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中国西部地区多城市男男性接触者近1年HIV检测行为分析 |
曾馨1,钟晓妮1*,彭斌1,张燕1,孔翠娥1,黄爱龙2 |
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(1. 重庆医科大学公共卫生与管理学院, 医学与社会发展研究中心, 健康领域社会风险预测治理协同创新中心, 重庆 400016; 2. 重庆医科大学感染性疾病分子生物学教育部重点实验室, 重庆 400016 *通信作者) |
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摘要: |
目的 了解我国西部地区男男性接触者(MSM)最近1年人类免疫缺陷病毒(HIV)检测比例及其影响因素。方法 在重庆及四川地区部分城市采用来自多个地区和途径的方便抽样,共招募1245例MSM。调查对象通过匿名的自填式问卷完成调查并同时接受现场HIV检测,采用logistic回归模型对该地区MSM近1年HIV检测行为的影响因素进行分析。结果 调查完成问卷1245份,有效问卷1199份(96.31%)。调查中最近1年HIV检测比例为43.45%(521/1199);HIV抗体阳性检出率为21.35%(256/1199),其中近1年没有做过HIV检测者中HIV抗体阳性检出率(24.93%)高于检测者(16.70%),差异具有统计学意义(χ2=11.8763,P=0.0006)。多因素logistic回归分析结果显示,艾滋病相关知识得分>10分(OR=1.593,95%CI:1.164~2.180)是MSM近1年参与HIV检测的促进因素,而既往未做过艾滋病主动咨询(OR=0.284,95%CI:0.218~0.371)、自认为所生活的市/区/县的“同志”人群感染艾滋病的比率低(OR=0.570,95%CI: 0.386~0.841)、最近6个月与男性肛交时偶尔使用或从不使用安全套(OR=0.688,95%CI: 0.514~0.919;OR=0.645,95%CI:0.421~0.987)是阻碍因素。结论 西部地区MSM人群近1年HIV检测比例较低,而整体HIV感染率较高,且近1年未接受HIV检测的MSM具有更高的HIV感染风险。应继续深入加强以“同志”社区为基础的艾滋病感染风险教育,进一步提高艾滋病高流行地区MSM人群定期主动HIV检测的比例,有效控制艾滋病流行。 |
关键词: 男男性接触者 人类免疫缺陷病毒 艾滋病 影响因素 |
DOI:10.16781/j.0258-879x.2016.07.0827 |
投稿时间:2016-03-06修订日期:2016-04-28 |
基金项目:国家科技重大专项课题(2012ZX10001007-007). |
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Analysis of recent HIV testing behavior among men who have sex with men: a multi-city cross-sectional study in western China |
ZENG Xin1,ZHONG Xiao-ni1*,PENG Bin1,ZHANG Yan1,KONG Cui-e1,HUANG Ai-long2 |
(1. School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing 400016, China; 2. Key Laboratory of Molecular Biology for Infectious Diseases of Ministry of Education, Chongqing Medical University, Chongqing 400016, China * Corresponding author) |
Abstract: |
Objective To know about the prevalence of recent human immunodeficiency virus (HIV) testing (in the last 12 months) and its associated factors among men who have sex with men (MSM) in western China. Methods A total of 1 245 MSM were recruited by convenient sampling from multiple sources and areas in Chongqing and Sichuan regions. The participants were interviewed with anonymous self-administered questionnaire and received HIV testing at the same time. Multivariate logistic regression was used to identify the factors associated with recent HIV testing behavior. Results A total of 1 245 questionnaires were completed, and 1 199 (96.31%) were valid and included for analysis. Of the 1 199 MSM, 43.45% (521/1 199) reported having HIV testing in recent one year. The overall HIV antibody positive rate was 21.35% (256/1 199) in the present study; the HIV positive rate was significantly higher in those did not receive HIV testing in recent one year compared with those received HIV testing (24.93% vs 16.70%, χ2=11.876 3,P=0.000 6). Logistic regression analysis revealed that a score >10 in HIV/AIDS knowledge test (OR=1.593, 95%CI:1.164-2.180) was associated with increased recent HIV testing among MSM, and the factors associated with lower HIV testing rate in recent one year included not receiving free HIV counseling voluntarily over past years (OR=0.284, 95%CI:0.218-0.371), self-perceived low prevalence of HIV infection among MSM in city/district/county they were living (OR=0.570, 95%CI:0.386-0.841), and occasionally/never using condoms during anal sex with men in recent six months (OR=0.688, 95%CI:0.514-0.919; OR=0.645, 95%CI:0.421-0.987). Conclusion The proportion of recent HIV testing among MSM in western China is low, although the HIV prevalence is still alarmingly high. MSM not receiving any HIV testing in recent one year have higher HIV infection risk compared with those receiving. The community-based HIV-related risk education should be strengthened so as to further promote regular HIV testing among MSM in these high epidemic areas. |
Key words: men who have sex with men human immunodeficiency virus acquired immune deficiency syndrome influencing factors |