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目的探讨厦门市在男男性行为人群(MSM)疫情调查中,出现艾滋病病毒(HIV)抗体阳性率增高的原因。方法采用回顾性核查现场调查与实验室检测、分析调查数据、对HIV阳性者追踪调查,以及在MSM人群中进行深入访谈等方法,分析可能导致HIV阳性率增高的因素。结果 (1)不同调查之间的实验室HIV检测判定标准出现了调整,前三轮调查没有HIV阳性者采用替代策略I判断标准,而最后一轮调查中则有3例阳性采用了这一判断标准;(2)调查对象的构成也发生了变化,第四轮调查对象的平均年龄大于前三轮(27.1±6.5岁vs 25.7±6.0岁,P<0.05),汉族所占的比例也高于前三轮(97.4%vs 91.6%,P<0.01);在MSM中进行的访谈提示,第四轮调查中来自会所的对象的比例可能出现了增加;(3)不能排除HIV在MSM人群中流行加剧的可能。结论 MSM人群HIV阳性率的增高可能是上述一个或几个因素单独或共同作用的结果。
Objective To investigate the causes of HIV antibody positive rate in the investigation of MSM epidemic in Xiamen City. Methods Retrospective field investigation and laboratory tests, analysis of survey data, follow-up survey of HIV positive persons and in-depth interviews with MSM population were conducted to analyze the factors that may lead to the increase of HIV positive rate. Results (1) There was an adjustment in laboratory HIV testing standards between different surveys. In the first three rounds of surveys, no alternative strategy was adopted for HIV-positive people. In the last round of investigation, 3 cases were positive for using this criterion (27.1 ± 6.5 vs 25.7 ± 6.0, P <0.05). The proportion of Han nationality was also higher than that of the first three rounds The first three rounds (97.4% vs 91.6%, P <0.01); interviews conducted in the MSM suggested that there may be an increase in the proportion of subjects from the clubhouse in the fourth round of investigation; (3) HIV prevalence in the MSM population can not be ruled out Exacerbated possible. Conclusion The increase of HIV positive rate in MSM population may be the result of one or several factors alone or in combination.