自报异性性传播HIV感染者中男男性行为人群特征及抑郁症状相关因素分析  

Characteristics and depressive symptoms among self-reported HIV infection through heterosexual transmission men who have sex with men

作　　者：朱晓艳[1] 王国永[1] 廖玫珍[1] 李亚君 张娜[1] 李玲 杨兴光[1] 黄鹏翔[1] 黄涛[1] 康殿民[1] Zhu Xiaoyan;Wang Guoyong;Liao Meizhen;Li Yajun;Zhang Na;Li Ling;Yang Xingguang;Huang Pengxiang;Huang Tao;Kang Dianmin(Department of AIDS Control and Prevention,Shandong Center for Disease Control and Prevention,Ji'nan 250014,China)

机构地区：[1]山东省疾病预防控制中心艾滋病防制所,济南250014

出　　处：《中华流行病学杂志》2022年第10期1639-1644,共6页Chinese Journal of Epidemiology

基　　金：山东省医药卫生科技发展计划(2019WS427,2019WS430,2019WS438);山东省人文社会科学课题(2021-ZXJK-18)。

摘　　要：目的分析自报异性性传播HIV感染者中MSM特征及抑郁症状相关因素,为HIV感染者实施个性化管理提供参考依据。方法采用横断面调查设计,2019年9-12月在山东省济南市、青岛市、潍坊市和临沂市选取≥15岁、自报异性性传播的男性HIV感染者作为研究对象,通过一对一访谈核实其感染途径,对核实后实际为MSM,按照1∶1匹配在当地选择年龄范围差≤3岁、自报为男男性行为传播的HIV感染者作为对照组,开展问卷调查,内容包括人口学及行为特征、流行病学调查中心抑郁量表(CES-D)、领悟社会支持量表(PSSS),分析其特征和抑郁症状的相关因素。结果自报感染途径为异性性传播的男性HIV感染者373例中,复核后实际为男男性行为传播的占39.7%(148/373),年龄(40.3±12.0)岁,已婚/同居占41.9%(62/148),确证HIV前做过检测占27.0%(40/148),同性性伴数≥2人占71.6%(106/148),有抑郁症状的占55.4%(82/148)。多因素分析结果显示,在自报异性性传播HIV感染者的MSM中,确证前未做过HIV检测、确证前同性性伴数≥2人、首次发生同性性行为年龄>30岁和有抑郁症状者,更有可能隐瞒真实的感染途径;抑郁症状与身体健康状况、社会支持情况和职业状况稳定的因素相关。结论在自报异性性传播的男性HIV感染者中,有一定比例实际为男男性行为传播的感染途径,并存在多性伴及双性性行为的高危行为,抑郁症状的比例较高。需加强随访的感染途径复核,开展针对性的心理和行为干预。Objective To understand the characteristics and depressive status of men who have sex with men(MSM)who self-reported HIV infection through heterosexual transmission and to provide evidence for personalized management of HIV infected people.Methods A cross-sectional survey was carried out in Shandong province from September to December in 2019.Male HIV patients aged≥15 years who self-reported HIV infection through heterosexual transmission were selected to verify the route of infection by one-to-one interview in Ji'nan,Qingdao Weifang and Linyi cities of Shangdong province.According to the 1∶1 ratio,local HIV patients with age difference≤3 years who self-reported MSM were selected as controls.A questionnaire survey was conducted,including data on demographic characteristics,behavior status,CES-D and PSSS.The related factors of the depressive symptoms and characteristics were analyzed.Results A total of 373 male HIV patients were interviewed,and 39.7%(148/373)were confirmed as MSM after reexamination.The interviewers were:aged(40.3±12.0)years old,41.9%(62/148)married/cohabiting.27.0%(40/148)had been tested before HIV diagnosis,71.6%(106/148)had homosexual partners≥2 and 55.4%(82/148)had depressive symptom.Multivariate analysis showed that the MSM without HIV testings before diagnosis,had homosexual partners≥2 before diagnosis,had first homosexual behavior at the age>30 years old and with depressive symptoms were more likely to conceal the true infection route.The incidence of depression among MSM who self-reported HIV infection through heterosexual transmission was related to physical health status social support and occupational stability.Conclusions Some male HIV persons self-reported as being heterosexually transmitted were really transmitted through homosexual behavior.There were high-risk behaviors such as multiple partners and intersex among this group,and with high incidence of depression.It is necessary to encourage the reexamination program during follow-up and target on psychological and behavi

关 键 词：艾滋病病毒 男男性行为者 感染途径 抑郁 

分 类 号：R512.91[医药卫生—内科学] R181.3[医药卫生—临床医学] R749.4