重庆市网络型与非网络型男男性行为人群HIV、梅毒、丙肝感染率及其相关行为特征比较研究

目的了解网络型与非网络型男男性行为人群（MSM）HIV、梅毒、丙肝感染率及其相关的行为特征,为开展有针对性的干预工作提供建议。方法通过滚雪球的方式招募MSM人群进行面对面的问卷调查和采集血样检测HIV、梅毒、丙肝。对比分析网络型与非网络型MSM人群的一般人口学、行为特征以及H1V、梅毒、丙肝感染率。结果共调查了网络型MSM587人和非网络型MSM358人。网络型MSM人群较非网络型MSM年龄较小、文化程度较高、未婚比例较大、艾滋病防治知识知晓率高、自我同性性取向认同度好。非网络型MSM最近6个月与男性发生肛交时发生无保护性性行为的比例、买性史、卖性史以及与女性发生性行为的比例均高于网络型MSM（70．6％vs61．3％）、（6．2％vs51．4％）、（14．4％vs3．4％）、（32.4％vs10．7％）。非网络型MSM最近1次以及最近6个月与女性发生性行为时,安全套使用率低于网络型MSM（28．4％vs54．0％）和（21．6％vs46．0％）。网络型与非网络型MSM人群HIV感染率都较高,分别为14．7％（4．5％～24.8％）和17．6％（0．6％～34．6％）,但差异无统计学意义。自报性病感染率非网络型MSM高于网络型MSM（22．1％ws16．7％,χ^2=4．22,P=0．04）。结论网络型与非网络型MSM人群HIV感染率均较高。非网络型较网络型MSM人群艾滋病防治知识知晓率低、与男性发生肛交时无保护性性行为比例更高、与女性发生性行为时安全套使用率更低,这部分人群感染艾滋病的危险性更大,是艾滋病由MSM人群向一般人群传播的重要桥梁人群,因此,探索针对网络型与非网络采取不同的干预措施将是当前MSM人群艾滋病防治的迫切任务。     

重庆市男男性接触人群高危行为和性病艾滋病感染率调查

目的了解男男性接触人群（MSM）高危行为情况及其HIV感染状况，为制定针对MSM的干预策略提供科学依据。方法通过滚雪球的方式招募男男性接触者进行面对面的问卷调查，采其静脉血5ml检测HIV抗体和梅毒抗体。资料经SPSS12．0进行统计分析。结果共计调查了1000名MSM，平均年龄（27．8±9．1）岁。调查结果显示，MSM发生首次性行为的平均年龄是（18．8±3．4），发生首次性行为的性伴56．8％是男性。近6个月有78．6％的MSM与男性有过肛交性行为，男性性伴数平均是3．7人，最近6个月与男性发生肛交时，只有31．8％的MSM每次都使用了安全套。HIV感染率为10．4％，梅毒感染率为9．3％。结论MSMHIV和梅毒感染率高，多性伴和发生肛交时安全套使用率低，将可能促进艾滋病在MSM中的快速蔓延；针对MSM的监测，干预工作亟待加强。     

2006-2009年重庆市男男性行为人群性行为特征及HIV和梅毒感染率分析

目的了解男男性行为（MSM）人群性行为特征及HIV和梅毒感染率与趋势变化,为开展该人群艾滋病综合防治提供建议。方法收集2006-2009年MSM人群调查资料,比较分析该人群性行为特征和HIV、梅毒感染率,以及估计HIV发病率的趋势变化。结果 2006-2009年分别调查了1000、1044、743和604名MSM,最近1次与男性发生性行为时安全套使用率由2006年的56.2%上升至2009年的66.1%,最近6个月与男性发生性行为时每次都使用安全套的比例低于40%。2006-2009年梅毒感染率分别为9.3%、8.5%、8.5%和11.9%,梅毒感染率2009年较2008年有上升的趋势,差异有统计学意义（P=0.04）;HIV感染率分别是10.4%、12.5%、16.6%和19.0%,2008年与2007年相比HIV感染率差异有统计学意义（P=0.01）;〈23岁年龄组MSM估计HIV发病率分别为2.4%、2.8%、4.8%和5.2%,2008年较2007年估计发病率差异有统计学意义（P=0.03）。结论重庆市MSM人群HIV感染率和估计发病率均呈逐年上升的趋势,安全套使用率低,MSM人群的艾滋病防治工作应引起高度重视。     

