364例男男同性恋者的梅毒筛查结果分析:基于线上测评和血清检测  

Analysis of serum syphilis screening results of 364 MSM patients:Based on the results of serum test and mobile app

作　　者：叶兴东[1] 杨韵青 何婉苹[1] 宁德锋 钟雪莲 戴向农[1] 罗权 YE Xingdong;YANG Yunqing;HE Wanping;NING Defeng;ZHONG Xuelian;DAI Xiangnong;LUO Quan(Guangzhou Institute of Dermatology,Guangzhou 510095,China)

机构地区：[1]广州市皮肤病防治所,广东广州510095

出　　处：《皮肤性病诊疗学杂志》2023年第5期422-427,共6页Journal of Diagnosis and Therapy on Dermato-venereology

基　　金：广州市科技攻关项目(20130000166);广州市医药卫生科技重大项目(20121A031001);广州市总工会劳模与工匠人才创新工作室项目。

摘　　要：目的调查广州地区男男同性恋者(MSM)的梅毒感染率现况及危险因素。方法设计风险自测问卷,开发“羊城医访”小程序,通过社交平台募集MSM到自愿咨询检测门诊(VCT)扫码填写问卷并提交,依据问卷评估输出梅毒感染高中低风险三种结果,在线通过“广州健康通”就近推荐到性病防治专科机构或综合性医院就诊,进行梅毒和HIV筛查并反馈结果,系统后台导出调查对象的问卷进行分析。结果通过小程序共测评364例MSM,梅毒感染风险测评结果为低风险者占6.04%(22/364),中风险占81.32%(296/364),高风险占12.64%(46/364);梅毒总阳性率为9.07%(33/364),HIV总阳性率为3.02%(11/364)。中、高风险人群梅毒阳性率分别为9.12%和13.04%,但两者间差异无统计学意义(χ^(2)=0.33,P=0.569)。偶尔或从不使用、经常使用安全套的风险等级高于每次使用者(χ^(2)=7.06,P=0.030)。性伴有梅毒感染者的风险等级高于性伴无梅毒感染病史者(χ^(2)=36.27,P<0.001)。结论广州地区MSM人群梅毒感染率仍然较高。通过风险测评线上就近转介挂号,线下筛查更有助于该人群梅毒精准防控。Objective To investigate the prevalence and risk factors of syphilis in MSM patients in Guangzhou.Methods Yang Cheng Yi Fang smart application integrated a set of assessment questionnaire for syphilis infection risk was developed for MSM to self-evaluate the risk of syphilis at voluntary counseling and testing(VCT)clinic in the study.The syphilis risk is classified into high-,middle-and low-risk levels.Subjects with middle to high risk were automatically referred to a STD prevention institution or general hospital for further screen for syphilis and HIV.The individuals′test results and their respective questionnaire were analyzed.Results Among the 364 evaluated MSM individuals,individuals at low-,middle-and high-risk accounted for 6.04%(22/364),81.32%(296/364)and 12.64%(46/364),respectively.The positive rates of syphilis and HIV were 9.07%(33/364)and 3.02%(11/364),respectively.The positive rates of syphilis did not differ significantly between middle-and high-risk groups(9.12%vs 13.04%,2=0.33,P=0.569).The risk of syphilis was higher in individuals who occasionally or never or often used condom than in those who always used condom(χ^(2)=7.06,P=0.030).Moreover,the risk of syphilis was higher in subjects whose sexual partner had syphilis than in those whose sexual partner did not have syphilis(χ^(2)=36.27,P<0.001).Conclusions The rate of syphilis infections is higher in MSM individuals in Guangzhou.Online assessment of the risk of syphilis infections and referral,followed by serum test can be helpful to precisely prevent and control syphilis infections in MSM individuals.

关 键 词：梅毒 电子健康技术 小程序 羊城医访 男男同性恋 

分 类 号：R512.91[医药卫生—内科学]