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目的了解艾滋病病毒(HIV)抗体阳性的男男性行为者(MSM)的性病感染状况及其影响因素,为MSM的艾滋病防治策略提供科学依据。方法 2016年8-11月,采用方便抽样的方法,在上海、济南两地两家医院内,抽取正在进行抗病毒治疗的HIV阳性MSM进行问卷调查和实验室检测。结果共调查380例HIV阳性MSM,其中梅毒感染者63例,感染率16.6%[95%可信区间(CI):12.9%~20.5%];尖锐湿疣50例,感染率13.2%(95%CI:10.0%~17.1%);生殖器疱疹和淋球菌感染各1例,感染率各为0.3%(95%CI:0~0.8%);未检出生殖道衣原体阳性者。总的性病感染者有98例,感染率为25.8%(95%CI:21.6%~30.0%)。影响性病感染的多因素Logistic回归分析显示,年龄≤29岁[比值比(OR)=4.94,95%CI:1.02~24.47]、CD4~+T淋巴细胞水平低于正常值(OR=2.20,95%CI:1.34~3.60)和不知晓性病知识(OR=1.82,95%CI:1.15~3.25),是感染性病的危险因素。结论抗病毒治疗门诊中的HIV抗体阳性MSM的性病感染率相对较高,建议进一步加强对该人群的性病防范宣传教育以及性病的筛查和诊疗服务,将有助于降低性病感染率,从而减少HIV的传播。
Objective To understand the STD infection status of HIV-positive MSM and its influencing factors in order to provide a scientific basis for AIDS prevention and control strategies of MSM. Methods From August to November 2016, questionnaires and laboratory tests were conducted on HIV-positive MSM undergoing antiviral therapy in two hospitals in Shanghai and Jinan using a convenient sampling method. Results A total of 380 cases of HIV-positive MSM were investigated. Among them 63 were infected with syphilis, the infection rate was 16.6% [95% confidence interval (CI): 12.9% -20.5%]; condyloma acuminatum 50 cases, infection rate was 13.2% : 10.0% -17.1%); 1 case of genital herpes and gonococcal infection, the infection rates were 0.3% (95% CI: 0 ~ 0.8%); no positive cases of genital Chlamydia were detected. The total number of STIs was 98, with an infection rate of 25.8% (95% CI: 21.6% -30.0%). Multivariate Logistic regression analysis showed that age ≤29 years (OR = 4.94, 95% CI: 1.02-24.47), CD4 ~ + T lymphocyte levels were lower than normal (OR = 2.20,95 % CI: 1.34-3.60) and no knowledge of STDs (OR = 1.82, 95% CI: 1.15-3.25), were risk factors for STDs. Conclusion HIV infection in HIV-infected MSM is relatively high in STDs, suggesting that further promotion of STD prevention and treatment and STD screening and treatment services in this population will help reduce the STD infection rate and thus reduce Transmission of HIV.