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目的了解江苏省苏州市男男性行为人群(MSM)艾滋病病毒(HIV)新发感染率及新发感染相关因素。方法 2010年4月—2012年12月,通过自愿咨询检测门诊、同伴转介等方式招募MSM,建立前瞻性、开放性队列,每隔6个月随访进行问卷调查和检测。结果共686名MSM纳入队列,研究对象平均年龄(30.8±8.4)岁,其中73.9%无配偶,99.2%为汉族,68.7%在本地居住时间>2年,53.6%为大专及以上文化程度。研究对象至少参加一次随访的比例为52.8%(362/686),累计随访487.0人年,HIV、梅毒发病率分别为4.93/100人年、8.25/100人年,未发现丙肝阳转病例。多因素COX比例风险回归分析结果表明,HIV感染相关因素主要有最近12个月内被诊断为性病感染(HR调整=1.77,95%CI=1.19~2.90)和最近6个月内同性肛交时不坚持使用安全套(HR调整=1.84,95%CI=1.14~2.95)。结论苏州市MSM人群新发感染率较高,性病感染和无保护同性性行为是HIV感染的危险因素。
Objective To investigate the prevalence of HIV and the related factors of new infections among men who have sex with men (MSM) in Suzhou City, Jiangsu Province. Methods From April 2010 to December 2012, MSM was recruited through voluntary counseling and testing clinic, peer referral and so on. A prospective and open cohort was established and questionnaires and tests were conducted every 6 months. Results A total of 686 MSM were included in the cohort. The average age of the subjects was 30.8 ± 8.4 years. 73.9% had no spouse, 99.2% were Han nationality, 68.7% lived in the area for more than 2 years, and 53.6% were college graduates or above. The proportion of subjects who participated in at least one follow-up was 52.8% (362/686). The cumulative follow-up was 487.0 years. The incidence rates of HIV and syphilis were 4.93 / 100 years and 8.25 / 100 years respectively. No cases of hepatitis C were found. Multivariate COX proportional hazards regression analysis showed that HIV infection-related factors were mainly diagnosed as STD infection in the past 12 months (HR adjustment = 1.77, 95% CI = 1.19-2.90) and homosexual anal intercourse during the last 6 months Adhere to the use of condoms (HR adjustment = 1.84, 95% CI = 1.14 ~ 2.95). Conclusions The prevalence of new infections in MSM population in Suzhou City is high. Sexually transmitted infections and unprotected homosexual behaviors are the risk factors of HIV infection.