绵阳市男男性行为人群队列基线HIV/梅毒感染及影响因素分析

目的了解绵阳市男男性行为者(MSM)艾滋病感染现状和影响因素。方法采用应答推动抽样法(RDS),招募符合条件的MSM进行相关行为的寻问式匿名调查和检测前咨询、采集血液进行HIV/梅毒等血清学检测,建立随访队列。结果共调查采血400例,艾滋病病毒(HIV)感染率7.8%,梅毒累计感染率23.8%、现症感染率12.7%,HIV合并梅毒现症感染、梅毒累计感染的比例分别为16.7%和40.0%。单因素分析,不同经济收入、寻找性伴场所、近6个月性伴数、近6个月性伴主要来自偶然性伴、首次性交年龄、近6个月性伴最大年龄,是否近1年接受过同伴教育、梅毒感染(累计感染)者HIV感染率,不同年龄、职业、婚姻状况、性取向、经济收入、寻找性伴场所、首次性交年龄、距首次性交时间、近6个月性伴最大年龄,是否近6个月性伴主要是妻子、在家认识性伴者等梅毒感染率(累计感染率)有关。多因素分析,感染HIV的独立影响因素包括浴室/公园/网络为主要性伴场所场所、近6月性伴数≥6、首次性交年龄≥19岁、近6月性伴主要来自偶然性伴。梅毒感染(累计感染)的独立影响因素包括离异/丧偶/同居、性伴最大年龄≥26岁、近6月主要在家里认识性伴、浴室/公园寻找性伴。结论绵阳市MSM人群HIV/梅毒感染率较高,受多性伴、性伴来源、性伴年龄特征等因素影响,应针对性加大干预力度。     

2020年四川省绵阳市男男性行为者HIV感染现状及影响因素

目的 了解2020年四川省绵阳市男男性行为者(MSM)艾滋病病毒(HIV)感染现状,分析影响因素。方法 用“滚雪球”抽样法,进行绵阳市MSM的性行为等问卷调查和血清学检测。用χ²检验、Logistic回归模型进行HIV感染影响因素的单因素及多因素分析。结果 有效问卷1 062份,艾滋病知识知晓率97.74%,近6个月无保护肛交21.37%,近1年艾滋病干预服务覆盖率为91.90%。HIV感染率3.20%,梅毒累计感染率14.20%、现症感染率10.21%。多因素分析结果,年龄≥25岁(OR=3.90,95%CI:1.42～10.70)、外市户籍(OR=2.72,95%CI:1.11～6.70)、市区居住(OR=2.75,95%CI:1.03～7.30)、近6个月无保护肛交(OR=14.19,95%CI:5.86～34.35)是HIV感染的危险因素,朋友支持得分增加(OR=0.90,95%CI:0.81～1.00)、近1年接受过宣传材料和安全套发放(OR=0.39,95%CI:0.15～0.98)、近1年做过HIV检测(OR=0.42,95%CI:0.18～0.97...     

梅毒的流行病学

<正>0063绵阳市MSM队列研究梅毒新发感染及影响因素王毅(绵阳市疾控中心艾滋病防治所),李六林,徐杰…//中国公共卫生.-2014,30(10).-1250~1255采用同伴推动招募法(RDS)在绵阳城区招募调查符合条件梅毒检测阴性的MSM建立开放性前瞻队列,每年随访1次,共3年。随访中不足基线调查样本部分结合滚雪球抽查法,依据纳入条件补充调查对象。结果:研究期间共纳入队列583人,随访535.5人年,梅毒阳转30例,新发感染率5.6/     

