limited their condomless anal sexual partners to men with low HIV transmission risk(HIV negative MSM had passed window period,or HIV negative MSM using pre-exposure prophylaxis,or HIV positive MSM had received successful antiretroviral treatment)."MSM had risky condomless anal sex"was identified as MSM who had condomless anal sex with men of high HIV transmission risk(HIV positive MSM without successful antiretroviral treatment,or HIV negative MSM had not passed the window period or MSM with uncertain HIV status).We also compared the HIV prevalence among the following three subpopulations:the serosortors,MSM had risky condomless anal sex,and MSM who used condoms on every anal sex and analyzed the HIV prevalence of learning and informing bilateral HIV status before homosexual sex among MSM.Results 542 MSM who have never been confirmed as HIV infectors were recruited,and the prevalence of serosorting is 16.05%.451(83.21%)MSM had homosexual anal sex in the last three months.The proportions of serosortors,MSM had risky condomless anal sex,and MSM who use the condom in every anal sex were 19.29%,30.16%,and 50.55%,respectively.Compared with serosortors,the MSM who had risky condomless anal sex were more likely to be newly confirmed as HIV infectors(aOR=3.74,95%CI:1.04~13.41).Despite the subsequent sexual behavior

关 键 词：知情交友 男男性行为者 艾滋病 艾滋病病毒检测 暴露前预防 

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