2013—2017年重庆市某郊区男男性行为者的HIV新发感染状况及影响因素
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摘要
目的了解重庆市某郊区男男性行为者(MSM)艾滋病病毒(HIV)新发感染状况,探讨其相关影响因素。方法对2013—2017年重庆市某郊区MSM哨点监测样本中,HIV抗体确证阳性样本采用捕获酶联免疫法(BED)或限制性抗原亲和力酶联免疫吸附法(LAg)进行新发感染检测,估算该人群新发感染率,多因素Logistic回归分析HIV新发感染的影响因素。结果该区2013—2017年MSM哨点监测的1 250例样本中1 061人(84.88%)来自网络招募,平均年龄(26.33±7.39)岁,未婚1 095人(87.60%),文化程度大专及以上者912人(72.96%);艾滋病知识知晓率和接受过干预服务的均>92.00%;最近6个月肛交每次都使用安全套的比例为56.83%;最近一年进行过HIV抗体筛查的比例为39.44%。每年的HIV阳性检出率均在10.00%～10.80%之间,每年的新发感染率分别为10.78%[95%可信区间(CI):2.94%～18.62%],12.18%(95%CI:4.22%～20.15%),5.65%(95%CI:0.09%～11.21%),1.84%(95%CI:-1.68%～5.35%),6.93%(95%CI:0.85%～13.01%)。5年总的新发感染率为7.98%(95%CI:4.95%～11.01%)。多因素Logistic回归分析显示,最近1年未参与过HIV抗体筛查[比值比(OR)=3.589,95%CI:1.210～10.645],最近6个月同性肛交未每次使用安全套MSM(OR=9.098,95%CI:3.116～26.569)是HIV新发感染的危险因素。结论重庆市某郊区MSM大多通过互联网社交,HIV感染率和新发感染率均较高,提示对MSM应通过互联网传递有效的HIV预防策略的信息,继续扩大检测和落实安全套使用等多种干预措施,从而降低新发感染。
Objective To understand the HIV infection rate and incidence among men who have sex with men(MSM)in a suburb of Chongqing from 2013 to 2017,and to explore the influence factors.Methods A total of 1250 MSM were surveyed via sentinel surveillance during 2013-2017.BED HIV capture enzyme immunoassay(BED)or limiting antigen avidity enzyme immunoassay(Lag-Avidity EIA)were used to detect HIV antibody as well as recent infections,to estimate the HIV incidence in MSM,and analyze the influence factors.Results Among the 1 250 MSM,84.88%(1 061)were recruited online.The average age was(26.33±7.39);87.60%(1 095)were unmar-ried;72.96%(912)had a junior college degree of education and above;more than 92.00% were aware of HIV/AIDS knowledge and received intervention services;56.83% had condom use in anal sex during the last 6 months;39.44% had HIV testing in the past year.The annual HIV positive detection rate was between 10.00% and 10.80% with the annual incidenceof 10.78%(95% CI:2.94%-18.62%),12.18%(95% CI:4.22%-20.15%),5.65%(95% CI:0.09%-11.21%),1.84%(95%CI:-1.68%-5.35%),and 6.93%(95%CI:0.85%-13.01%)respectively.The total 5-year incidence was 7.98%(95%CI:4.95%-11.01%).Multivariate logistic regression analysis showed that the risk factors for HIV infection were no HIV testing in the recent year(OR=3.589,95%CI:1.210-10.645)and no consistent condom use in anal intercourse in the past 6 months(OR=9.098,95%CI:3.116-26.569).Conclusion Most of the MSM in the suburb of Chongqing has social contacts through the internet.The HIV infection rate and incidence among MSM are high.It is suggested that effective HIV prevention measures should be disseminated through the internet,and HIV testing should be expanded in combination with behavior intervention such as condom use so as to reduce HIV infection among MSM.
