2017—2020年济南市男男性行为者新型毒品滥用趋势及相关因素分析

目的 了解济南市男男性行为者（men who have sex with men，MSM）新型毒品滥用趋势及相关因素。方法 用社区组织-合作医院-疾控中心三方合作的“三位一体”的方式开展MSM面对面问卷调查项目，收集人口学特征、高危性行为及艾滋病防治相关信息。采用χ2 检验和非条件二分类多因素logistic回归分析MSM人群新型毒品滥用趋势及影响新型毒品使用的相关因素。结果 2017—2020年共调查1 700名MSM人群中，每年使用过新型毒品比例分别为12.50%（50/400）、6.47%（26/402）、33.25%（134/403）、51.52%（255/495），呈逐年递增趋势（χ2趋 = 237.28，P＜0.01）；各年份HIV抗体阳性率分别为4.00%（16/400）、3.48%（14/402）、3.72%（15/403）、2.42%（12/495）（χ2 = 2.025，P = 0.567）；梅毒抗体阳性率分别为1.00%（4/100）、4.00%（16/400）、5.21%（21/403）、3.23%（16/495）（χ2 = 11.637，P = 0.009）。多因素logistic回归分析结果显示，在吸食新型毒品的相关因素中，25岁及以下年龄组是35岁以上年龄组的1.72倍（95%CI: 1.29～2.28）、26～35岁年龄组是35岁以上年龄组的1.64倍（95%CI: 1.21～2.24）、自我认定同性恋者是其他人群的2.15倍（95%CI: 1.54～3.01）、最近1周同性肛交发生次数≥2次是＜2次的2.61倍（95%CI: 2.00～3.40）、最近六个月发生同性商业性行为是未发生的2.44倍（95%CI:1.03～5.83）、最近六个月发生异性性行为是未发生的1.57倍（95%CI:1.19～2.06）、HIV阳性感染者是阴性的1.89倍（95%CI:1.07～3.35）、梅毒阳性感染者是阴性的2.19倍（95%CI:1.25～3.85）。结论 济南MSM人群新型毒品滥用呈逐年上升趋势，新型毒品滥用和HIV、梅毒感染相关，同时年轻人、同性恋倾向、同性商业性行为者及双性性行为者是新型毒品滥用的重点人群，应加强其警示性教育。

Trends and related factors of new-type drug abuse among men who have sex with men in Jinan from 2017 to 2020

Objective To understand the trends and related factors of new-type drug abuse among men who have sex with men (MSM) in Jinan. Methods A face-to-face MSM questionnaire survey was conducted using a trinity approach of community organization-partner hospital-CDC to collect information on demographic characteristics, high-risk sexual behaviors and HIV prevention and treatment. The χ2 test and unconditional dichotomous multi-factor logistic regression were used to analyze the trend of new drug abuse among MSM population and related influencing factors. Results Among a total of 1 700 MSM surveyed from 2017 to 2020, the proportion of those who used new drugs per year was 12.50% (50/400), 6.47% (26/402), 33.25% (134/403), and 51.52% (255/495), respectively, showing an increasing trend year by year (χ2trend = 237.28, P<0.01). The positive rates of HIV antibody each year were 4.00% (16/400), 3.48% (14/402), 3.72% (15/403) and 2.42% (12/495) (χ2=2.025, P=0.567), respectively. The positive rates of syphilis antibody each year were 1.00% (4/100), 4.00% (16/400), 5.21% (21/403), 3.23% (16/495) (χ2=11.637, P=0.009), respectively. Multivariate logistic regression analysis showed that new-type drug abuse among MSM in Jinan were more likely to be the group aged 25 and below (OR=1.72, 95%CI: 1.29-2.28) or the group aged 26-35 (OR=1.64, 95%CI: 1.21-2.24), with self-identified as homosexuals orientation (OR=2.15, 95%CI: 1.54-3.01), with the number of male anal sex more than 2 times in the last week (OR=2.61, 95%CI: 2.00-3.40), ever having male commercial sex in the last six months (OR=2.44, 95%CI: 1.03-5.83), ever having heterosexual behavior in the last six months (OR=1.57, 95%CI: 1.19-2.06), with HIV positive (OR=1.89, 95%CI: 1.07-3.35) and syphilis positive (OR=2.19, 95%CI: 1.25-3.85). Conclusion New-type drug abuse among MSM in Jinan is increasing year by year and it is related to HIV and syphilis infection. Warning education should be strengthened to the key groups of new-type drug abuse with characteristics including young people, homosexual tendency, male commercial sex behavior and bisexual sex behavior.