青岛市男男性行为人群HIV暴露后预防药物使用及相关因素分析  

Analysis on the use of HIV post-exposure prophylaxis and related factors in men who have sex with men in Qingdao

作　　者：苏容 朱丽敏 黄贵花 李培龙[1] 葛琳[1] 廖玫珍[2] 傅泳 宋鑫[3] 李东民[1] Su Rong;Zhu Limin;Huang Guihua;Li Peilong;Ge Lin;Liao Meizhen;Fu Yong;Song Xin;Li Dongmin(Division of Epidemiology,National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Department of AIDS/STD Control and Prevention,Shandong Center for Disease Control and Prevention,Ji'nan 250014,China;Qingdao Center for Disease Control and Prevention,Qingdao 266033,China)

机构地区：[1]中国疾病预防控制中心性病艾滋病预防控制中心流行病学室,北京102206 [2]山东省疾病预防控制中心艾滋病防治所,济南250014 [3]青岛市疾病预防控制中心,青岛266033

出　　处：《中华流行病学杂志》2024年第1期134-138,共5页Chinese Journal of Epidemiology

基　　金：国家科技重大专项(2017ZX10201101-002-005)。

摘　　要：目的了解青岛市MSM对HIV暴露后预防(PEP)药物使用率及相关因素,为MSM艾滋病防控工作提供参考。方法采用横断面调查设计,于2022年4月至2023年2月,依托青岛市MSM社会组织,采用滚雪球抽样方法招募MSM研究对象,纳入标准为年龄≥18岁男性、最近6个月发生同性肛交或口交、HIV阴性或感染状态未知,估计样本量为566人。通过现场问卷调查收集研究对象的人口学特征、性行为特征和PEP药物使用情况等信息。采用logistic回归模型分析使用PEP药物的相关因素。结果MSM研究对象共811人,以25~34岁(53.6%,435/811)、未婚(74.7%,606/811)、月均收入≥5000元(52.2%,423/811)和在青岛市居住时间≥10年(75.6%,613/811)为主,最近6个月知晓性伴HIV感染状态者占67.1%(544/811)、有HIV阳性性伴者占3.6%(29/811),最近6个月发生群交、发生无保护肛交和使用新型毒品者分别占86.4%(701/811)、98.2%(796/811)、80.3%(651/811)。PEP药物使用率为28.4%(230/811)。多因素logistic回归分析结果显示,研究对象使用PEP药物的相关因素包括离异/丧偶(aOR=5.46,95%CI:1.96~15.17)、月均收入≥5000元(aOR=2.04,95%CI:1.44~2.89)、性取向为同性恋(aOR=0.40,95%CI:0.22~0.71)、最近6个月有HIV阳性性伴(aOR=2.54,95%CI:1.13~5.71)、最近6个月HIV检测≥3次(aOR=1.46,95%CI:1.04~2.06)。结论青岛市MSM的危险行为发生率较高,PEP药物使用率较低,应加大对该人群的艾滋病防治知识宣教,倡导知情交友,降低危险行为发生率;探索PEP药物的医保报销方案,降低使用成本,促进MSM在发生HIV暴露后尽早使用PEP药物。Objective To understand the use of post-exposure prophylaxis(PEP)and analyze related factors among men who have sex with men(MSM)in Qingdao,and provide a reference for the AIDS prevention and control in this population.Methods A cross-sectional survey conducted from April 2022 to February 2023.Relying on MSM social groups in Qingdao,a snowball sampling method was applied to recruit research subjects who met the inclusion criteria of age≥18 years old,having had homosexual anal or oral sex in the past six months,and HIV-negative or infection status unknown.The sample size was estimated at 566.Data on demographic characteristics,sexual behavior characteristics,PEP use,and others of the research subjects was collected through on-site questionnaires.The logistic regression model was used to analyze the factors associated with using PEP.Results A total of 811 participants were recruited,mainly aged 25-34(53.6%,435/811),unmarried(74.7%,606/811),with an average monthly income of≥5000 yuan(52.2%,423/811),and having lived in Qingdao for≥10 years(75.6%,613/811).The proportion of those who knew the HIV status of their sexual partners in the last six months was 67.1%(544/811),and those with HIV-positive partners were 3.6%(29/811).In the last six months,the proportion of participants who had group sex(86.4%,701/811),unprotected anal sex(98.2%,796/811),and use of club drugs(80.3%,651/811)was high.Moreover,28.4%(230/811)had used PEP.The multivariate logistic regression analysis showed that the factors related to the use of PEP included divorced or widowed(aOR=5.46,95%CI:1.96-15.17),average monthly income≥5000 yuan(aOR=2.04,95%CI:1.44-2.89),same-sex sexual orientation(aOR=0.40,95%CI:0.22-0.71),having HIV-positive sexual partners in the last six months(aOR=2.54,95%CI:1.13-5.71)and having been tested for HIV≥3 times in the last six months(aOR=1.46,95%CI:1.04-2.06).Conclusions The prevalence of risk behaviors among MSM in Qingdao was high,and the use of PEP was low.In the future,it is essential to increase HIV/AIDS prevent

关 键 词：艾滋病病毒 男男性行为人群 暴露后预防 相关因素 

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