海口市2019—2023年男男性行为者哨点监测人群HIV-1新发感染情况及影响因素分析  

Analysis of HIV-1 new infections and influencing factors among men who have sex with men sentinel surveillance population in Haikou City, 2019-2023

作　　者：陈明 陆秋娟[1] 于德娥[2] 曹莉[2] 秦玲 陈奎霖 周东华 李建 包宝辉 CHEN Ming;LU Qiujuan;YU De'e;CAO Li;QIN Ling;CHEN Kuilin;ZHOU Donghua;LI Jian;BAO Baohui(Haikou Center for Disease Control and Prevention,Haikou,Hainan 571100,China;School of Public Health,Hainan Medical University,Haikou,Hainan 571199,China;Hainan Center for Disease Control and Prevention,Haikou,Hainan 570203,China)

机构地区：[1]海口市疾病预防控制中心,海南海口571100 [2]海南医学院公共卫生学院,海南海口571199 [3]海南省疾病预防控制中心,海南海口570203

出　　处：《中国热带医学》2024年第6期686-690,696,共6页China Tropical Medicine

基　　金：海南省自然科学基金项目(No.821MS0856)。

摘　　要：目的了解海口市2019—2023年男男性行为者(men who have sex with men,MSM)哨点监测人群HIV-1新发感染情况并探究影响因素,为艾滋病防控提供依据。方法采用连续横断面研究方法,检测海口市2019—2023年MSM哨点监测人群HIV-1感染情况,排除已知既往阳性和抗病毒治疗半年以上者,对符合新发感染检测的阳性者采用HIV-1限制性抗原亲和力酶联免疫方法进行新发感染检测,采用二分类非条件logistic回归模型进行新发感染多因素分析。结果本研究共招募2001名MSM,年龄中位数M(P25,P75)为28(23,33)岁,89.8%来自网络招募,90.8%为单身;在本地居住>2年者占79.7%,大专及以上文化程度者占72.6%,本省户籍占78.0%。2019—2023年海口市MSM哨点监测人群HIV-1阳性率为6.85%(137/2001),新发感染率为2.95%(59/2001),新发感染率估算值为8.61%(95%CI:6.41~10.81),2019—2023年HIV-1阳性率和新发感染率趋势变化不明显(P>0.05)。多因素分析发现,与在本地居住时间≤2年相比,在本地居住时间>2年者新近感染HIV-1的概率更低(OR=0.473,95%CI:0.273~0.821);与未接受过干预服务者相比,接受过干预服务者新近感染HIV-1的风险更低(OR=0.347,95%CI:0.197~0.613)。结论海口市近年来MSM人群呈现高学历年轻化的特征,HIV-1新发感染率未见显著变化,接受干预服务是防止发生HIV-1新发感染的保护因素,而流动MSM人群具有更高的HIV-1新发感染风险,应加强对流动MSM人群的健康管理,扩大艾滋病干预服务的覆盖面。Objective To understand the new HIV-1 infection in MSM(men who have sex with men)sentinel population in Haikou and explore the influencing factors of HIV/AIDS epidemic,so as to provide a basis for AIDS prevention and control.Methods A continuous cross-sectional study was used to detect HIV-1 infection in the MSM sentinel surveillance population in Haikou City from 2019 to 2023,excluding those with known past positive results and those who had been on antiretroviral therapy for more than six months.The positive cases suitable for new infection testing were examined by HIV-1 restriction antigen affinity enzyme immunization method,and binary non-conditional logistic regression model conducted multivariate analysis of new infections.Results A total of 2001 MSM were recruited,with a median age M(P25,P75)of 28(23,33)years,89.8%were recruited from the Internet,90.8%were single;79.7%resided in the local area for>2 years,72.6%were educated to college level or above,and the proportion of household registration in the province was 78.0%.From 2019 to 2023,the HIV-1 positive rate among MSM in Haikou from 2019 to 2023 was 6.85%(137/2001),with a new infection rate of 2.95%(59/2001).The estimated new infection rate was 8.61%(95%CI:6.41-10.81),with no significant trend changes in HIV-1 positivity and new infection rates over the years(P>0.05).Multivariate analysis revealed that,compared to those who lived locally for≤2 years,those residing locally for>2 years had a lower probability of recent HIV-1 infection(OR=0.473,95%CI:0.273-0.821).Compared to those who had never received intervention services,those who had received such services had a lower risk of recent HIV-1 infection(OR=0.347,95%CI:0.197-0.613).Conclusions In recent years,the Haikou MSM population has shown characteristics of higher education and younger age,and the rate of new HIV-1 infections has not changed significantly.Receiving intervention services is the protection factor to prevent HIV-1 new infections,whereas the mobile MSM population has a higher risk of HIV

关 键 词：人类免疫缺陷病毒 海口市 哨点监测 男男性行为者 新发感染 影响因素 

分 类 号：R512.91[医药卫生—内科学]