江苏省部分城市男男性接触者性传播疾病流行情况调查

【摘要】 目的 探讨江苏省部分城市男男性接触者（MSM）人群性传播疾病（STD）的流行情况。 方法 用横断面调查。选择在江苏省部分城市MSM酒吧活动的人群,填写调查问卷并自愿选择STD检测。对MSM人群性传播疾病病原体相关因素分析用单因素分析和Logistic回归分析。结果 388人接受问卷调查、体检并提供检测标本,仅有同性性行为者占45.6％。尿液及尿拭子实验室检测：淋球菌阳性率1.3％（5/388）,沙眼衣原体9.4％（36/385）,生殖支原体17.2％（66/384）。血清学检查人类免疫缺陷病毒（HIV）抗体阳性率1.0% （4/388）,梅毒螺旋体明胶凝集试验（TPPA）阳性率18.8％（73/388）,快速血浆反应素试验（RPR）阳性率12.1％（47/388）,2型单纯疱疹病毒（HSV-2）IgG抗体阳性率9.8％（38/388）,乙型肝炎病毒表面抗原（HBsAg）、 丙型肝炎病毒（HCV）抗体、戊型肝炎病毒（HEV）抗体的阳性率分别为9.8％（38/388）、1.0%（4/388）和2.1％（8/388）。尿拭子涂片中性粒细胞计数是沙眼衣原体感染的独立相关因素［调整比值比（AOR）：5.30,95% CI：2.04 ~ 13.77,P < 0.01］。生殖支原体感染与年龄（AOR：2.84,95% CI：1.17 ~ 6.87,P < 0.05）、尿拭子涂片中性粒细胞计数（AOR：2.37,95% CI：1.01 ~ 5.57,P < 0.05）、尿道不适症状（AOR：2.43,95% CI：1.18 ~ 5.02,P < 0.05）的相关性具有统计学意义。梅毒感染（RPR与TPPA检测同时阳性）与年龄（AOR：2.46,95% CI：1.05 ~ 5.75,P < 0.05）、HSV-2抗体（AOR：3.70,95% CI：1.62 ~ 8.44,P < 0.01）有显著相关性。结论 MSM人群中具有较高的STD患病率,沙眼衣原体和生殖支原体是MSM人群尿道炎的主要病原体。 【关键词】 同性恋,男性; 性传播疾病; 性行为     

2011-2015年广东省江门市男男性行为人群HIV和梅毒感染状况及影响因素分析

目的:了解江门市男男性行为人群(MSM)HIV和梅毒感染状况及其影响因素,为控制艾滋病性病的蔓延提供科学依据。方法:利用2011-2015年国家级MSM监测哨点的数据资料进行分析。结果:调查的1 916名调查对象中,艾滋病相关知识总体知晓率为90.19%;HIV抗体阳性率为6.73%,梅毒阳性率为4.07%。最近6个月与同性发生肛交性行为时每次都使用安全套的比例为51.93%。多因素Logistic回归分析结果显示,与异性婚姻状况为在婚/同居(OR=1.408,95%CI 1.153~1.720)、最近6个月与同性发生商业性行为(OR=2.458,95%CI 1.266~3.787)、感染梅毒(OR=5.804,95%CI3.196~10.540)是HIV感染的危险因素;吸毒(OR=1.164,95%CI 1.037~3.722)、最近6个月与同性发生肛交性行为(OR=10.753,95%CI 7.958~12.685)是梅毒感染的危险因素,而最近一年非梅毒STD史是梅毒感染的保护性因素(OR=0.239,95%CI 0.090~0.629)。结论:江门市MSM人群HIV和梅毒感染率较高,且梅毒、已婚/同居与同性发生商业性行为可增加HIV感染的风险;吸毒、与同性发生肛交性行为可增加梅毒感染的风险。     

广州市520名男男性行为者HIV感染情况及影响因素分析

目的:了解广州市男男性行为者(MSM)的艾滋病知识、高危行为以及艾滋病、梅毒感染情况及影响因素,为针对性开展MSM人群艾滋病防治工作提供依据。方法:面对面问卷调查520名MSM人群的艾滋病知识、行为情况,并进行艾滋病、梅毒血清学检测。结果:艾滋病知识知晓率为90.19%(469/520);HIV抗体阳性率为9.23%(48/520),梅毒阳性检出率为5.77%(30/520);最近六个月同性肛交性行为时每次均用安全套比例为53.81%(240/446);多因素logistic回归分析结果显示,感染了性病[OR=3.333,95%CI:(1.146~9.696)]、最近六个月与同性发生肛交性行为使用安全套的频率较少[OR=3.460,95%CI:(1.770~6.763)]是HIV感染的危险因素(P0.05)。结论:广州市MSM人群艾滋病知识知晓率高、安全套使用率低、知行分离严重,艾滋病、梅毒感染率高,应加强有效的干预检测和性病诊治。     