HIV检测对MSM人群艾滋病感染风险的影响

目的分析艾滋病检测对MSM人群知识、行为与感染HIV风险的影响,为调整MSM人群艾滋病防治策略提供依据。方法以过去一年接受过艾滋病检测的MSM人群为干预组,未接受过艾滋病检测的为对照组,比较两组的人口学特征、知识、行为以及梅毒与HIV感染率。结果干预组和对照组分别有423人和528人,平均年龄分别为（26.8±8.0）岁和（26.3±6.2）岁。干预组艾滋病防治知识知晓率高于对照组（χ2=28.9,P〈0.001）,最近6个月与男性发生无保护性性行为的比例低于对照组（χ2=14.7,P〈0.001）,HIV感染率明显低于对照组（χ2=15.0,P〈0.001）。结论艾滋病检测可以有效提高MSM人群安全套使用率,降低感染艾滋病的风险,应在MSM人群中倡导主动咨询检测,扩大咨询检测覆盖面。     

重庆市男男性行为人群干预效果评估

目的评估针对男男性行为人群（MSM）的干预效果,为调整干预策略提供建议。方法比较分析2006、2007和2008年3次横断面调查的MSM人群知识、行为、HIV和梅毒感染率变化趋势。结果2006、2007和2008年分别调查了1000、1044和743名MSM,研究结果显示干预后MSM人群艾滋病防治知识知晓率无明显变化,过去1年接受过咨询检测服务的比例明显上升,最近一次与男性发生肛交时安全套使用率也由2006年的56.4%上升至2008年的64.4%（χ^2=9.25,P=0.002）,HIV感染率呈逐年上升的趋势,由2006年的10.4%上升至2008年的17.0%（χ^2=15.95,P〈0.001）,梅毒感染率2007年较2006年有所下降,但差异无统计学意义（χ^2=0.38,P=0.54）。结论干预后MSM人群艾滋病防治知识认知水平较高,安全套使用率有所提高,但仍处于较低水平,与HIV感染率快速上升的趋势相比,防治形势严峻,开展针对MSM人群的持续有效的综合干预至关重要。     

男男性接触人群艾滋病高危行为互联网QQ干预效果

目的了解普宁市男男性接触者人群（MSM）的基本情况,利用互联网QQ对MSM进行艾滋病高危行为干预并评价干预效果,探讨互联网QQ干预模式的可行性,为基层县市提供借鉴经验。方法建立项目专用QQ群,在普宁市采用同伴推动抽样法（RDS）招募MSM作为干预对象加入该QQ群,通过互联网在QQ群内进行调查及干预,对干预效果进行评价。评价内容包括艾滋病知识知晓率、安全套使用情况、求医意识及行为变化等。结果干预前与干预后分别调查58、54人。艾滋病相关知识总知晓率由干预前的62．07％提高到干预后的88．89％（P〈0．01）;最近一次与男性发生肛交性行为时安全套使用率由干预前的18．97％提高到干预后的40．74％（P〈0．05）,近3个月来与男性发生肛交性行为时每次都使用安全套的比例由干预前的10．34％提高到干预后的31．48％（P〈0．01）;如果出现生殖器破损或HIV病毒感染相关症状时,调查对象打算“到合法正规医院就诊”的比例从干预前的53．45％上升到干预后的85．19％（P〈0．01）。干预前后比较差异均有统计学意义。结论采用互联网QQ对MSM进行艾滋病高危行为干预效果显著．有推广及借鉴价值。     