2011-2015年广东省江门市男男性行为人群HIV和梅毒感染状况及影响因素分析

目的:了解江门市男男性行为人群(MSM)HIV和梅毒感染状况及其影响因素,为控制艾滋病性病的蔓延提供科学依据。方法:利用2011-2015年国家级MSM监测哨点的数据资料进行分析。结果:调查的1 916名调查对象中,艾滋病相关知识总体知晓率为90.19%;HIV抗体阳性率为6.73%,梅毒阳性率为4.07%。最近6个月与同性发生肛交性行为时每次都使用安全套的比例为51.93%。多因素Logistic回归分析结果显示,与异性婚姻状况为在婚/同居(OR=1.408,95%CI 1.153~1.720)、最近6个月与同性发生商业性行为(OR=2.458,95%CI 1.266~3.787)、感染梅毒(OR=5.804,95%CI3.196~10.540)是HIV感染的危险因素;吸毒(OR=1.164,95%CI 1.037~3.722)、最近6个月与同性发生肛交性行为(OR=10.753,95%CI 7.958~12.685)是梅毒感染的危险因素,而最近一年非梅毒STD史是梅毒感染的保护性因素(OR=0.239,95%CI 0.090~0.629)。结论:江门市MSM人群HIV和梅毒感染率较高,且梅毒、已婚/同居与同性发生商业性行为可增加HIV感染的风险;吸毒、与同性发生肛交性行为可增加梅毒感染的风险。     

广州地区MSM和FSWs的性病知晓情况及梅毒艾滋病感染因素分析

目的:了解广州地区男男同性性行为者(MSM)、女性性工作者(FSWs)的性病知晓情况及梅毒、艾滋病病毒感染现况,并分析感染因素。方法:经知情同意后,2017年4-8月对广州地区MSM和FSWs两类高危人群进行面对面问卷调查,采集静脉血检测梅毒及HIV抗体,并进行统计学分析。结果:314例MSM的性病相关疾病知晓率、性病传播途径知晓率、性病防止感染方式知晓率分别为62.10%、44.59%、41.08%,408例FSWs以上知晓率分别为49.02%、22.06%、31.13%。264例MSM参与梅毒及HIV抗体检测,梅毒感染率为1.52%,HIV感染率为10.23%;多因素Logistic逐步回归分析结果显示,学历高中及以上(OR=0.360,95%CI:0.131~0.989),知晓性病相关疾病(OR=0.373,95%CI:0.157~0.881)是感染HIV的保护因素,认为自己可能感染艾滋病(OR=3.440,95%CI:1.401~8.443)和梅毒检测结果阳性(OR=14.151,95%CI:1.745~114.736)是危险因素。FSWs梅毒感染率为3.92%,HIV感染率为0.25%;场所为中高档是感染梅毒的保护因素(OR=0.166,95%CI:0.052~0.526)。结论:广州地区MSM和FSWs的梅毒、艾滋病病毒感染率高,性病知识知晓率低,应扩大高危人群梅毒、艾滋病病毒筛查范围,并加强性病知识宣教。     

广州市520名男男性行为者HIV感染情况及影响因素分析

目的:了解广州市男男性行为者(MSM)的艾滋病知识、高危行为以及艾滋病、梅毒感染情况及影响因素,为针对性开展MSM人群艾滋病防治工作提供依据。方法:面对面问卷调查520名MSM人群的艾滋病知识、行为情况,并进行艾滋病、梅毒血清学检测。结果:艾滋病知识知晓率为90.19%(469/520);HIV抗体阳性率为9.23%(48/520),梅毒阳性检出率为5.77%(30/520);最近六个月同性肛交性行为时每次均用安全套比例为53.81%(240/446);多因素logistic回归分析结果显示,感染了性病[OR=3.333,95%CI:(1.146~9.696)]、最近六个月与同性发生肛交性行为使用安全套的频率较少[OR=3.460,95%CI:(1.770~6.763)]是HIV感染的危险因素(P0.05)。结论:广州市MSM人群艾滋病知识知晓率高、安全套使用率低、知行分离严重,艾滋病、梅毒感染率高,应加强有效的干预检测和性病诊治。     

