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目的了解北京市男男性行为者(MSM)中梅毒的新发感染及影响因素,为开展更具针对性、有效性和科学性的预防干预措施提供科学依据。方法 2011年7月至2013年7月完成MSM基线队列招募,运用问卷调查的形式,收集研究对象的社会人口学和性行为情况,并进行梅毒抗体检测。结果 3年内梅毒抗体阴性基线共招募1074名MSM,6个月随访到660人,梅毒新发感染率为6.12/100人年[95%可信区间(CI)=4.09~8.14]。多因素COX回归分析结果显示,研究对象大专以下的文化程度[风险指数(HR)=2.47,95%CI=1.24~4.91,P=0.01],首次与男性发生性关系的年龄(HR=2.24,95%CI=1.04~4.80,P<0.01)和2011-2013年3年内艾滋病病毒检测次数(HR=3.94,95%CI=1.49~10.41,P<0.001)是梅毒血清抗体阳转的影响因素。结论北京市MSM中梅毒新发感染率仍处在较高水平,急需针对梅毒新发感染的相关影响因素开展预防干预工作。
Objective To understand the new infections and influencing factors of syphilis among MSM in Beijing and to provide a scientific basis for more targeted, effective and scientific preventive interventions. Methods The MSM baseline cohort was recruited from July 2011 to July 2013. The questionnaires were used to collect the socio-demographic and sexual behaviors of the subjects and to detect the syphilis antibodies. Results A total of 1074 MSM were recruited in the negative baseline of syphilis antibody within 3 years. The follow-up was 6 months to 660 with a new onset of syphilis of 6.12 / 100 years [95% confidence interval (CI) = 4.09 ~ 8.14]. The results of multivariate Cox regression analysis showed that the educational level (HR = 2.47, 95% CI = 1.24-4.91, P = 0.01) and the age at first sexual contact with men (HR = 2.24, 95% CI = 1.04-4.80, P <0.01) and the number of HIV tests (HR = 3.94, 95% CI = 1.49 to 10.41, P <0.001) within 3 years from 2011 to 2013 were the influencing factors of positive conversion of syphilis serum. Conclusions The prevalence of syphilis in MSM in Beijing is still at a high level, so it is urgent to carry out preventive interventions in response to the new influencing factors of syphilis.