秦皇岛市男男性行为者艾滋病相关知识行为现状及血清学检测结果分析

目的了解秦皇岛市男男性行为者(MSM)知识行为及艾滋病/梅毒/丙肝感染状况,为制定该人群有效的干预措施和防治策略提供依据。方法 2009-2012年采用自愿招募和滚雪球的方法,对寻求艾滋病咨询的MSM进行面对面问卷调查和知情同意血清学检测。结果共有1 043例MSM接受调查,其平均年龄(26.9±7.16)岁,未婚占75.65%,高中及以上文化占84.75%,本地居住超过2年者占72.58%。艾滋病知识知晓率为88.11%。近6个月中86.10%有肛交行为,最近一次肛交安全套使用率69.38%,每次坚持使用安全套率为42.76%,从不使用安全套者主要是未婚大中专院校在校年龄段的学生。参与商业性行为者9.02%,29.82%的人有异性性行为。异性性行为中从不使用安全套者,在婚和同居者占69.70%。近1年中,6.81%报告有性病诊断史。检测发现HIV感染率为5.75%,梅毒感染率7.19%,HCV阳性感染率为0.19%。结论秦皇岛市MSM人群需要加强艾滋病全面相关知识的普及,同时要关注梅毒和丙肝防控宣传和及早发现治疗梅毒以有效降低HIV传播。     

大学生男男性行为人群首次同性性行为与相关行为调查

目的:探索大学生男男性行为人群首次同性性行为与相关行为状况。方法:采用横断面调查方法。通过同伴推动抽样方法(RDS)和咨询检测等方式招募方便样本,一对一自填式问卷调查,收集人口学特征、首次性行为状况及安全套使用信息。结果:成功招募了127名大学生男男性行为者(MSM),88.2%的调查对象首次性行为对象是男性,首次同性性行为发生的年龄中位数为19岁;当第一个男性性伴是校外人员时,首次同性性行为被引诱或被胁迫的比例占到28.8%;首次性行为的性伴是男性其自认为性取向是同性恋的比例更高(χ~2=13.49,P=0.00);首次同性性行为时安全套使用率为70.1%,首次同性性行为使用安全套的调查对象最近一次肛交安全套使用比例更高(χ~2=7.72,P=0.05)。结论:首次同性性行为对青年学生的影响较大,应当关注学生首次性行为教育。     

青岛市男男性行为人群艾滋病高危性行为调查

目的:了解男男性行为人群(MSM)的高危性行为,为制定预防控制策略提供依据。方法:采用同伴推动抽样法对MSM人群进行问卷调查。结果:累计调查1849人,年龄中位数26岁,与男性发生过肛交者占98.37%;最近3个月男性性伴在2人以上者占46.29%,有女性性伴者占11.14%;最近一次与男性肛交时安全套使用率为57.92%,最近3个月与男性肛交时每次都使用安全套的比例为35.37%。结论:MSM人群普遍存在多性伴、无保护的性行为,传播性病艾滋病的风险较大。     

龙岩市男男性行为人群HIV感染与行为学监测

目的:调查龙岩市男男性行为(MSM)人群中HIV感染和行为学情况.方法:2012年1～11月对龙岩市208名MSM进行问卷调查和血清学检测.结果:该人群平均年龄28.1岁,小于40岁占92.3％.208份标本中HIV抗体阳性率为7.2％、梅毒抗体阳性率为2.88％.近6个月与男性发生肛交时每次都用安全套者占58.2％;与异性发生性行为时每次使用安全套14人(21.9％).结论:该人群安全套使用率低,因此应大力推广安全套的使用.     

贵阳市2010～2014年MSM人群HIV感染者性行为情况

目的：了解2010-2014年贵阳市MSM人群（men who have sex with men,MSM）HIV感染者性行为特征,为预防控制MSM人群HIV感染者二代传播提供依据。方法：本研究以2010-2014年的4-7月份在贵阳市MSM人群监测哨点检测出的HIV感染者为研究对象,以一对一的方式进行问卷调查,并采集静脉血进行HIV和梅毒检测。结果：2010-2014年贵阳市MSM人群监测哨点共检测出的333名HIV感染者,年龄在18-24岁,所占的比例由2010年的55.4%下降到2014年的26.7%,在婚或同居所占的比例在5.0%-15.8%之间;文化程度大专及以上者由2010年的45.7%上升到2014年的70.0%。2010-2014年MSM人群感染者的梅毒感染检出率在6.7%-23.9%之间;最近6个月与同性发生肛交性行为所占的比例分别为79.7%-98.9%,与异性发生性行为所占的比例在7.8%-11.7%之间。73.6%-91.4%的MSM最近6个月同性肛交未坚持使用安全套;异性行为坚持使用安全套所占的比例仅为33.3%。结论：MSM人群HIV感染者年龄较小,主要处于性活跃阶段,梅毒的感染检出率较高,同性性行为及异性性行为时坚持使用安全套的比例均较低,将加速HIV和梅毒在MSM人群间及向异性人群传播。     