云南省2012-2014年某男男性行为人群检测平台HIV-1新发感染状况分析

目的了解男男性行为人群(MSM)中人类免疫缺陷病毒I型(HIV-1)新发感染情况及影响因素,为有针对性地开展艾滋病防治工作提供基础数据。方法回顾性分析云南省2012-2014年某检测平台MSM人群HIV和梅毒血清学检测资料。结果 1 113名调查对象HIV抗体阳性检出率12.94%(144/1 113),梅毒血清学阳性检出率6.83%(76/1 113)。144例HIV感染者中,HIV-1新发感染77人,年龄17~62岁,平均28.73±8.85岁,34岁及以下占80.52%(62/77)。以未婚(占80.52%,62/77)和大专及以上文化程度者(占55.84%,43/77)居多。年平均新发感染率15.19%(95%CI:11.80%~18.58%)。梅毒患者较非梅毒患者更易发生HIV新发感染(OR=4.013,95%CI:2.115~7.614,P0.001)。MSM人群中年龄、婚姻状况和受教育程度的差异未成为HIV新发感染的统计学变量(P0.05)。结论 MSM人群的HIV感染率和HIV-1新发感染率较高,男男性传播对青年人的威胁值得关注,受教育程度提高并未减少HIV新发感染发生,预防和规范治疗梅毒等性传播疾病是预防HIV传播的有效措施。     

依托性病门诊开展男男性行为人群梅毒感染调查

目的:依托性病门诊在佛山地区开展男男同性性行为人群(men who have sex with men,MSM)梅毒感染状况的调查,为预防与控制梅毒的流行、向MSM提供相应的高危行为干预及高质量的公共卫生服务提供科学依据.方法:2010年7月~2011年12月,通过性病门诊共对161名MSM进行血清学检测和问卷调查.应用酶联免疫吸附方法检测血清中特异性梅毒螺旋体抗体和对HIV抗体初筛,用甲苯胺红不加热血清试验检测非特异性梅毒螺旋体抗体.用2 检验进行单因素分析;运用二分类logistic回归模型分析梅毒感染的相关因素.结果:调查对象的梅毒感染率为12.4%(20/161),与梅毒感染相关的高危因素有不与家人同住(OR=4.35)、性伴多于3人(OR=12.58)、最近一次性行为没有使用安全套(OR=5.19)以及HIV感染(OR=16.84)等原因.结论:多性伴、既往HIV感染、发生性行为时不使用安全套等是梅毒感染的高危因素,应在性病防治工作中开展有效干预,遏制梅毒传播.     

深圳市男男性接触人群梅毒合并HIV感染状况及其危险因素分析

目的：了解深圳市近6个月内发生过同性临时性行为的MSM人群梅毒合并HIV感染状况及其相关影响因素。方法：运用滚雪球法和同伴推动抽样法招募MSM进行问卷调查和血清学检测,采用χ2检验和Logistic回归分析梅毒HIV合并感染的相关影响因素。结果：共调查434例MSM,梅毒和HIV感染率分别为16.4%和12.2%,梅毒合并HIV感染率为7.3%。年龄越大（OR=4.0,P=0.0007）、高中/中专文化者（OR=6.5,P=0.0081）、性角色以被动方为主者（OR=12.1,P=0.0017）、多个同性肛交性伴者（OR=1.5,P=0.0455）、不能坚持每次使用安全套者（OR=2.9,P=0.0236）,其梅毒合并HIV感染风险越高。结论：需要采取更大努力来应对该人群的梅毒和HIV双重感染问题。     

男男性行为艾滋病毒感染者梅毒感染的影响因素分析

目的:了解男男性行为(MSM)艾滋病毒感染者之梅毒感染的影响因素,为医师制定合适的行为介入和卫教宣导干预方案提供指导。方法:本研究于2014年1月至2015年6月期间,以自填问卷的方式,对我院建档复诊的MSM艾滋病毒感染者进行问卷调查,问卷调查内容主要包括人口学基本资料、健康状况及服药情况、性行为模式三大部分。结果:263例MSM艾滋病毒感染者中,48.7%出现梅毒感染,单因素分析发现,职业、病程、CD4 T细胞数量、病毒载量、是否使用HAART药物、主要性伴侣是否为HIV感染者、是否有非主要性伴侣、有无使用娱乐性药物8个因素是艾滋病毒感染者之梅毒感染的相关变项。多因素分析发现,教师/军人/公职人员(OR=0.20)是梅毒感染的保护因素,使用HAART药物(OR=4.67)、主要性伴侣是/有的是有的不是HIV感染者(OR=3.41)、有非主要性伴侣(OR=2.19)以及使用娱乐性药物(OR=2.14)是梅毒感染的危险因素。结论:MSM艾滋病感染者之后感染梅毒的情况较为普遍,在后续的追踪管理中应结合危险因素加强对高危人员的行为介入和卫教宣导,减少其梅毒感染几率。     

