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目的了解成都市接受社区组织艾滋病病毒(HIV)抗体快速检测服务的男男性行为者(MSM)的特征,以及HIV抗体快速检测阳性者后续确认检测行为的影响因素。方法以2015年1-12月接受成都同乐健康咨询服务中心HIV抗体指尖血快速检测服务的MSM为研究对象,搜集人口学和行为学资料、HIV抗体快速检测结果及后续确认检测情况等信息。采用Logistic回归方法分析快检阳性者后续确认检测行为的影响因素。结果共纳入研究对象3 173人,互联网途径找寻性伴(互联网型)占70.4%(2 235人);互联网型和非网络型MSM在年龄、文化程度、婚姻状况、咨询检测地点、最近6个月男性性伴数和最近6个月与男性发生肛交行为时安全套使用频率的分布上,差异有统计学意义(P<0.001)。HIV抗体快速检测阳性率为10.6%(335人),84.2%(282/335)接受了后续蛋白印迹试验确认检测,确认阳性率为95.7%(270/282)。多因素分析结果显示:MSM进行后续HIV确认检测的影响因素包括:高中或中专文化程度[VS.文盲/小学,比值比(OR)=4.60,95%可信区间(CI):1.36~15.51]、大专及以上文化程度(VS.文盲/小学,OR=6.11,95%CI:1.90~19.60)、在浴室接受咨询检测(VS.办公室,OR=0.41,95%CI:0.19~0.85)。结论互联网已经成为MSM寻找性伴的主要途径,而非网络型MSM具有多性伴和安全套使用差的特征,应有针对性地进行艾滋病宣传教育和行为干预。文化程度低、在浴室被动员的MSM后续确认检测率低,应加强检测前后咨询,减少快检阳性脱失。
Objective To investigate the characteristics of MSM in community-based HIV testing in Chengdu and the factors that subsequently confirm the detection of HIV-positive HIV infection. METHODS: From January to December 2015, MSMs receiving HIV antibody fingerprinting rapid testing services from Chengdu Tongle Health Counseling Center were included in this study. Demographic and behavioral data, rapid HIV antibody test results and follow-up confirmation tests were collected . Logistic regression analysis was used to analyze the influencing factors of follow-up confirmatory testing. Results A total of 3 173 subjects were included in the study, 70.4% (2 235) of whom were found via Internet for sexual partners (Internet type). The Internet and non-network MSM were significantly different in age, education level, marital status, counseling and testing sites, Monthly males and the frequency of condom use in anal intercourse with men during the past 6 months. The difference was statistically significant (P <0.001). The positive rate of rapid detection of HIV antibody was 10.6% (335), 84.2% (282/335) were confirmed by subsequent Western blot test, and the positive rate was 95.7% (270/282). The results of multivariate analysis showed that the influencing factors of follow-up HIV confirmatory test in MSM included: high school or secondary school education [VS. illiterate / primary school, odds ratio = 4.60, 95% confidence interval (CI): 1.36 ~ 15.51 ], College degree or above (VS. illiterate / primary school, OR = 6.11, 95% CI: 1.90-19.60). Consultation was performed in the bathroom (VS. Office, OR = 0.41, 95% CI: 0.19-0.85). Conclusion The Internet has become the main route for MSM to search for sexual partners. Non-network-based MSM has the characteristics of poor use of multiple sexual partners and condoms, and should be targeted for AIDS publicity and education and behavior intervention. Low level of education, MSM mobilized in the bathroom follow-up to confirm the detection rate is low, should be strengthened before and after testing advice to reduce the rapid positive test loss.