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目的了解深圳市男男性行为者(men who have sex with men,MSM)个体性网络大小及其对感染梅毒的影响,为男男性行为者采取干预措施降低梅毒感染风险提供新的视角。方法 2014—2016年深圳市南山区慢性病防治院采用外展干预和男同彩虹门诊相结合的方式对男男性行为者开展匿名自填式问卷调查,收集男男性行为者基本人口学、行为学、性网络特征及梅毒知识知晓情况,开展HIV、梅毒检测,通过卡方检验、Logistic回归探索该人群性行为、性网络与梅毒的相关性。结果共调查429名男男性行为者,梅毒检测阳性率9.1%。平均年龄(27.2±5.8)岁;汉族占98.1%;文化程度大专以上占70%;户籍是外省的占一半以上;约50%在深圳居住时间在半年以内;梅毒预防知识知晓率较低,仅70.2%。个体性网络大小做单因素分析,年龄(P=0.009)、文化程度(P=0.012)、在深居住时间(P=0.002)、最近6月与男性发生肛交时安全套的使用情况(P=0.041)、梅毒知识知晓情况(P=0.047)均与最近6月个体性网络大小情况有统计学意义。梅毒感染单因素分析文化程度、最近6月个体性网络大小、最近6月与男性发生肛交时安全套使用情况与感染梅毒有统计学意义;多因素分析显示个体性网络大小为15人以上(adjusted OR=3.383,95%CI=0.997~23.030)是感染梅毒的危险因素;最近6月与男性发生肛交时每次使用安全套(adjusted OR=0.059,95%CI=0.011~0.305)是感染梅毒的保护因素。结论 MSM人群是梅毒的一个易感人群,感染梅毒会增加感染HIV的风险,预防HIV和梅毒需同步。性网络作为传播HIV/STI桥梁的同时也是预防的关键,通过性网络建立同伴健康教育干预方法是预防性病的重要措施。
Objective To understand the individual network size of men who have sex with men (MSM) in Shenzhen and its impact on syphilis infection, and to provide a new perspective for men who have sex with men (MSM) to reduce the risk of syphilis infection through interventions. Methods From 2014 to 2016, Nanshan District Chronic Diseases Prevention and Treatment Center of Shenzhen City used an outreach intervention combined with male rainbow clinic to conduct anonymous self-contained questionnaire survey on men who have sex with men and collected basic demography, behavior and sex Network characteristics and syphilis knowledge to carry out HIV, syphilis testing, by chi-square test, Logistic regression to explore the population sexual behavior, sex network and syphilis correlation. Results A total of 429 men who had sex with men were investigated. The positive rate of syphilis was 9.1%. The average age was (27.2 ± 5.8) years old; Han accounted for 98.1%; college education accounted for 70%; household registration is more than half of other provinces; about 50% living in Shenzhen within six months; awareness of syphilis prevention knowledge is low, only 70.2%. Univariate analysis showed that the age of the individuals (P = 0.009), educational level (P = 0.012), condom use during anal intercourse with men in the deep living time (P = 0.002) and recent 6 months ), Knowledge of syphilis (P = 0.047) and the size of individual network in recent 6 months were statistically significant. Syphilis infection univariate analysis of the degree of education, the size of the individual network in recent June, the recent June and anal sex with men with condom use and syphilis infection was statistically significant; multivariate analysis showed that the individual network size of more than 15 (adjusted OR = 3.383, 95% CI = 0.997 ~ 23.030) were risk factors for syphilis infection. Condom use (adjusted OR = 0.059, 95% CI = 0.011-0.305) was the protective factor of syphilis infection in recent anal intercourse with men . Conclusion The MSM population is a susceptible population of syphilis. Infection with syphilis increases the risk of HIV infection and prevents HIV and syphilis from synchronizing. As a bridge between HIV and STI, sex network is also the key to prevention. Establishing companion health education intervention through sexual networks is an important measure to prevent venereal diseases.