2006-2008年重庆市男男性服务工作者HIV和梅毒感染率及其高危行为分析

目的了解重庆市男男性服务工作者（MB）在男男性接触者中艾滋病和梅毒感染率及其高危行为状况,为开展该人群的干预提供科学建议。方法分析2006-2008年男男性服务工作者调查资料,比较分析该人群HIV、梅毒感染率及其高危行为状况。结果 2006-2008年分别调查了男男性服务工作者47、71和54人,最近1次与男性肛交时安全套使用率由2006年的66.0%上升至2008年的75.9%;最近1次因金钱与男性发生肛交性行为时安全套使用率由2006年的70.2%上升至2008年的79.6%;2006-2008年最近6个月因金钱与男性发生无保护性肛交的比例分别为42.6%、40.8%、50.0%。2006-2008年HIV感染率分别为12.8%、9.9%、7.4%;梅毒感染率分别为19.1%、8.5%、5.6%。结论重庆市男男性服务工作者HIV感染率高,高危行为普遍存在,应加强该人群的干预工作。     

常德市MSM人群艾滋病、性病感染状况调查

目的了解常德市男男性行为者（MSM）人群艾滋病、梅毒和丙型肝炎病毒的感染状况,为制定有效的防治措施提供信息和依据。方法对287例MSM分别进行人类免疫缺陷病毒（HIV）、丙型肝炎病毒（HCV）和梅毒螺旋体（TP）抗体检测。结果 MSM的总感染率为16.4%,其中HIV阳性10份（3.5%）,HCV阳性3份（1.0%）,TP阳性37份（12.9%）。结论常德市MSM人群的HIV和梅毒感染率较高,是艾滋病防治的重点人群,应立即采取积极有效的预防和干预措施。     

清远市高危人群HIV感染状况及艾滋病相关知识知晓情况调查

目的了解清远市高危人群HIV感染流行趋势和艾滋病相关知识知晓情况,为采取有针对性的行为干预措施和开展宣传教育工作提供准确的信息。方法于2005-2008年采用横断面调查的方法对强制戒毒者、暗娼和性病门诊就诊者等高危人群进行监测,并调查吸毒者和暗娼的艾滋病相关知识知晓情况。结果吸毒人群HIV抗体阳性率介于2.58%～4.15%之间;吸毒者中注射吸毒的比例为82.05%,其中共用注射器吸毒的比例为57.26%;吸毒者中42.39%有商业性行为,而且从未使用安全套的比例为52.53%。在227名暗娼中未发现HIV抗体阳性者,暗娼中最近1个月与客人发生性行为时坚持每次使用安全套的比例为39.43%。性病门诊就诊者HIV抗体阳性率介于0.20%～0.42%之间;34.56%的性病门诊就诊者最近3个月有非婚性伴,而且从未使用安全套的比例为16.25%。调查人群的艾滋病相关知识总体知晓率为57.17%,其中吸毒者和暗娼艾滋病相关知识总知晓率分别为53.05%、61.73%。结论清远市高危人群中以吸毒者HIV抗体阳性率较高,注射吸毒及共用注射器的比例较高,性乱人群中HIV流行水平较低,但存在不安全性行为;高危人群中艾滋病相关知识知晓率低,需采取有效的行为干预措施,加大宣传力度和覆盖面。     

柳州市不同层次暗娼人群梅毒及艾滋病感染状况分析

目的了解柳州市不同层次商业性工作者人群特征、艾滋病相关知识、行为及梅毒、艾滋病病毒感染等现状。方法采用二阶段整群抽样方法抽取调查对象,使用健康问卷面对面调查并采集血样检测HIV和梅毒抗体。结果本次研究共调查403人,部分调查对象认为能够从表面区分艾滋病感染者,与客人发生性行为时安全套使用率较高,但与固定性伴安全套使用率很低。不同档次对象的年龄、婚姻和文化程度略有不同,安全套使用率也略有差别。调查者中1d接客最多20人,1周接客最多25人;首次性行为年龄最小12岁,首次商业性服务年龄最小14岁。58.50%的调查者最近1年患过性传播疾病。未发现HIV阳性者,但发现梅毒RPR初筛阳性者10人,阳性率为2.48%。结论在干预活动时应针对不同层次人群特点,对有配偶或固定性伴者应当加大干预力度和采取不同的策略促其使用安全套,以减少HIV进一步传播。     

