福州市应用自我评估和自我检测平台对男男同性性行为人群开展HIV检测的调查研究  

Survey on the application of self-assessment and self-testing platform for HIV testing among men who have sex with men population in Fuzhou

作　　者：张宏[1,2] 陈剑惠 许绍溢[1,2] 林春仲 薛洪洪[3] 何鼎盛 陈传刚 刘梅艳 ZHANG Hong;CHEN Jianhui;XU Shaoyi;LIN Chunzhong;XUE Honghong;HE Dingsheng;CHEN Chuangang;LIU Meiyan(Fuzhou Center for Disease Control and Prevention,Fuzhou,Fujian 350004,China;不详)

机构地区：[1]福州市疾病预防控制中心,福建福州35000 [2]福建医科大学公共卫生学院 [3]福建省性病艾滋病防治志愿者协会

出　　处：《中国预防医学杂志》2023年第5期414-419,共6页Chinese Preventive Medicine

基　　金：2021—2022年社会组织参与艾滋病防治基金项目(2021-2022350100NGOMSM944087);福建省卫生健康委员会科技计划项目-医学创新课题(2021CXA044);福建省卫生健康委员会科技计划项目-医学创新课题(2019-cx-9);福州科技局社会发展项目-医疗项目(2020-ws-115)。

摘　　要：目的 调查男男同性性行为人群(men who have sex with men,MSM)应用自我评估和自我检测平台开展人类免疫缺陷病毒(human immunodeficiency virus,HIV)检测情况,为指导福州市开展MSM艾滋病防治提供科学依据。方法 2021年6—12月通过自检平台开展福州市MSM自我评估和HIV自我检测。采用单因素和多因素logistic回归对影响参与对象使用HIV自检试剂和HIV感染的相关因素进行分析。结果共纳入MSM3 191人,风险评估低风险组、中风险组、高风险组、极高风险组分别占16.20%(517/3 191)、45.91%(1 465/3 191)、23.22%(741/3 191)、14.67%(468/3 191);暴露前预防评估需要进行暴露前预防预警占59.14%(1 887/3 191);暴露后预防评估需要进行暴露后预防占21.15%(675/3 191)。参与自检比例为51.36%(1 639/3 191),自检并回传结果比例为93.23%(1 528/1 639),自检阳性率为2.09%(32/1 528),且随不同评估风险等级呈现上升趋势(χ^(2)_(趋势)=5.636,P=0.018)。HIV自检多因素logistic回归分析:大专及以上学历是初中及以下的1.35倍(95%CI:1.03~1.77);省外户籍是本省户籍的0.68倍(95%CI:0.57~0.79);本地居住时间1~2年、>2年分别是本地居住时间0~<1年的1.49倍(95%CI:1.15~1.93)、1.50倍(95%CI:1.28~1.76);第一次性行为年龄>18岁是≤18岁的1.66倍(95%CI:1.42~1.94);既往接受HIV检测是未检测的1.63倍(95%CI:1.40~1.88);知晓艾滋病知识是不知晓的1.37倍(95%CI:1.10~1.70)。HIV自检阳性多因素logistic回归分析发现,≥25岁是<25岁的2.66倍(95%CI:1.20~5.80);作为被插入方是非插入方的3.45倍(95%CI:1.50~7.93)、最近一周发生肛交是未发生的2.70倍(95%CI:1.24~5.89)、既往接受HIV检测是未检测的0.44倍(95%CI:0.22~0.90)。结论 福州市HIV自我评估和自我检测平台在保护MSM隐私的同时,有助于及时发现MSM危险因素,扩大HIV检测覆盖面,对MSM群体艾滋病防控有重要意义。Objective To analyze the status quo of self-testing using self-assessment and self-testing platform among different men who have sex with men(MSM) populations, so as to provide scientific evidence for guiding prevention and treatment of human immunodeficiency virus(HIV) infection in MSM population in Fuzhou.Methods MSM population assessment and HIV testing were conducted through the self-testing platform from June to December 2021 in Fuzhou. Univariable and multivariable logistic regression were used to analyze the correlates of the use of HIV self-testing reagents and HIV infection among the participants. Result A total of 3 191 MSM were included, of whom the low-, medium-, high-and very-high-risk groups accounted for 16. 20%(517/3 191), 45. 91%(1 465/3 191), 23. 22%(741/3 191) and 14. 67%(468/3 191), respectively;59. 14%(1 887/3 191) were assessed as needing pre-exposure prophylaxis warning, and 21. 15%(675/3 191)assessed as needing post-exposure prophylaxis. The proportion of participants who used self-testing was 51. 36%(1 639/3 191), of whom 93. 23%(1 528/1 639) submitted the results, and 2. 09%(32/1528) of the submitted results were positive. The proportion of positive self-testing results showed an increasing trend along with the assessed risk levels(χ^(2)_(trend)=5. 636, P=0. 018). Multivariable logistic regression showed that having educational level of college degree or above versus junior high school or below(a OR=1. 35, 95%CI: 1. 03-1. 77), living in Fuzhou for 1-2 years and more than 2 years versus less than 1 year(a OR=1. 49, 95%CI: 1. 15-1. 93, a OR=1. 50, 95%CI: 1. 28-1. 76), the age at first sexual intercourse being >18 years versus ≤ 18 years(a OR=1. 66, 95%CI: 1. 42-1. 94), having received HIV testing before(a OR=1. 63, 95%CI: 1. 40-1. 88), and having knowledge of prevention and control of acquired immunodeficiency syndrome(AIDS)(a OR=1. 37,95%CI: 1. 40-1. 88) were associated with higher odds of using HIV self-testing, whilst having a registered residence outside Fujian versus a residence in

关 键 词：男男同性性行为人群 艾滋病 自我评估 自我检测 感染因素 

分 类 号：R512.91[医药卫生—内科学]