江苏省男男性行为人群性传播疾病感染状况及危险因素

目的 分析江苏省男男性行为人群梅毒、淋球菌和沙眼衣原体感染状况及其相关危险因素.方法 采用滚雪球法于2010年8-10月在江苏省常州市和扬州市选取400名男男性行为者(MSM)进行现场问卷调查,共获得328份既采集静脉血又采集直肠拭子的有效对象.对静脉血使用ELISA法和甲苯胺红不加热血清试验(TRUST)进行梅毒螺旋体检测,对采集的直肠拭子进行淋球菌和沙眼衣原体的检测.采用logistic回归分析梅毒螺旋体、淋球菌和沙眼衣原体感染的影响因素.结果 328名调查对象年龄为(32.46 +9.72)岁,未婚者占59.15％ (194/328);75.00％ (246/328)的调查对象最近3个月与男性发生过肛交行为,最近1次肛交时使用安全套的比率为56.71％(186/328),53.05％ (174/328)的调查对象在最近3个月内未与女性发生过性行为.梅毒的现症感染率为13.41％ (44/328),淋球菌的感染率为3.66％( 12/328),沙眼衣原体的感染率为11.59％( 38/328).有1～2名男性性伴者的梅毒感染率为7.55％ (8/106),有3名及以上男性性伴者的梅毒感染率为25.81％ (16/62).男性性伴数越多感染梅毒的危险性就越大(OR =4.213,95％ CI:1.133～15.656).结论 江苏省部分城市MSM人群梅毒和沙眼衣原体感染率高,高危性行为发生率高,应加强对MSM高危行为的干预.

Analysis on sexually transmitted diseases and the related risk factors among men who have sex with men in Jiangsu province

Objective To investigate infections of syphilis,neisseria gonorrhoeae,chlamydia trachomatis and the related risk factors in men who have sex with men (MSM) in Jiangsu province.Methods A total of 400 MSM were enrolled by Snowball Sampling Method from August to October in 2010 and then 328 cases were surveyed by a questionnaire and collected serum sample 5 ml per person as well as rectal swab on the spot; all of the serum samples were tested for syphilis by ELISA and TRUST,and all of the rectal swabs were tested for neisseria gonorrhoeae or chlamydia trachomatis.The influencing factors of syphilis,neisseria gonorrhoeae,chlamydia trachomatis were analyzed by logistic regression analysis.Results The328 MSM were(32.46 ±9.72)years old,59.15％ (194/328) were unmarried.75.00％(246/328) MSM had rectal sex with men in the past 3 months,and condom use rate for recent sex was 56.71％ (186/328),while 53.05％ (174/328) MSM didn't have sex with women in the last 3 months.The syphilis infection rate among MSM was 13.41％ (44/328),the neisseria gonorrhoeae infection rate was 3.66％ (12/328),and the chlamydia trachomatis rate was 11.59％ (38/328).The number of sex partners was the key factor that influenced syphilis infections (OR=4.213,95％CI:1.133 -15.656).Conclusion The prevalence of syphilis and chlamydia trachomatis was high in MSM in Jiangsu,while risk behavior rate were high in the MSM and then should be intervened.