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目的了解温州市男男性行为(men who have sex with men,MSM)人群艾滋病(acquired immunodeficiency syndrome,AIDS)流行趋势及其相关影响因素,为制定有效的艾滋病防控措施提供科学依据。方法于2011-2013年采用滚雪球、活动场所招募和网络招募等方法获得调查对象,采用统一的监测问卷进行调查,并抽血进行艾滋病病毒(HIV)抗体、梅毒抗体检测。描述性分析MSM人群的人口学特征、艾滋病知晓率、危险行为特点,χ2检验、多因素非条件logistic回归分析不同人口学特征人群的HIV感染率差异,P<0.05为差异有统计学意义。结果 2011-2013年共调查MSM 1204例,样本来源以公园/公厕为主,占28.9%,平均年龄(30.16±8.64)岁,30岁以下占53.8%,未婚占59.7%,高中及以上占59.8%,本地居住时间2年以上占62.4%。艾滋病知晓率呈现出逐年增加的趋势(χ2=80.23,P<0.05)。MSM人群中最近6个月与同性发生肛交性行为比例为75.7%。最近6个月安全套坚持使用率和最近一次安全套使用率分别为47.1%和75.7%,历年无变化(χ2值分别为3.81和0.06,均P>0.05)。最近6个月与同性发生商业性行为的比例在逐年下降(χ2=73.69,P<0.05),但是安全套坚持使用率历年未发生变化(χ2=7.82,P>0.05)。HIV阳性检出率为7.39%,历年差异无统计学意义(χ2=3.63,P>0.05)。多因素非条件logistic回归分析显示,样本来源、本地居住时间、梅毒感染与HIV感染有关。结论温州市MSM人群HIV感染率处于较高水平,“知-行”分离现象明显,需引起重点关注,应该根据MSM人群特点进一步完善综合干预措施和方法。
Objective To understand the prevalence of acquired immunodeficiency syndrome (AIDS) in men who have sex with men (MSM) and its related influencing factors in Wenzhou, and to provide a scientific basis for developing effective AIDS prevention and control measures. Methods From 2011 to 2013, the subjects were investigated using snowballs, recruitment of venues and recruitment of internet. The questionnaires were collected by a unified questionnaire and blood was collected for HIV and syphilis antibody testing. Descriptive analysis MSM population demographic characteristics, awareness of AIDS, risk behavior characteristics, χ2 test, multivariate non-conditional logistic regression analysis of population demographics HIV prevalence differences, P lt; 0.05 for the difference was statistically significant. Results A total of 1204 cases of MSM were investigated in 2011-2013. The samples were mainly from parks and public toilets, accounting for 28.9%, average age (30.16 ± 8.64) years, accounting for 53.8% under 30, unmarried 59.7%, and high school 5915 %, Local living more than 2 years accounted for 62.4%. AIDS awareness showed a trend of increasing year by year (χ2 = 80.23, P <0.05). The proportion of anal intercourse with MSM in the last 6 months in MSM population was 75.7%. The condom use rate and the most recent condom use rate in the last 6 months were 47.1% and 75.7%, respectively, with no changes over the years (χ2 = 3.81 and 0.06, all P> 0.05). The proportion of commercial sex with the same sex in the recent 6 months declined year by year (χ2 = 73.69, P <0.05). However, the rate of condom use did not change over the years (χ2 = 7.82, P> 0.05). The positive rate of HIV was 7.39%, with no significant difference over the years (χ2 = 3.63, P> 0.05). Multivariate non-conditional logistic regression analysis showed that sample source, local residence time and syphilis infection were related to HIV infection. Conclusions HIV infection rate of MSM population in Wenzhou is at a high level, and the phenomenon of “knowing - walking” is obvious. It needs to pay more attention to it. The comprehensive intervention measures and methods should be further improved according to the features of MSM population.