不同性角色MSM的HIV感染风险研究  

HIV infection risk of men who have sex with men with different sex roles

作　　者：徐冰钰 阿力亚·阿迪力努尔 何倩[1] 李月飞 倪明健[2] XU Bingyu;Aliya Adilinuer;HE Qian;LI Yuefei;NI Mingjian(School of Public Health,Xinjiang Medical University,Urumqi,Xinjiang 830011,China;Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention,Urumqi,Xinjiang 830002,China)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐830011 [2]新疆维吾尔自治区疾病预防控制中心,新疆乌鲁木齐830002

出　　处：《预防医学》2023年第12期1018-1023,共6页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：新疆艾滋病防控研究重点实验室项目(XJYS1706);国家“十三五”科技重大专项(2018ZX10715-007)。

摘　　要：目的了解不同性角色的男男性行为人群(MSM)艾滋病病毒(HIV)感染风险,为制定MSM人群HIV感染防治策略提供依据。方法于2022年采用同伴推动法在新疆维吾尔自治区某市招募MSM开展问卷调查,收集人口学信息和性行为情况,检测HIV和梅毒抗体;分析不同性角色MSM的性行为特征及HIV感染情况,采用多因素logistic回归模型分析HIV感染的影响因素。结果调查MSM 666人,年龄为(28.70±8.09)岁;本市户籍577人,占86.64%。性角色为主动插入166人,占24.92%;被动接受179人,占26.88%;两者兼有321人,占48.20%。检出HIV感染55例,检出率为8.26%;主动插入、被动接受和两者兼有MSM的HIV检出率分别为3.61%、13.41%和7.79%。不同性角色MSM年龄、招募途径、性倾向、首次同性性行为年龄、与临时性伴使用安全套情况和HIV检出率差异均有统计学意义(P<0.05)。多因素logistic回归结果显示,主动插入MSM的HIV感染风险较两者兼有MSM低(OR=0.513,95%CI:0.272~0.969),被动接受MSM与两者兼有MSM的HIV感染风险差异无统计学意义(OR=2.088,95%CI:0.081~5.380)。结论性角色为被动接受和两者兼有MSM的HIV感染风险高于主动插入MSM,应分类施策以减少HIV在该人群中的传播。Objective To identify the risk of HIV infection among men who have sex with men(MSM)with different sex roles,so as to provide insights into the prevention and control strategies for HIV infection among MSM.Methods Peer-driven sampling method was employed to recruit MSM in a city in Xinjiang Uygur Autonomous Region in 2022,a questionnaire survey was conducted to collect demographic information and sexual behaviors,and laboratory tests were conducted to detect HIV and syphilis antibodies.The characteristics of sexual behaviors among MSM with different sex roles and prevalence of HIV infection were analyzed,and factors affecting HIV infection among MSM were identified us-ing a multivariable logistic regression model.Results A total of 666 MSM were investigated,with a mean age of(28.70±8.09)years and 577 local residents(86.64%).There were 166 insertive MSM(24.92%),179 receptive MSM(26.88%)and 321 both receptive and insertive MSM(48.20%).The HIV infection rate was 8.26%,with 3.61%in in-sertive MSM,13.41%in receptive MSM,and 7.79%in both receptive and insertive MSM.Significant differences were seen in age,recruitment route,sexual orientation,age of first homosexual sex,condom use with temporary partners and HIV infection rate among different sex roles(all P<0.05).Multivariable logistic regression analysis showed that insertive MSM had a lower risk of HIV infection than both receptive and insertive MSM(OR=0.513,95%CI:0.272-0.969),while there was no significant difference in the risk of HIV infection between receptive MSM and both receptive and in-sertive MSM(OR=2.088,95%CI:0.081-5.380).Conclusions The risk of HIV infection among receptive and both recep-tive and insertive MSM are higher than that among insertive MSM.Classified measures should be taken to reduce the transmission of HIV in this population.

关 键 词：男男性行为人群 性角色 性行为 HIV感染 

分 类 号：R512.91[医药卫生—内科学]