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目的了解南京市不同性角色男男性行为者(MSM)的行为特征及艾滋病病毒(HIV)、梅毒感染现状,为制定更有针对性的干预措施提供依据。方法在知情同意的前提下,采用分类滚雪球法招募MSM,开展问卷调查,收集人口学、行为学等信息,并进行HIV、梅毒抗体血清学检测。结果共调查MSM 2 377人,根据最近6个月肛交时的性角色分为三组:插入组800人(33.66%)、被插入组615人(25.87%)和双向组962人(40.47%),三组在平均年龄、文化程度、在婚比例、同性恋自我认同比例、艾滋病知识知晓率、第一次肛交年龄、最近6个月与同性肛交的频率、男性性伴总数、与同性商业性行为时安全套使用频率、与异性性行为频率方面,差异有统计学意义(P<0.05)。三组梅毒感染率分别为7.63%、8.29%和6.55%,差异无统计学意义(χ~2=1.79,P=0.41);HIV感染率分别为7.00%、13.50%和13.62%,差异有统计学意义(χ~2=22.76,P<0.05)。多因素Logistic回归分析结果显示,被插入组感染HIV的风险是插入组的1.98倍[95%可信区间(CI)∶1.38~2.85],双向组感染HIV的风险是插入组的2.13倍(95%CI∶1.53~2.97)。结论南京市不同性角色MSM具有不同的人口学、行为学特征,插入组、被插入组和双向组感染HIV的风险依次增高,应根据各自的特点制定更有针对性的干预措施。
Objective To understand the behavioral characteristics and the status of HIV and syphilis infection in MSM with different sexual roles in Nanjing and provide the basis for more targeted interventions. Methods Under the condition of informed consent, MSM was recruited by classified snowballing method, and questionnaires were conducted to collect demographic and behavioral information, and serological tests were performed on HIV and syphilis antibodies. Results A total of 2 377 MSM were investigated and divided into three groups based on their sexual roles during the last 6 months: 800 in the insertion group (33.66%), 615 in the insertion group (25.87%) and 962 in the bi-directional group (40.47%), , The three groups in the average age, education level, the proportion of marriage, the proportion of homosexual self-identity, awareness of AIDS knowledge, the first anal sex age, the frequency of same-sex anal sex in the last 6 months, the total number of male partners, and same-sex commercial sex The frequency of condom use and the frequency of heterosexual behavior were significantly different (P <0.05). The infection rates of syphilis among the three groups were 7.63%, 8.29% and 6.55% respectively, with no significant difference (χ ~ 2 = 1.79, P = 0.41). The HIV infection rates were 7.00%, 13.50% and 13.62% Significance (χ ~ 2 = 22.76, P <0.05). Multivariate logistic regression analysis showed that the risk of HIV infection in the inserted group was 1.98 times [95% confidence interval (CI): 1.38-2.85] in the insert group and 2.13 times (95% confidence interval) in the bidirectional group % CI: 1.53 ~ 2.97). Conclusion The MSMs with different sexual roles in Nanjing have different demographic and behavioral characteristics. The risk of HIV infection in the insertion group, the inserted group and the bi-directional group increases in turn, and more targeted interventions should be formulated according to their respective characteristics.