2010-2014年遵义市男男性行为人群艾滋病哨点监测结果分析北大核心CSCD

目的了解遵义市男男性行为人群(MSM)艾滋病、梅毒感染状况及相关行为因素,为调整防治策略,制定有针对性的干预措施提供科学依据。方法对2010-2014年遵义市MSM人群哨点监测结果进行分析,计算历年艾滋病、梅毒、丙肝感染状况及相关行为因素进行分析,并进行统计学分析。结果5年共调查MSM人群922人份,确认HIV抗体阳性184例(19.96%),历年HIV阳性率分别为3.92%,42.41%,22.38%,13.89%和17.23%,各年度差异有统计学意义(P<0.01);梅毒抗体阳性44例(4.77%),HCV抗体阳性13例(1.41%)。最近半年内,有肛交行为者79.33%,其中坚持每次使用安全套比例30.14%,最近一次肛交时安全套使用比例为78.25%。有1.92%与同性发生过商业性行为,坚持每次使用安全套比例仅占7.14%;11.71%与异性发生过性行为,坚持每次使用安全套比例占12.15%。结论遵义市MSM人群HIV感染率高,安全套使用率偏低,防控形式非常严峻,调整和采取有针对性的防治措施非常必要。     

天津市使用新型毒品的男男性行为者梅毒感染状况调查

目的:了解天津市男男性行为者(men who have sex with men, MSM)新型毒品使用者梅毒感染情况。方法:本研究自2020年10月至2021年9月，通过线上与线下招募结合的方式，招募使用新型毒品的MSM。收集参与者基本人口学信息、性行为情况、新型毒品使用等信息。使用统计学检验比较使用新型毒品的MSM中梅毒感染者与非感染者的特征差异。结果:最终纳入研究的使用新型毒品的MSM共计416人，年龄20～70岁，平均(35.17±9.41)岁。梅毒感染者107例，感染率为25.72%。亚硝酸盐吸入剂(Rush Popper)是使用最为广泛的毒品，使用新型毒品的梅毒感染者与非感染者在年龄(P=0.003)、婚姻状况(P=0.024)、工作状态(P=0.001)、自身HIV感染状况认知(P=0.021)以及最近一次肛交安全套使用情况(P=0.020)等变量上的差异具有统计学意义。MSM梅毒感染的多因素分析显示，在最近一次肛交中不使用安全套是该人群感染梅毒的危险因素(OR=2.416)。结论:天津市使用新型毒品的MSM人群中梅毒的感染率处于较高的水平。     

Commercial sex venues: a closer look at their impact on the syphilis and HIV epidemics among men who have sex with men

OBJECTIVE: To provide insight into the role of commercial sex venues in the spread of syphilis and HIV among men who have sex with men (MSM). Study: A cross sectional study of 1351 MSM who were diagnosed with early syphilis who did and did not encounter sexual partners at commercial sex venues. RESULTS: Overall, 26% MSM diagnosed with syphilis had sexual encounters at commercial sex venues. Of these, 74% were HIV positive, 94% reported anonymous sex, and 66% did not use a condom. Compared to those who did not have a sexual encounter at these venues, they were twice as likely to be HIV positive (OR = 1.91, 95% CI 1.36 to 2.68), six times more likely to have anonymous sex (OR = 6.18, 95% CI 3.37 to 11.32), twice as likely not to use condom (OR = 2.02, 95% CI 1.71 to 2.38), and twice as likely to use non-injecting drugs (OR = 1.65, 95% CI 1.21 to 2.37). CONCLUSIONS: MSM diagnosed with syphilis who frequent commercial sex venues are engaging in high risk behaviours for syphilis and HIV transmission and acquisition. Thus commercial sex venues are one of the focal points of syphilis and HIV transmission and acquisition.     

Relationship between syphilis and HIV infections among men who have sex with men in Beijing, China