A survey of HIV infection and related high-risk factors among men who have sex with men in Suzhou,Jiangsu,China

A cross-sectional study using the snowball sampling method was conducted in May 2008 to investigate human immunodeficiency virus (HIV) infection status and related high risk factors among men who have sex with men (MSM) in Suzhou city of Jiangsu province. The researchers carried out a face-to-face questionnaire interview among MSM, and collected their blood samples to test for HIV and other sexually transmitted diseases (STDs). Among the 280 respondents, 91.1% had homosexual acts in the past 6 months and 87.5% had multiple homosexual partners; 46.4% had heterosexual sex in the past 6 months and 33.1% had multiple heterosexual partners. The rate of continued condom use was 44.3% in homosexual sex in the past 6 months, while the rate in heterosexual sex was 33.9%. Laboratory test results showed that the prevalences of HIV and syphilis were 7.1% (20/280) and 15.0% (42/280), respectively, but no HCV-positive person was found. In the multivariate logistic regression model, subjects with a monthly income of more than RMB $ 1,000 (OR=4.83,95% CI=1.44-16.22), subjects who often went to bars for sexual partners (OR=2.25, 95%CI=1.21-4.20), and subjects who had more than one sexual partner in the past 6 months (OR=0.49, 95%CI=0.25-0.97) and had sex with fixed sexual partners in the past 6 months (OR=0.42, 95%CI=0.25-0.75) were significantly associated with the rate of continued condom use in homosexual sex in the past 6 months. Unprotected sex and multiple sexual partners were more common among MSM in Suzhou city; furthermore, the prevalences of HIV infection and syphilis were relatively high. HIV preventive measures should be designed to address these risk factors and control the spread of HIV among MSM.     

HIV knowledge and risk factors among men who have sex with men in Ho Chi Minh City,Vietnam

OBJECTIVES: To describe health risk behavior, knowledge, and attitudes about HIV/AIDS and its prevention in men who have sex with men (MSM) in Ho Chi Minh City (HCMC), Vietnam. METHODS: A cross-sectional survey of 219 MSM using a standardized questionnaire. RESULTS: Men who have sex with men were easy to locate and willing to answer detailed questions about their sexual behavior. Self-identified sexual orientation was 67% homosexual, 31% bisexual, and 1.4% heterosexual. High-risk sexual behavior was common. The mean number of sexual partners was 3.3 in the previous month and 14.8 in the previous year. Only 32% used condoms during their last intercourse, and only 40% used a condom when their last intercourse included anal sex. Eighty-one percent reported sex with nonregular male partners, and 22% also had sex with women in the past year. Drug use other than alcohol was rare. Most correctly identified high-risk sexual behavior and body fluids that could transmit HIV; however, only about half knew that someone who appeared healthy could transmit HIV or that there was no cure for AIDS. Self-rated risk for HIV was very low, and fewer than one third believed that homosexuals in Vietnam are at increased risk for HIV. CONCLUSION: Men who have sex with men in HCMC are at high risk for HIV. Knowledge about HIV transmission and prevention could be improved. Education and interventions specifically aimed at MSM are needed, because education targeted at the general population may not reach MSM or influence their behavior.     

