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某市1 000名男男性接触者艾滋病高危行为及影响因素分析
杨旭1,2,易东1*,丁贤彬3
0
(1.第三军医大学预防医学学院卫生统计学教研室,重庆 400038;2.重庆市沙坪坝区疾病预防控制中心, 重庆 400038;3.重庆市疾病预防控制中心性病艾滋病防治所, 重庆 400042)
摘要:
目的:分析某市男男性接触者(MSM)艾滋病高危行为及影响因素,为制定针对性的防制措施提供依据。方法:2006年7~10月间采用“滚雪球”的方式,由经过培训的调查员在知情同意的原则下对某市1 000名MSM艾滋病高危行为及影响因素(年龄、文化程度、自我性取向等)进行面对面的问卷调查,并抽取3 ml静脉血进行HIV及梅毒检测,对上述调查及检测结果进行χ2检验和Logistic回归分析。结果:1 000名MSM年龄15~68岁,平均(27.8±9.1)岁。最近6个月,43.6%有3个及以上同性性伴,53.6%有同性无保护肛交性行为,8.0%有同性商业性行为,24.3%有异性性行为。分析显示:大年龄组发生无保护肛交性行为和异性性行为的比例高,低文化组多性伴和异性性行为比例高,浴室来源组商业性行为和异性性行为比例高,自我性取向为异性恋或未确定组商业性行为比例高。共检出梅毒阳性93例(9.3%),HIV阳性104例(10.4%),其中有18人同时检出梅毒和HIV。分析显示:年龄大(>35岁,OR=3.5, 95%CI 1.7~7.1)、多性伴(2个以上性伴,OR=3.8,95%CI 1.9~7.6)、同性无保护性行为(OR=1.9,95%CI 1.0~3.5)、梅毒感染(OR=2.3,95%CI 1.3~4.1)是感染HIV的危险因素;艾滋病防治知识(OR=0.5,95%CI 0.3~0.7)是感染HIV的保护因素。结论:该地区MSM人群中艾滋病高危行为普遍存在,并存在HIV的局部流行,需针对年龄、文化程度、性取向等不同影响因素开展相应行为干预措施。
关键词:  男男性接触者  获得性免疫缺陷综合征  危险因素
DOI:10.3724/SP.J.1008.2007.01223
投稿时间:2007-05-16
基金项目:第五轮中国全球基金艾滋病项目(CHN-506-G06-H).
High risk behaviors of HIV/AIDS in man man sex and its influencing factors in 1 000 men in a city
YANG Xu1,2,YI Dong1*,DING Xian-bin3
(1.Department of Health Statistics, Third Military Medical University, Chongqing 400038, China; 2.Center for Disease Control and Prevention of Shapingba District, Chongqing 400038;3. Chongqing Center for Disease Control and Prevention, Chongqing 400042)
Abstract:
Objective:To analyze the high risk behaviors of HIV/AIDS and its influencing factors in men who have sex with man (MSM) in a city, so as to provide evidence for the targeted intervention. Methods: Between July 2006 and October 2006, 1000 MSM were sampled by snowball sampling and had a face to face interview by well trained investigators with informed consent. Questions on age, education background, and sex orientation were designated and 3 ml blood samples were obtained for examination of HIV and syphilis. χ2 test and logistic regression analysis were used for statistical analysis. Results: The average age of the 1 000 MSM was 27.8±9.1 years old. In the past 6 months, 43.6% of them had 3 or more male sex partners, 53.6% had unprotected anal intercourse with men, 8.0% had commercial sex with men, and 24.3% had sex with women. Elder subjects had a higher ratio of unprotected anal intercourse and malefemale sex; subjects with lower educational background had more sex partners and malefemale sex. Subjects working in the bathhouse had a higher ratio of commercial sex and malefemale sex. Subjects with a malefemale sex orientation or undetermined sex orientation had a higher ratio of commercial sex. Syphilis was detected in 93(9.3%) subjects and HIV was detected in 104 (10.4%) subjects; among them 18 subjects had both syphilis and HIV. Multivariate logistic regression analysis showed that the aged (OR=3.5, 95%CI 1.77.1), the number of male sex partners (OR=3.8,95%CI 1.97.6), the behavior of unprotected anal intercourse (OR=1.9,95%CI 1.03.5) and the infection of syphilis (OR=2.1,95%CI 1.43.4) were independently associated with the risk of HIV/AIDS prevalence; the knowledge of AIDS was the protective factor of HIV/AIDS prevalence(OR=0.5,95%CI 0.30.7). Conclusion: High risk behaviors of HIV exist in MSM population in the researched city; there is local epidemic of HIV. Interventions should be given according to age, educational background, sex orientation, etc.
Key words:  men who have sex with men  acquired immunodeficiency syndrome  risk factors