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。

Results and the Factors of Separation Between Knowledge and Action Among Cross-sectional Survey of Men who Had Sex with Men in Yuxi Prefecture,Yunnan Province,2010-2019

Objective To understand the infection status of HIV,HCV and syphilis,awareness of AIDS and to analyze the factors of separation between knowledge and action among men who had sex with men(MSM)in Yuxi prefecture,Yunnan province over the period of 2010 and 2019.Methods According to the requirement of sentinel surveillance protocol,each year,cross-sectional survey were conducted to collect the information about the demographic characteristic,awareness of AIDS,related behaviors and AIDS intervention services between April and July,multivariate logistic regression was used to analyze the factors associated with separation between knowledge and action.Results Among 3765 MSM,the awareness rate of AIDS was 98.94%(3725/3765),and the rate of separation between knowledge and action was 25.42%(946/3721),of those MSM had anal sex with men in the last six months,the rate of consistent used condoms were 79.18%(2586/3266)and showed an increasing trend(B=3.384,P=0.011).The HIV,syphilis and HCV infection rates were 4.54%(95%confidence interval95%CI]3.88%~5.21%),3.45%(95%CI:2.87%~4.04%)and 0.64%(95%CI:0.38%~0.89%)respectively.Multivariate Logistic regression analyzes indicated that the older,those come from other provinces,those education level was junior high school and below,being had sex with female in the last six months,diagnosed STDs in the last year and HIV infected were more likely to had separation between knowledge and action,while those had received AIDS intervention services was more likely unity of knowledge and action.Conclusion The HIV prevalence among MSM was stably in Yuxi prefecture over the period of 2010 and 2019,but the consistent condom use rate was at a low level,and had separation between knowledge and action.So taken specific interventions to promote persistent condom use was needed.