Objective To understand the HIV infection rate and incidence among men who have sex with men(MSM)in a suburb of Chongqing from 2013 to 2017,and to explore the influence factors.Methods A total of 1250 MSM were surveyed via sentinel surveillance during 2013-2017.BED HIV capture enzyme immunoassay(BED)or limiting antigen avidity enzyme immunoassay(Lag-Avidity EIA)were used to detect HIV antibody as well as recent infections,to estimate the HIV incidence in MSM,and analyze the influence factors.Results Among the 1 250 MSM,84.88%(1 061)were recruited online.The average age was(26.33±7.39);87.60%(1 095)were unmar-ried;72.96%(912)had a junior college degree of education and above;more than 92.00% were aware of HIV/AIDS knowledge and received intervention services;56.83% had condom use in anal sex during the last 6 months;39.44% had HIV testing in the past year.The annual HIV positive detection rate was between 10.00% and 10.80% with the annual incidenceof 10.78%(95% CI:2.94%-18.62%),12.18%(95% CI:4.22%-20.15%),5.65%(95% CI:0.09%-11.21%),1.84%(95%CI:-1.68%-5.35%),and 6.93%(95%CI:0.85%-13.01%)respectively.The total 5-year incidence was 7.98%(95%CI:4.95%-11.01%).Multivariate logistic regression analysis showed that the risk factors for HIV infection were no HIV testing in the recent year(OR=3.589,95%CI:1.210-10.645)and no consistent condom use in anal intercourse in the past 6 months(OR=9.098,95%CI:3.116-26.569).Conclusion Most of the MSM in the suburb of Chongqing has social contacts through the internet.The HIV infection rate and incidence among MSM are high.It is suggested that effective HIV prevention measures should be disseminated through the internet,and HIV testing should be expanded in combination with behavior intervention such as condom use so as to reduce HIV infection among MSM.
引文
[1]中国疾病预防控制中心性病艾滋病预防控制中心性病控制中心.2015年12月全国艾滋病性病疫情[J].中国艾滋病性病,2016,22(2):69.
[2]严心诚,朱志先.GSN apps对男男性行为者性行为的影响与艾滋病防控[J].中国艾滋病性病,2018,24(2):216-219.
[3]欧阳琳,吴国辉,周颖,等.2010-2013年重庆市部分男男性行为人群认知艾滋病和感染状况分析[J].疾病监测,2014,29(2):124-129.
[4]陈宗良,申涛,吴国辉,等.2011-2015年重庆市主城9区艾滋病流行特征分析[J].现代预防医学,2017,44(22):4042-4045,4057.
[5]梁君,高志云,颜浩,等.限制性抗原亲和力酶免法用于MSM哨点HIV-1新发感染检测研究[J].中国病毒病杂志,2014,4(2):101-105.
[6]彭庭海,彭国平,阳凯,等.2010-2015年湖北省男男性行为者艾滋病新发感染流行病学特征分析[J].公共卫生与预防医学,2017,28(5):49-52.
[7]张梦妍,胡婷,贾华,等.2011-2015年陕西省男男性行为者哨点HIV新发感染状况及其影响因素分析[J].现代预防医学,2017,44(1):160-162,166.
[8]马婧,李佑芳,章任重,等.昆明市2012-2016年MSM中HIV新发感染队列研究[J].中国艾滋病性病,2017,23(8):755-757,763.
[9]张静瑜,李青青,韩德琳,等.男男性行为人群性角色状况及其与安全套使用和HIV检测的关系[J].中华疾病控制杂志,2013,17(5):400-403.
[10]Zeng G,Feng L,Ouyang L,et al.The Dynamic Trends of HIVPrevalence,Risks,and Prevention among Men Who Have Sex with Men in Chongqing,China[J].Biomed Res Int,2014,2014(350):602719.
[11]Geng GZ,Gao G,Ruan YH,et al.Behavioral Risk Profile of Men Who Have Sex with Men in Beijing,China:Results from a Cross-sectional Survey with Randomized Response Techniques[J].Chin Med J(Engl),2016,129(5):523-529.
[12]赵立华,蒋岸,张蕴慧,等.宁夏男男性行为者HIV新发感染及影响因素分析[J].中国皮肤性病学杂志,2015,29(1):50-52.
[13]韩扬,夏冬艳,孙燕鸣,等.北京市部分男男性行为人群HIV感染情况及影响因素[J].中国艾滋病性病,2013,19(6):399-401.
[14]姜婷婷,陈琳,周欣,等.男男性行为者定期检测现状及其影响因素分析[J].中国艾滋病性病,2018,24(2):148-151.
[15]JS St Lawrence,JA Kelly,J Dicksongomez,et al.Attitudes Toward HIV Voluntary Counseling and Testing(VCT)Among African American Men Who Have Sex With Men:Concerns Underlying Reluctance to Test[J].AIDS Educ Prev,2015,27(3):195-211.
