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目的了解男性性工作者(MSW)和男男性接触者(MSM)的HIV、HCV和梅毒感染状况,为预防干预工作提供依据。方法联合258工作组,到MSW和MSM活动场所进行外展服务。在知情同意情况下,分别对深圳市MSW和MSM(不包括MSW)的人口学特征、婚姻及性取向、安全套使用情况等进行问卷调查,采集血样进行HIV抗体、HCV抗体和梅毒血清学检测,比较分析2组人群的检测结果,并以人口学特征为因变量,对MSM(包括MSW)的HIV及梅毒感染状况的影响进行多因素logistic回归分析。结果共调查MSW505人、MSM401人,MSW和MSM的平均年龄分别为23.48、27.65岁;大专及以上学历分别占17.82%、41.71%;≥4000元/月收入者分别占35.84%、18.99%。MSW和MSM均以未婚为主,分别占90.67%、83.75%;同性恋分别占35.25%、61.60%,双性恋分别占34.26%、32.67%,异性恋分别占21.98%、1.50%。MSW有过无保护性主动、被动肛交及口交的比例均低于MSM。MSW人群HIV、HCV和梅毒感染率分别为3.56%、1.19%和11.09%;MSM人群HIV、HCV和梅毒感染率分别为5.00%、1.00%和18.75%。多因素logistic回归分析显示年龄越高(OR=1.399)、月收入越低(OR=0.796)的MSM感染HIV的可能性就越大。年龄越高(OR=1.403)、月收入越低(OR=0.875)、离异或丧偶(OR=3.731)的MSM感染梅毒的危险就越大。结论 MSW和MSM人群的人口学特征、性取向、安全套使用情况存在一定的差异,MSW梅毒阳性率低于MSM,应对2类人群采取针对性的干预措施,以减少STDs/HIV传播的机会。
Objective To understand the status of HIV, HCV and syphilis infection among male sex workers (MSW) and men who have sex with men (MSM) and provide the basis for preventive intervention. Methods Jointly with Working Party 258, outreach to MSW and MSM venues. Under informed consent, questionnaires were conducted on the demographic characteristics, marital and sexual orientation, and the use of condoms of MSW and MSM (excluding MSW) in Shenzhen. Serum samples were collected for HIV antibody, HCV antibody and syphilis serological tests. Multivariate logistic regression analysis was performed to compare the detection results of two groups of people and demographic characteristics as dependent variables on the status of HIV and syphilis infection in MSM (including MSW). Results The average ages of MSW505, MSM401, MSW and MSM were 23.48 and 27.65 years old, respectively. The educational level of junior college and above accounted for 17.82% and 41.71% respectively. The monthly income of ≥4000 yuan / month was 35.84% and 18.99% respectively. MSW and MSM are both unmarried, accounting for 90.67% and 83.75% respectively; homosexuals account for 35.25% and 61.60% respectively, bisexual accounts for 34.26% and 32.67% respectively, and heterosexuals account for 21.98% and 1.50% respectively. The proportion of MSW who had unprotected active, passive anal and oral sex was lower than that of MSM. The infection rates of HIV, HCV and syphilis in MSW population were 3.56%, 1.19% and 11.09% respectively. The infection rates of HIV, HCV and syphilis among MSM population were 5.00%, 1.00% and 18.75% respectively. Multivariate logistic regression analysis showed that the higher the age (OR = 1.399), the lower the monthly income (OR = 0.796) MSM infected with HIV the greater the possibility. The higher the age (OR = 1.403), the lower the monthly income (OR = 0.875). The greater the risk of MSM infection of syphilis with divorced or widowed (OR = 3.731). Conclusion There are some differences in demographic characteristics, sexual orientation and condom use between MSW and MSM. The positive rate of MSW syphilis is lower than that of MSM. Two kinds of interventions should be taken to reduce the chances of STDs / HIV transmission.