西安市2010—2012年HIV抗体确证阳性样本的人群分布及变化趋势

目的分析2010—2012年西安市艾滋病病毒（HIV）感染人群的分布状况和变化趋势，为制定更加有效的艾滋病防治策略提供科学依据。方法收集2010—2012年HIV抗体确证阳性样本，横向分析样本人群来源及年龄、职业分布．纵向比较数据的年度变化，统计分析揭示数据背后的流行病学规律。结果由于监测力度增大，HIV抗体确证阳性样本逐年增加，2010—2012年分别检出372人、643人、808人，男性占90．O％，女性占10．O％。阳性样本在男男人群（MSM）和非婚异性性接触传播人群中所占比例最高，分别为45．4％和34．0％。MSM占阳性人群比例由32．5％增加到49．6％（P〈O．01）。MSM年龄多集中在15～45岁之间，大专及以上学历者占该人群的47．5％。非婚异性性接触感染阳性构成比3年分别为28．5％、31．7％、38．3％（P〈0．01）。注射毒品、输血／血制品及母婴传播3种途径的感染构成比呈逐年下降趋势。〈15岁感染者为母婴传播。结论3年来西安市HIV感染阳性人数逐年增加，感染人群的分布及构成变化不同．因此．应该根据检出阳性人群的分布特征制定出更加合理有效的防治策略。     

Importance of sex partner HIV status in HIV risk assessment among men who have sex with men

Clinical HIV risk assessments have not typically integrated questions about sex partners' HIV status with questions about condom use and type of sex. Since 2001, we have asked all men who have sex with men (MSM) evaluated in an urban sexually transmitted disease (STD) clinic how often in the preceding 12 months they used condoms for anal sex with partners who were HIV-positive, HIV-negative, and of unknown HIV status. Overall, MSM displayed a pattern of assortative mixing by HIV status, particularly for unprotected anal intercourse (UAI). Nevertheless, 433 (27%) of 1580 MSM who denied knowing they were HIV-positive and 93 (43%) of 217 HIV-positive MSM reported having UAI with a partner of opposite or unknown HIV status. Among men who denied previously knowing they were HIV-positive, 24 (9.6%) of 251 MSM who reported having UAI with an HIV-positive partner or partner of unknown HIV status compared with 11 (1.7%) of 620 MSM who denied such exposure tested HIV-positive (odds ratio=5.8, 95% confidence interval: 2.8-12.1). UAI with an HIV-positive partner or partner with unknown HIV status was 69% sensitive and 73% specific in identifying men with previously undiagnosed HIV infection; UAI regardless of partner HIV status was 80% sensitive but only 45% specific. The positive predictive value was highest for risk assessments that included partner HIV status. Integrating questions about anal sex partner HIV status and condom use identifies MSM at greatest risk for HIV acquisition and transmission. These risk criteria might be effectively used to triage MSM into more intensive prevention interventions.     

Prevalence and risk factors of HIV and syphilis,and knowledge and risk behaviors related to HIV/AIDS among men who have sex with men in Chongqing,China

High HIV prevalence and incidence burdens have been reported in men who have sex with men (MSM) in Chongqing, China. We aimed to estimate the prevalence of HIV and other sexually transmitted infections (STIs), to appraise the knowledge and risk behaviors related to HIV/AIDS among MSM, and to analyze the possible causes of deviation between behavior and knowledge to make better strategies. We recruited 617 MSM from February to July in 2008 by using a respondent-driven sampling (RDS) method in Chongqing, China. Through the collection of questionnaire-based data and biological testing results from all objects, we launched a cross-sectional survey. STATA/SE was used for data analysis by frequency, ANOVA, rank sum test and logistic regression models. MSM with syphilis (OR=4.16, 95%CI: 2.35-7.33, P<0.0001) were more likely to be HIV infected. Being a company employee (OR=3.64, 95%CI: 1.22-10.08, P<0.0001) and having bought male for sex (OR=3.52, 95%CI: 1.10-11.32, P < 0.034) were associated with a higher probability of syphilis. MSM with younger age, higher education and greater monthly income had a higher mean knowledge score. MSM who had HIV testing had a higher mean knowledge score than those who never had. Students, venues for finding sex partners by Internet and homosexuals in MSM had a higher mean knowledge score compared to other occupations, venues for finding sex partners and sexual orientation. There is an urgent need for delivery of barrier and biomedical interventions with coordinated behavioral and structural strategies to improve the effect of HIV interventions among MSM.