[16]马仲慧,杨彦玲,邢文革译,世界卫生组织著.WHO推荐艾滋病自我检测[J].中国艾滋病性病,2018,24(2):211-212.
[17]韩梅,张波.HIV新发感染的实验室检测方法进展[J].国际检验医学杂志,2014,35(8):53-55.
[18]于海英,叶艺,张娜,等.检测HIV-1新发感染的限制性抗原亲和力方法的重复性与稳定性评价[J].中国艾滋病性病,2013,19(5):318-321.
[19]杨洪,李东民,苏玲,等.HIV-1新发感染2种检测方法在MSM哨点人群中的对比[J].预防医学情报杂志,2017,33(1):10-14.
[2]严心诚,朱志先.GSN apps对男男性行为者性行为的影响与艾滋病防控[J].中国艾滋病性病,2018,24(2):216-219.
[3]欧阳琳,吴国辉,周颖,等.2010-2013年重庆市部分男男性行为人群认知艾滋病和感染状况分析[J].疾病监测,2014,29(2):124-129.
[4]陈宗良,申涛,吴国辉,等.2011-2015年重庆市主城9区艾滋病流行特征分析[J].现代预防医学,2017,44(22):4042-4045,4057.
[5]梁君,高志云,颜浩,等.限制性抗原亲和力酶免法用于MSM哨点HIV-1新发感染检测研究[J].中国病毒病杂志,2014,4(2):101-105.
[6]彭庭海,彭国平,阳凯,等.2010-2015年湖北省男男性行为者艾滋病新发感染流行病学特征分析[J].公共卫生与预防医学,2017,28(5):49-52.
[7]张梦妍,胡婷,贾华,等.2011-2015年陕西省男男性行为者哨点HIV新发感染状况及其影响因素分析[J].现代预防医学,2017,44(1):160-162,166.
[8]马婧,李佑芳,章任重,等.昆明市2012-2016年MSM中HIV新发感染队列研究[J].中国艾滋病性病,2017,23(8):755-757,763.
[9]张静瑜,李青青,韩德琳,等.男男性行为人群性角色状况及其与安全套使用和HIV检测的关系[J].中华疾病控制杂志,2013,17(5):400-403.
[10]Zeng G,Feng L,Ouyang L,et al.The Dynamic Trends of HIVPrevalence,Risks,and Prevention among Men Who Have Sex with Men in Chongqing,China[J].Biomed Res Int,2014,2014(350):602719.
[11]Geng GZ,Gao G,Ruan YH,et al.Behavioral Risk Profile of Men Who Have Sex with Men in Beijing,China:Results from a Cross-sectional Survey with Randomized Response Techniques[J].Chin Med J(Engl),2016,129(5):523-529.
[12]赵立华,蒋岸,张蕴慧,等.宁夏男男性行为者HIV新发感染及影响因素分析[J].中国皮肤性病学杂志,2015,29(1):50-52.
[13]韩扬,夏冬艳,孙燕鸣,等.北京市部分男男性行为人群HIV感染情况及影响因素[J].中国艾滋病性病,2013,19(6):399-401.
[14]姜婷婷,陈琳,周欣,等.男男性行为者定期检测现状及其影响因素分析[J].中国艾滋病性病,2018,24(2):148-151.
[15]JS St Lawrence,JA Kelly,J Dicksongomez,et al.Attitudes Toward HIV Voluntary Counseling and Testing(VCT)Among African American Men Who Have Sex With Men:Concerns Underlying Reluctance to Test[J].AIDS Educ Prev,2015,27(3):195-211.
[16]马仲慧,杨彦玲,邢文革译,世界卫生组织著.WHO推荐艾滋病自我检测[J].中国艾滋病性病,2018,24(2):211-212.
[17]韩梅,张波.HIV新发感染的实验室检测方法进展[J].国际检验医学杂志,2014,35(8):53-55.
[18]于海英,叶艺,张娜,等.检测HIV-1新发感染的限制性抗原亲和力方法的重复性与稳定性评价[J].中国艾滋病性病,2013,19(5):318-321.
[19]杨洪,李东民,苏玲,等.HIV-1新发感染2种检测方法在MSM哨点人群中的对比[J].预防医学情报杂志,2017,33(1):10-14.
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