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目的了解陕西西安市男男性行为人群(MSM)艾滋病病毒(HIV)既往感染和新发感染状况。方法通过滚雪球和同伴推动方法于2013—2015年在西安市招募MSM,面对面一对一问卷调查和静脉采血3~5 m L,应用BED HIV-1 IgG捕获酶免疫法(BED-CEIA)结合病程判断既往感染和新发感染。结果 2 441名调查对象平均年龄(28.98±7.54)岁,未婚占70.8%(1 728/2 441),在本市居住时间≥2年占81.5%(1 989/2 441),大专及以上占78.1%(1 907/2 441),认同自己为男男同性恋者占75.5%(1 844/2 441),寻找性伴场所最多的为网络,占50.6%(1 235/2 441)。83.7%(2 042/2 441)的调查对象在近6个月内与同性发生过无保护性肛交性行为。HIV总感染率7.29%(178/2 441),进行BED检测163例,发现新发感染71例,新发感染者占39.9%(71/178),估算发病率为6.08%。使用助性剂是新发感染的危险因素(OR=2.082,95%CI=1.135~3.820),最近12个月进行HIV检测是其保护因素(OR=0.234,95%CI=0.131~0.417)。结论西安市MSM的HIV感染率仍处于较高水平,定期检测可减少HIV新发感染。
Objective To understand the past and new infections of HIV among men who have sex with men (MSM) in Xi’an, Shaanxi Province. Methods The MSM was recruited in Xi’an from 2013 to 2015 by means of snowball and peer promotion. Face-to- face one-to-one questionnaires and venous blood samples were collected for 3 ~ 5 mL. BED-CEIA was used in combination with the course of disease Judgments of past infections and new infections. Results The average age of 2 441 subjects was (28.98 ± 7.54) years old, 70.8% (728/2 441) were unmarried, 81.5% (1 989/2 441) lived in the city for 2 years or more, college and above accounted for 78.1% (1 907/2 441), 75.5% (1844/2441) agreeing to be gay men and 50.6% (1 235/2441) looking for partners. 83.7% (2 042/2 441) of the respondents had unprotected anal sex with their peers in the past 6 months. The total HIV infection rate was 7.29% (178/2 441). Of the 163 cases detected by BED, 71 cases were found new infections, accounting for 39.9% (71/178) of new infections and the estimated incidence was 6.08%. The use of aids was a risk factor for new infections (OR = 2.082, 95% CI = 1.135-3.820). HIV testing was the protective factor in the 12 months (OR = 0.234, 95% CI = 0.131-0.417). Conclusion HIV infection rate of MSM in Xi’an is still at a high level, and regular testing can reduce new HIV infection.