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目的了解江苏省镇江市男男性行为者(men who have sex with men,MSM)艾滋病高危行为特征、感染情况及其影响因素。方法采用分类滚雪球抽样的方法于2010年2—9月,在镇江市范围内招募MSM进行问卷调查,了解其社会人口学及艾滋病高危行为特征,并采集血样进行人类免疫缺陷病毒(HIV)抗体、梅毒抗体、丙型肝炎病毒(HCV)抗体的检测。结果共调查456名MSM,77.0%最近6个月发生过同性口交性行为,其中61.0%有多个同性口交性伴;87.1%最近6个月发生过同性肛交性行为,其中55.3%有多个同性肛交性伴,14.9%最近1周发生过多次同性肛交性行为;11.3%最近6个月与同性发生过商业性行为,34.9%与异性发生过性行为;最近6个月与同性发生口交性行为时坚持使用安全套的比例为16.0%,肛交时坚持使用安全套的比例是40.3%,与同性发生商业性行为时坚持使用安全套的比例是40.0%,与异性发生性行为时坚持使用安全套的比例为26.4%。456名调查者均采集血样进行了血清学检测,初筛HIV阳性人数40人,确证HIV阳性人数35人,阳性率为7.3%(95%CI 5.40%～10.51%);确证梅毒抗体阳性人数为48人,阳性率为10.5%(95%CI7.86%～13.71%);确证HCV抗体阳性人数为2人,阳性率为0.4%(95%CI0.05%～1.58%);确证HIV抗体与梅毒抗体合并阳性人数为4人,合并阳性率为0.9%(95%CI 0.24%～2.23%)。在多因素logistic回归模型中,月收入为1 000～3 000元(OR=0.40,95%CI 0.18～0.87)与HIV感染的关系具有统计学意义。结论镇江市MSM中无保护性性行为较为普遍,HIV和梅毒感染率较高,应在该人群中加强包括艾滋病宣传和安全套推广在内的艾滋病干预措施,控制艾滋病等性传播疾病的流行。
Objective To investigate the risk behaviors, infection status and influencing factors of HIV / AIDS in men who have sex with men (MSM) in Zhenjiang City, Jiangsu Province. Methods The classification snowball sampling method was used to survey the MSM from January to September 2010 in Zhenjiang City to find out its social demography and characteristics of high risk behaviors of AIDS. Blood samples were collected for HIV antibody, Syphilis antibody, hepatitis C virus (HCV) antibody detection. Results A total of 456 MSM were investigated, 77.0% had same-sex oral sex in the last 6 months, 61.0% had multiple same-sex oral sex partners, 87.1% had homosexual anal sex in recent 6 months, of which 55.3% had multiple Same-sex anal sex, 14.9% of the same sex anal sex occurred many times in the last week; 11.3% of the last 6 months have sex with the same sex, 34.9% and heterosexual sex; the last 6 months with same sex oral sex The proportion of people who consistently use condoms during sexual intercourse was 16.0%, that of insisting on condom use during anal sex was 40.3%, that of insisting on condom use during same-sex sexual activities was 40.0%, and that the proportion of people who consistently used condoms during sex with heterosexuals 26.4%. Serum samples were collected from 456 investigators. The number of HIV-positive individuals was 40 and the number of positive HIV-positive patients was 35 (7.3% (95% CI: 5.40% -10.51%)). The positive number of confirmed syphilis antibody was 48, the positive rate was 10.5% (95% CI7.86% ~ 13.71%); the number of confirmed positive HCV antibody was 2, the positive rate was 0.4% (95% CI0.05% ~ 1.58% Syphilis antibody co-positive number of 4, the positive rate of 0.9% (95% CI 0.24% ~ 2.23%). In the multivariate logistic regression model, the monthly income of 1000 ~ 3000 yuan (OR = 0.40, 95% CI 0.18 ~ 0.87) and the relationship between HIV infection was statistically significant. Conclusions Unprotected sex is common in MSM in Zhenjiang City. HIV and syphilis infection rates are high. HIV / AIDS interventions such as HIV / AIDS and condom promotion should be strengthened to control the prevalence of sexually transmitted diseases such as HIV / AIDS.