云南省2010－2013年男男性行为人群艾滋病相关危险因素变化趋势分析

目的 了解云南省MSM人群知晓率、行为等艾滋病相关危险因素的变化趋势及其安全套使用的影响因素,为干预策略制定和效果评价提供依据。方法 2010-2013年在云南省连续开展MSM哨点监测,调查该人群一般人口学特征、艾滋病相关知识、性行为及安全套使用、吸毒行为、干预措施覆盖等情况,进行趋势和影响因素分析。结果 共调查9 073人,艾滋病知识知晓率、与同性发生性行为比例及安全套使用率均呈逐年上升趋势(P<0.01),与异性发生性行为时安全套使用率明显低于同性,吸毒比例和患性病比例呈下降趋势(P<0.01).同居、低知晓率、外省/外籍、居住时间不足一年、文化程度低、未接受过干预、肛交次数多、未曾做过HIV抗体检测等因素为影响MSM坚持使用安全套的危险因素。结论 云南省近4年MSM艾滋病综合干预效果初显,但多项指标仍处于较低水平,仍需重点关注同居、文化程度低、流动性较大、肛交次数多、有异性性行为的MSM干预,扩大干预覆盖面,继续强化落实HIV动员检测、安全套推广使用等核心干预措施。

Change trend of HIV/AIDS related risk factors and influencing factors among men who have sex with men in Yunnan,2010-2013

Objective To understand the change trend of the awareness rate of HIV/AIDS related knowledge,risk behaviors among men who have sex with men (MSM) in Yunnan and the factors influencing their condom use,and evaluate the effect of comprehensive intervention. Methods The data about the MSM''s demographic information,HIV/AIDS related knowledge awareness,and sex behavior,condom use,drug use and intervention receiving were obtained from AIDS sentinel surveillance among MSM in Yunnan province during 2010-2013 to conduct change trend and influencing factor analysis. Results A total of 9 073 MSM were surveyed. The awareness rate of the HIV/AIDS related knowledge,homosexual behavior and condom use rate increased year by year(P<0.01). The condom use rate was lower in heterosexual behavior,and the drug use rate and sexually transmitted disease prevalence declined with year(P<0.01). Multivariate logistic regression analysis indicated that cohabiting,low awareness of HIV/AIDS related knowledge,being from other provinces,local residence for <1 year,low education level,receiving no intervention,frequent anal sex and receiving no HIV/AIDS detection were the risk factors influencing persistent condom use among MSM. Conclusion The effect of HIV/AIDS comprehensive intervention was observed after 4 years implantation,but most of the index were at low level. More attention should be paid to the intervention among MSM with cohabiting habit,low education level,frequent anal sex,and heterosexual sex. It is necessary to expand intervention coverage,strengthen HIV test and promote condom use among MSM.