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目的了解我国西部地区男男性接触者(MSM)最近1年人类免疫缺陷病毒(HIV)检测比例及其影响因素。方法在重庆及四川地区部分城市采用来自多个地区和途径的方便抽样,共招募1 245例MSM。调查对象通过匿名的自填式问卷完成调查并同时接受现场HIV检测,采用logistic回归模型对该地区MSM近1年HIV检测行为的影响因素进行分析。结果调查完成问卷1 245份,有效问卷1 199份(96.31%)。调查中最近1年HIV检测比例为43.45%(521/1 199);HIV抗体阳性检出率为21.35%(256/1 199),其中近1年没有做过HIV检测者中HIV抗体阳性检出率(24.93%)高于检测者(16.70%),差异具有统计学意义(χ2=11.876 3,P=0.000 6)。多因素logistic回归分析结果显示,艾滋病相关知识得分>10分(OR=1.593,95%CI:1.164~2.180)是MSM近1年参与HIV检测的促进因素,而既往未做过艾滋病主动咨询(OR=0.284,95%CI:0.218~0.371)、自认为所生活的市/区/县的“同志”人群感染艾滋病的比率低(OR=0.570,95%CI:0.386~0.841)、最近6个月与男性肛交时偶尔使用或从不使用安全套(OR=0.688,95%CI:0.514~0.919;OR=0.645,95%CI:0.421~0.987)是阻碍因素。结论西部地区MSM人群近1年HIV检测比例较低,而整体HIV感染率较高,且近1年未接受HIV检测的MSM具有更高的HIV感染风险。应继续深入加强以“同志”社区为基础的艾滋病感染风险教育,进一步提高艾滋病高流行地区MSM人群定期主动HIV检测的比例,有效控制艾滋病流行。
Objective To understand the detection rate of human immunodeficiency virus (HIV) in MSM in the western region of China in recent years and its influencing factors. Methods In some cities of Chongqing and Sichuan, convenient sampling from multiple regions and routes was used, and 1,255 MSMs were recruited. Respondents completed the survey through anonymous self-administered questionnaires and received on-site HIV testing. Logistic regression models were used to analyze the influencing factors of HIV testing in MSM in the past year. Results The survey completed 1 245 questionnaires and 1 199 valid questionnaires (96.31%). In the survey, the HIV detection rate was 43.45% (521/1 199) in the recent one year. The positive rate of HIV antibody was 21.35% (256/1 199), of which HIV antibody was not detected in HIV test in the past year The rate (24.93%) was higher than that of the test (16.70%), the difference was statistically significant (χ2 = 11.876 3, P = 0.0006). Multivariate logistic regression analysis showed that AIDS-related knowledge scores> 10 points (OR = 1.593, 95% CI: 1.164-2.180) were the contributing factors for MSM to be involved in HIV testing in the recent one year. However, AIDS-related counseling (OR = 0.284, 95% CI: 0.218 ~ 0.371). The rates of HIV / AIDS among the “gay people” in the cities / districts / counties they live in are low (OR = 0.570,95% CI: 0.386-0.841) Occasionally or without condom use was associated with male anal sex in months (OR = 0.688, 95% CI: 0.514-0.919; OR = 0.645, 95% CI: 0.421-0.987) as obstructive factors. Conclusion MSM population in western China has a lower HIV detection rate in the past year and a higher overall HIV infection rate. MSM who did not receive HIV detection in the past year has a higher risk of HIV infection. The HIV / AIDS risk education based on “gay community” should be further strengthened to further increase the proportion of regular active HIV testing among MSM population in areas with high HIV prevalence and to effectively control the AIDS epidemic.