天津市青年男男同性性行为人群精神活性物质使用者艾滋病病毒新发感染研究  

Study on the new incidence of HIV infection among young men who have sex with men using psychoactive substances in Tianjin

作　　者：郭燕[1,2] 杨杰 柏建芸[1,2] 柳忠泉[1,2] 董笑月[1,2] 李龙[1,2] 赵璇[1,2] 于茂河[1,2] GUO Yan;YANG Jie;BAI Jianyun;LIU Zhongquan;DONG Xiaoyue;LI Long;ZHAO Xuan;YU Maohe(Department of AIDS/STD Prevention and Control,Tianjin Key Laboratory of Infectious Disease Pathogens and Microorganisms,Tianjin Center for Disease Control and Prevention,Tianjin 300011,China;不详)

机构地区：[1]天津市疾病预防控制中心性病艾滋病预防控制所,天津300011 [2]天津市疾病预防控制中心、天津市传染病病原微生物重点实验室,天津300011 [3]深蓝公共卫生咨询服务中心,天津300121

出　　处：《中国病毒病杂志》2025年第1期42-48,共7页Chinese Journal of Viral Diseases

基　　金：天津市医学重点学科(专科)建设项目(TJYXZDXK-050A)。

摘　　要：目的调查天津市精神活性物质使用青年男男同性性行为人群(young men who have sex with men,YMSM)艾滋病病毒(human immunodificiency virus,HIV)新发感染状况及影响因素,为在该人群中开展艾滋病防治工作提供依据。方法采用队列研究设计,2017年1月—2022年12月采用滚雪球抽样方法在天津市招募最近6个月内有精神活性物质使用经历的16~24岁YMSM为研究对象,并建立开放性队列,在完成基线调查和HIV检测的基础上每6个月开展1次随访调查和检测,主要调查内容包含人口学信息及艾滋病相关行为学信息。应用Cox比例风险回归模型分析HIV新发感染的影响因素。结果849例纳入队列的研究对象,研究期间HIV新发感染54例,累积观察时间为1586.0人·年,HIV新发感染率为3.4(95%CI:2.5~4.3)/100人·年。其中2017—2018、2019—2020、2021—2022年HIV新发感染率分别为4.5(95%CI:2.3~6.7)/100人·年、3.0(95%CI:1.8~4.2)/100人·年和3.3(95%CI:1.7~4.9)/100人·年。多因素Cox回归分析结果显示,相比于首次同性性行为年龄<16岁者,首次同性性行为年龄≥16岁者(HR=0.408,95%CI:0.190~0.877)发生HIV感染风险较低;相比于天津市居住时间<2年者、主要通过线上寻找性伴者、基线调查时未感染梅毒者,天津市居住时间≥2年者(HR=2.530,95%CI:1.006~6.363)、主要通过线下寻找性伴者(HR=2.045,95%CI:1.064~3.931)和基线调查时感染梅毒者(HR=2.347,95%CI:1.206~4.566)发生HIV感染风险较高。结论天津市精神活性物质使用的YMSM中HIV新发感染率未见明显下降,并且HIV新发感染影响因素较多,应持续加强针对此人群的艾滋病预防干预工作。Objective To investigate the incidence of HIV infection and identify associated factors in psychoactive substances users among young men who have sex with men(YMSM)in Tianjin and provide basis for HIV/AIDS prevention and control among this population.Methods A prospective cohort study was conducted among 16-24 years old YMSM who had used psychoactive substance within the last six months from January 2017 to December 2022 in Tianjin using a snowball sampling method.An open cohort was established,and participants underwent baseline surveys and HIV testing,followed by follow-up surveys and testing every six months;key data collected included demographic information and HIV-related behavioral information.Cox proportional hazards regression analysis was conducted to identify the associated factors to the incidence of HIV infection.Results A total of 849 participants were included in the cohort,with 54 new HIV infections observed during the study period,resulting in a cumulative observation time of 1586.0 person-years and an HIV incidence rate of 3.4(95%CI:2.5–4.3)/100 person-years.The incidence rates for the periods 2017-2018,2019-2020and 2021-2022 were 4.5(95%CI:2.3–6.7),3.0(95%CI:1.8–4.2),and 3.3(95%CI:1.7–4.9)per 100 person-years,respectively.Multivariate Cox regression analysis results showed that compared to those who had first homosexual intercourse at the age of<16 years,those who had first homosexual intercourse at the age of≥16 years(HR=0.408,95%CI:0.190-0.877)had a lower risk of HIV incidence.Meanwhile compared to those who have lived in Tianjin<2 years,mainly finding sexual partners online,and those who were infected with syphilis at the baseline survey,those who have lived in Tianjin≥2 years(HR=2.530,95%CI:1.006-6.363),mainly finding sexual partners offline(HR=2.045,95%CI:1.064-3.931),and those who were infected with syphilis at the baseline survey(HR=2.347,95%CI:1.206-4.566)have a higher risk of HIV incidence.Conclusions There is no significant decrease in the HIV incidence among YMSM who use

关 键 词：青年男男同性性行为人群 精神活性物质 新发感染 队列 

分 类 号：R183.7[医药卫生—流行病学]