Relationship between syphilis and HIV infections among men who have sex with men in Beijing, China

BACKGROUND: Little is known about risk of HIV and other STDs among men who have sex with men (MSM) in China. OBJECTIVE: To survey the prevalence and risk factors of HIV and syphilis and evaluate correlation of two infections among MSM in the Chinese capital city. METHODS: A community-based sample of 526 MSM was recruited in 2005 through Internet advertising, community outreach, and peer referring. Interviewer-administered interviews were conducted to collect information on demographics and sexual and other risk behaviors, and blood samples were collected to test for syphilis and HIV infections. RESULTS: Seventeen (3.2%) participants were HIV seropositive and 59 (11.2%) syphilis seropositive. Sixty-four percent of participants were migrants who did not have Beijing residence. Forty percent had >10 lifetime male sex partners and 28.8% reported having ever had sex with women. Consistent condom use with primary male sex partners ranged from 21% to 24%, with nonprimary male sex partners from 35% to 42%, and with female partners around 33%. Illicit drug use was not common; only 2.5% reported using Ecstasy or ketamine in the past 6 months. Multivariate logistic regression analyses demonstrated that >10 lifetime male sex partners were independently associated with seropositivity of both syphilis (OR, 1.9; 95% CI, 1.1-3.4) and HIV (OR, 4.3; 95% CI, 1.4-13.6). In addition, HIV infection is significantly associated with syphilis seropositivity (OR, 3.8; 95% CI, 1.3-10.8). CONCLUSIONS: High mobility, multiple sexual partners, and high prevalence of unprotected sex behaviors and syphilis infection suggest a potential rapid spread of HIV in Chinese MSM.     

中国16个城区男男性行为人群梅毒感染情况及影响因素分析

目的 了解中国6个省（自治区、直辖市）的16个城区的男男性行为人群（MSM）的梅毒感染情况及其影响因素。方法 于2007年在开展绘制MSM活动场所地理分布图及人群规模估计的基础上，用分类的非概率抽样方法在MSM中开展横断面调查；通过问卷调查收集人口学、危险行为以及梅毒感染等信息。用SPSS软件对数据进行单因素及多因素Logistic回归分析。结果 2007年共收集4211份有效问卷。所调查的MSM平均年龄为28岁，自报为同性恋占66.7%，未婚占72.5%，高中及其以上教育程度占76.4%。近6个月MSM的性行为调查结果显示：8.7%有10个以上的男性性伴，5.6%曾买男性性服务，11.3%曾为男性提供商业性服务，18.9%曾与女性发生过性关系，与男性肛交性行为中的安全套坚持使用率仅为36.3%。所调查MSM的梅毒感染率为10.6%。多因素Logistic回归分析结果显示：年龄 > 25岁［调整OR（AOR） = 1.7，95% CI：1.3 ~ 2.0］、本市户籍（AOR = 1.3，95% CI：1.0 ~ 1.7）、调查地区、酒吧/公园招募对象（AOR = 1.3，95% CI：1.1 ~ 1.7）、买男性性服务（AOR = 1.5，95% CI：1.0 ~ 2.1）、男男肛交行为中不坚持使用安全套（AOR = 1.2，95% CI：1.0 ~ 1.5）和自报性病史（AOR = 1.3，95% CI：1.0 ~ 1.7）是梅毒感染的独立相关变量。结论 16个城区MSM的梅毒感染率已达一定水平、男男商业性服务及不安全性行为的流行率较高，亟待加强MSM的梅毒防治工作，包括梅毒和ＨＩＶ筛查、推广使用安全套等综合干预措施。     

