浙江省台州市哨点监测男男性行为人群HIV感染及干预服务利用情况  

Changes in HIV prevalence and intervention service utilization among MSM under sentinel monitoring in Taizhou of Zhejiang Province

作　　者：陈潇潇 孙宇[1] 汪剡灵 王婷婷 谢亚莉 沈伟伟 刘星[1] 林海江[2] CHEN Xiaoxiao;SUN Yu;WANG Shanling;WANG Tingting;XIE Yali;SHEN Weiwei;LIU Xing;LIN Haijiang(School of Public Health,Key Laboratory of Public Health Safety,Ministy of Education,Fudan University,Shanghai200032,China;Taizhou Prefectural Center for Disease Control and Prevention,Taizhou,Zhejiang 318000,China)

机构地区：[1]复旦大学公共卫生学院,公共卫生安全教育部重点实验室,上海200032 [2]台州市疾病预防控制中心,浙江台州318000

出　　处：《上海预防医学》2023年第12期1181-1186,共6页Shanghai Journal of Preventive Medicine

基　　金：浙江省台州市科技计划项目(No.21ywa68);浙江省台州市高层次人才特殊支持计划项目。

摘　　要：【目的】分析浙江省台州市2017—2022年男男性行为(MSM)人群人类免疫缺陷病毒(HIV)、梅毒、丙型肝炎感染率的变化及HIV干预服务利用与其影响因素。【方法】通过“滚雪球”抽样方法招募研究对象,采用调查问卷的方式收集并统计各年份浙江省台州市MSM哨点人群的社会人口学特征、性行为特征、HIV干预服务与知识知晓等信息;采集MSM哨点人群静脉血进行HIV、梅毒和丙型肝炎病毒(HCV)抗体检测以报告各年份感染率。利用多因素logistic回归分析MSM人群HIV干预服务利用的影响因素。【结果】2017—2022年共纳入分析2499名MSM人群,HIV感染率为5.8%,梅毒感染率为4.0%,HCV感染率为0.6%。感染率、同性肛交性行为及异性性行为的比例总体呈下降趋势,而同性肛交性行为坚持使用安全套、接受安全套宣传和发放及艾滋病咨询与检测、接受同伴教育的比例增加,发生网络临时同性性行为的比例也有增加,差异均有统计学意义。多因素logistic回归分析显示,MSM人群处于新型冠状病毒感染疫情(简称“新冠疫情”)期间(aOR=1.66,95%CI:1.04~2.64)和HIV知识知晓(aOR=2.57,95%CI:1.22~5.40),它们与安全套宣传和发放及艾滋病咨询与检测服务的利用增加相关。线下途径寻找男性性伴(aOR=3.44,95%CI:1.16~10.21)、一年内诊断过性病(aOR=5.47,95%CI:1.04~28.76)者更可能利用社区药物维持治疗、清洁针具提供和交换服务;而处于新冠疫情期间(aOR=0.35,95%CI:0.14~0.88)与该服务利用减少相关。处于新冠疫情期间(aOR=2.11,95%CI:1.54~2.89)、HIV知识知晓(aOR=2.09,95%CI:1.08~4.02)、线下途径寻找男性性伴(aOR=1.47,95%CI:1.03~2.11)、知晓性伴HIV感染状况(aOR=2.09,95%CI:1.62~2.69)等与同伴教育服务利用的增加有关;而在婚或同居(aOR=0.73,95%CI:0.55~0.98)、来源为主动到自愿咨询检测(VCT)门诊(aOR=0.61,95%CI:0.46~0.82)与减少同伴教育服务利用相关。【结论】浙江省台�[Objective]To analyze the changes in HIV,syphilis and hepatitis C prevalence among men who have sex with men(MSM)in Taizhou City,Zhejiang Province from 2017 to 2022,and the utilization of HIV intervention services and its influencing factors.[Methods]MSM participants were recruited from HIV sentinel surveillance in Taizhou through snowball sampling method.Participants’socio-demographic characteristics,sexual behavior characteristics,knowledge of HIV and utilization of HIV intervention services were collected and statistically described by questionnaire survey.Blood samples from MSM sentinel population were also collected for HIV,syphilis,and HCV antibody testing.Multivariate logistic regression analysis was used to analyze the influencing factors for utilizing HIV intervention services among MSM.[Results]A total of 2499 MSM were included in the analysis from 2017 to 2022,with HIV prevalence of 5.8%,syphilis prevalence of 4.0%,and HCV prevalence of 0.6%.The infection rate,proportion of homosexual anal sex and heterosexual sex showed a decreasing trend,while the proportion of condom use during homosexual anal sex,condom publicity and distribution,AIDS consultation and testing,acceptance of peer education,and online temporary homosexual sex showed an increasing trend.All these differences were statistically significant.Multivariate logistic regression analysis showed that COVID-19 epidemic(aOR=1.66,95%CI:1.04‒2.64)and HIV knowledge awareness(aOR=2.57,95%CI:1.22‒5.40)were positively correlated with increased acceptance of condom publicity and distribution,and utilization of AIDS counseling and testing.Those who sought male sexual partners through offline route(aOR=3.44,95%CI:1.16‒10.21),and had a history of sexually transmitted diseases within one year(aOR=5.47,95%CI:1.04‒28.76)were positively correlated with community-based methadone maintenance therapy,clean needle provision and exchange services,while COVID-19 epidemic(aOR=0.35,95%CI:0.14‒0.88)was negatively correlated with the utilization of these ser

关 键 词：男男性行为者 哨点监测 艾滋病 HIV干预服务 新型冠状病毒感染疫情 

分 类 号：R183[医药卫生—流行病学] R512.91[医药卫生—公共卫生与预防医学]