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目的了解互联网+自我检测模式下,首次接受艾滋病病毒(HIV)检测的男男性行为者(MSM)的特征及其感染危险因素。方法与北京当地社区组织合作,通过互联网+自我检测模式,为有HIV检测意向的MSM提供免费HIV快速检测试剂。通过快递收到HIV快速检测试剂后,按操作说明要求进行自我检测,并将HIV自我检测结果反馈回HIV自检试剂领取网站。结果 2015-2016年共发放检测试剂5 072份,其中491例未反馈HIV自检结果,未反馈自检结果的比例为9.7%。4 581例反馈结果的网络自检MSM中,680例为既往阳性/重复检测,809例既往进行过HIV检测却不知晓检测结果,3 092例为首次HIV检测者。互联网+自我检测MSM具有受教育程度高、多性伴和肛交行为中未能使用安全套等特点。首次自检MSM的HIV阳性率为7.9%(244/3 092),最近1个月内肛交行为活跃(≥5次)与HIV感染相关[比值比(OR)=1.50,95%可信区间(CI):1.04~2.16],<25岁(OR=1.98,95%CI:1.35~2.91)、初中及以下受教育程度(OR=1.47,95%CI:1.06~2.04)和最近一个月未全程使用安全套(OR=1.36,95%CI:1.00~1.85)首次自检者的HIV感染率较高。结论与社区组织合作的互联网+自我检测模式可有效提高HIV检测服务的可及性。
Objectives To understand the characteristics and risk factors of MSM in HIV + HIV testing under the Internet plus self-testing model. Methods In collaboration with Beijing local community organizations, free HIV rapid test reagents were provided to MSM with HIV testing intent through Internet + self-testing mode. After receiving the HIV Rapid Test Reagent through courier, self-test as required by the operating instructions, and feedback the HIV self-test results back to the HIV self-test regex website. Results A total of 5 072 testing reagents were distributed between 2015 and 2016, of which 491 did not feedback the HIV self-test results, and the proportion of non-feedback self-test results was 9.7%. Of the 5881 selftesting MSMs with feedback, 680 were positive past / repeat, 809 had previous HIV testing but no test results, and 3 092 were first HIV test. Internet + self-testing MSM has the characteristics of being highly educated, having sex with multiple sex partners and not using condoms in anal sex. The HIV positive rate was 7.9% (244/3 092) for MSM on the first self-examination and was active (≥5) for HIV within the last month [odds ratio (OR) = 1.50,95% confidence interval (OR = 1.47, 95% CI: 1.06 ~ 2.04) and not in the most recent month (CI = 1.04-2.16), <25 years old (OR = 1.98,95% CI 1.35-2.91) Condom use (OR = 1.36, 95% CI: 1.00-1.85) was associated with a higher HIV prevalence among first self-exams. Conclusion The Internet + self-testing model in collaboration with community-based organizations can effectively increase the availability of HIV testing services.