2010-2019年云南省玉溪市男男性行为者艾滋病哨点监测结果及知行分离影响因素分析

目的了解2010-2019年云南省玉溪市MSM人群HIV、梅毒和HCV感染状况及艾滋病知晓情况并分析知行分离的影响因素。方法根据《全国艾滋病哨点监测方案》的要求,以每年4-7月为监测期,采用横断面调查法对玉溪市MSM人群的人口学特征、艾滋病知识知晓情况、行为学和接受艾滋病干预服务等情况进行连续监测,应用Logistic回归分析分析MSM人群知行分离的相关影响因素。结果2010-2019年玉溪市监测MSM共3765人次,98.94%(3725/3765)知晓艾滋病基本知识,25.42%(946/3721)存在知行分离。79.18%(2586/3266)的MSM最近6个月与同性肛交时坚持使用安全套,历年坚持使用安全套比例呈上升趋势(B=3.384,P=0.011)。HIV、梅毒和HCV感染率分别为4.54%(95%CI:3.88%~5.21%)、3.45%(95%CI:2.87%~4.04%)和0.64%(95%CI:0.38%~0.89%)。多因素Logistic回归分析显示,年龄越大、户籍为外省、文化程度为初中及以下、最近6个月与异性发生过性行为、最近1年患有性病和HIV抗体阳性者是知行分离的危险因素,而最近1年接受过艾滋病干预服务是保护因素。结论2010-2019年玉溪市MSM人群HIV感染率基本平稳,但坚持使用安全套的比例不高,存在知行分离现象,应提供精准干预,促进MSM坚持使用安全套。     

Commercial sex venues: a closer look at their impact on the syphilis and HIV epidemics among men who have sex with men

OBJECTIVE: To provide insight into the role of commercial sex venues in the spread of syphilis and HIV among men who have sex with men (MSM). Study: A cross sectional study of 1351 MSM who were diagnosed with early syphilis who did and did not encounter sexual partners at commercial sex venues. RESULTS: Overall, 26% MSM diagnosed with syphilis had sexual encounters at commercial sex venues. Of these, 74% were HIV positive, 94% reported anonymous sex, and 66% did not use a condom. Compared to those who did not have a sexual encounter at these venues, they were twice as likely to be HIV positive (OR = 1.91, 95% CI 1.36 to 2.68), six times more likely to have anonymous sex (OR = 6.18, 95% CI 3.37 to 11.32), twice as likely not to use condom (OR = 2.02, 95% CI 1.71 to 2.38), and twice as likely to use non-injecting drugs (OR = 1.65, 95% CI 1.21 to 2.37). CONCLUSIONS: MSM diagnosed with syphilis who frequent commercial sex venues are engaging in high risk behaviours for syphilis and HIV transmission and acquisition. Thus commercial sex venues are one of the focal points of syphilis and HIV transmission and acquisition.     

Syphilis among female sex workers in southwestern China: potential for HIV transmission

OBJECTIVE: The objective of this study was to investigate the prevalence and risk factors of syphilis infection among female sex workers in a southwestern Chinese city along a drug trafficking route. METHODS: From December 2004 to January 2005, 343 female sex workers (FSWs) were recruited through community outreach and peer referring. Confidential questionnaire interviews were administered to collect information on sexual and other sexually transmitted diseases/HIV risk behaviors. Cervical and blood samples were collected to test for syphilis and HIV antibodies and Neisseria gonorrhoeae infection; Condyloma acuminatum infection was diagnosed clinically. RESULTS: Of 343 FSWs, 15.7% were infected with syphilis. The prevalence of HIV, gonorrhea, and C. acuminatum was 0.6%, 2.0%, and 1.5%, respectively. The subtype of 2 HIV-1 infections was both CRF 07BC. Nearly 10% of FSWs reported using illicit drugs. Consistent use, inconsistent use, and never use of condoms with commercial sex clients in the last month were reported by 53.9%, 38.5%, and 7.6% FSWs, respectively. Longer duration of sex work (odds ratio [OR] = 1.98; 95% confidence interval [CI] = 1.08-3.62), working at low-end establishments (OR = 2.03; 95% CI = 1.10-3.76), and if primary sex partners had sex with other women in the past 6 months (OR = 2.06; 95% CI = 1.08-3.91) were independently associated with syphilis infection. CONCLUSIONS: High prevalence of syphilis and overlapped unprotected commercial sex and drug using behaviors among FSWs along a drug-trafficking route may suggest a potential for rapid spread of HIV from injection drug users to FSWs and then to the general population and underscore the urgency of preventive interventions to break the bridge of FSWs for HIV/sexually transmitted disease spread.     

HIV related behaviours and attitudes among Chinese men who have sex with men in Hong Kong: a population based study

OBJECTIVE: This study was conducted in order to determine the prevalence of men having sex with men (MSM) and their HIV related behaviours and attitudes among Chinese men in Hong Kong. METHODS: A large scale, random, population based, anonymous telephone survey of 14 963 men between the ages of 18-60 was conducted. The overall response rate was approximately 57%. RESULTS: Of the respondents, 4.6% had ever engaged in MSM activity. In the 6 months preceding the survey, 2.0% had engaged in MSM behaviours (active MSM) and 0.5% reported having engaged in anal sex MSM behaviours. Among anal sex MSM, consistent condom use was 42.9% with male non-commercial sex partners and even lower with male commercial sex partners (35.7%). Approximately 11% of anal sex MSM and 4.1% of the non-anal sex MSM had contracted an STD in the last 6 months. The prevalence of HIV testing was only 20.6% among anal sex MSM and 11.9% among non-anal sex MSM. CONCLUSIONS: Active MSM in Hong Kong are at high risk of HIV infection. The belief of low vulnerability to HIV is prevalent among active MSM in Hong Kong with only 2.0% believing that their chances of HIV infection as being "very likely."     

广州市男男性行为人群STD/HIV相关高危行为特征及就诊延误影响因素调查分析

目的:了解广州市男男性行为(MSM)人群STD/HIV相关高危行为特征和就诊延误影响因素,为制定有针对性的防控措施提供依据。方法:2014年10月至2015年9月期间,对参加STD/HIV自愿咨询检测且已经出现疑似STD/HIV感染相关症状、近2年内发生过同性性行为的MSM进行面对面问卷调查,采集静脉血检测HIV和梅毒。结果:共调查313名MSM,38.02%近2年内与异性发生过性行为,40.89%拥有固定的同性性伴,肛交性行为中每次都使用安全套的比例为47.04%。本次病程中80.51%发生就诊延误,首次就诊间隔时间平均为30天,影响就诊延误的因素主要包括职业、对同性恋的态度、近2年是否发生异性性行为、是否曾患其它非梅毒性病、就诊频次、是否暂停性生活。血清学监测结果 HIV感染率为20.77%,现症梅毒感染率为6.39%,同时感染HIV和梅毒的比例为4.79%,就诊延误发生者的HIV感染率和梅毒感染率均高于未发生就诊延误者,差异有统计学意义(P值均0.05)。结论:广州市MSM人群HIV感染率高,高危行为普遍存在,就诊延误发生率高,防控形势严峻,应加大宣传教育、提高医疗服务可及性和服务质量以减少就诊延误的发生。     

HIV serodiscordant sex partners and the prevalence of human herpesvirus 8 infection among HIV negative men who have sex with men: baseline data from the EXPLORE Study

OBJECTIVES: Human herpesvirus 8 (HHV-8) infection is common among men who have sex with men (MSM), especially those infected with HIV, and is frequently detected in saliva. We sought to determine whether oral or anogenital contact with HIV discordant, or unknown serostatus sexual partners is associated with HHV-8 seroprevalence among HIV negative MSM. METHODS: HIV negative MSM participating in a behavioural intervention trial for the prevention of HIV infection (the EXPLORE study) were recruited from the Seattle and Denver areas for participation in this cross sectional study. Participants completed detailed questionnaires regarding sexual behaviour, focusing on activities with possible exposure to the oropharynx. Serum samples from study enrollment were tested for the presence of HHV-8 antibodies using whole virus enzyme immunoassay and immunofluorescence assay to latent and lytic proteins. RESULTS: 198/819 MSM (24.3%) were HHV-8 antibody positive. Exposure to saliva with HIV positive and HIV unknown serostatus sex partners was reported by 83% and 90% of all men, respectively. In a multivariate model, reporting more than the median number of lifetime sex partners (OR 2.2, p = 0.03) or lifetime sex partners of unknown HIV status (OR 1.7, p = 0.03), and the performance of oro-anal sex ("rimming") on partners whose HIV status is unknown (OR 2.7, p = 0.04) were independently associated with HHV-8 infection. CONCLUSIONS: The oropharynx may be an important anatomical site in HHV-8 acquisition, and contact with HIV serodiscordant or unknown sex partners is associated with higher HHV-8 seroprevalence among HIV negative MSM.