BACKGROUND: Little is known about risk of HIV and other STDs among men who have sex with men (MSM) in China. OBJECTIVE: To survey the prevalence and risk factors of HIV and syphilis and evaluate correlation of two infections among MSM in the Chinese capital city. METHODS: A community-based sample of 526 MSM was recruited in 2005 through Internet advertising, community outreach, and peer referring. Interviewer-administered interviews were conducted to collect information on demographics and sexual and other risk behaviors, and blood samples were collected to test for syphilis and HIV infections. RESULTS: Seventeen (3.2%) participants were HIV seropositive and 59 (11.2%) syphilis seropositive. Sixty-four percent of participants were migrants who did not have Beijing residence. Forty percent had >10 lifetime male sex partners and 28.8% reported having ever had sex with women. Consistent condom use with primary male sex partners ranged from 21% to 24%, with nonprimary male sex partners from 35% to 42%, and with female partners around 33%. Illicit drug use was not common; only 2.5% reported using Ecstasy or ketamine in the past 6 months. Multivariate logistic regression analyses demonstrated that >10 lifetime male sex partners were independently associated with seropositivity of both syphilis (OR, 1.9; 95% CI, 1.1-3.4) and HIV (OR, 4.3; 95% CI, 1.4-13.6). In addition, HIV infection is significantly associated with syphilis seropositivity (OR, 3.8; 95% CI, 1.3-10.8). CONCLUSIONS: High mobility, multiple sexual partners, and high prevalence of unprotected sex behaviors and syphilis infection suggest a potential rapid spread of HIV in Chinese MSM.     

Associations between substance use and sexual risk among very young men who have sex with men

OBJECTIVE: To determine if an association exists in young men who have sex with men (MSM) between being under the influence of alcohol or drugs during sex and participation in sexual behaviors which increase the risk of human immunodeficiency virus (HIV). STUDY DESIGN: A total of 3492 young MSM were interviewed through the Young Men's Survey, an anonymous, cross-sectional, multisite, venue-based survey conducted from 1994 through 1998 at 194 public venues frequented by MSM aged 15 to 22 years in 7 US cities. RESULTS: The majority of young MSM reported both receptive and insertive anal intercourse, and of these, approximately half reported not using condoms. Report of unprotected receptive anal intercourse at least once in the prior 6 months was associated with being under the influence of alcohol (adjusted odds ratio [AOR]=1.5; 95% confidence interval [CI]=1.2-1.8), cocaine (AOR=1.6; 95% CI=1.1-2.2), amphetamines (AOR=1.5; 95% CI=1.1-2.0) or marijuana during sex (AOR=1.3; 95% CI=1.1-1.6). Report of unprotected insertive anal intercourse at least once in the prior 6 months was associated with being under the influence of alcohol (AOR=1.2; 95% CI=1.0-1.5), cocaine (AOR=1.5; 95% CI=1.1-2.0) or amphetamines (AOR=1.9; 95% CI=1.4-2.6). CONCLUSIONS: HIV prevention strategies for young MSM need to incorporate substance use risk reduction.     

Correlates of Internet use to meet sex partners among men who have sex with men diagnosed with early syphilis in Los Angeles County

OBJECTIVE: The objective of this study was to evaluate use of the Internet to solicit sex partners by men who have sex with men (MSM) who were diagnosed with early syphilis infection. STUDY: Field interview records for syphilis patients were reviewed for factors associated with Internet use. RESULTS: Internet users were more likely to be of white race (prevalence ratio [PR], 1.6; 95% confidence interval [CI], 1.4-1.8), to report anal insertive sex (PR, 1.1; 95% CI, 1.1-1.2), sex with anonymous partners (PR, 1.2; 95% CI, 1.1-1.3), intravenous drug use (PR, 2.7; 95% CI, 1.1-6.7), and nonintravenous drug use (PR, 1.4; 95% CI, 1.1-1.8). Controlling for race and sexual risk behaviors, white race (odds ratio [OR], 2.8; 95% CI, 1.8-4.6), having anonymous sex partners (OR, 3.4; 95% CI, 1.6-7.0), and nonintravenous drug use (OR, 1.6; 95% CI, 1.1-2.6) were associated with meeting sex partners through the Internet. CONCLUSIONS: Effective sexually transmitted disease risk reduction interventions using the Internet are needed to reach Internet-using, sex-seeking MSM populations engaging in high-risk behaviors.     

深圳市男男性接触人群梅毒合并HIV感染状况及其危险因素分析

目的：了解深圳市近6个月内发生过同性临时性行为的MSM人群梅毒合并HIV感染状况及其相关影响因素。方法：运用滚雪球法和同伴推动抽样法招募MSM进行问卷调查和血清学检测,采用χ2检验和Logistic回归分析梅毒HIV合并感染的相关影响因素。结果：共调查434例MSM,梅毒和HIV感染率分别为16.4%和12.2%,梅毒合并HIV感染率为7.3%。年龄越大（OR=4.0,P=0.0007）、高中/中专文化者（OR=6.5,P=0.0081）、性角色以被动方为主者（OR=12.1,P=0.0017）、多个同性肛交性伴者（OR=1.5,P=0.0455）、不能坚持每次使用安全套者（OR=2.9,P=0.0236）,其梅毒合并HIV感染风险越高。结论：需要采取更大努力来应对该人群的梅毒和HIV双重感染问题。     

Symptoms of non-gonococcal urethritis in heterosexual men: a case control study

OBJECTIVE: To determine microbial and behavioural factors contributing to non-gonococcal urethral symptoms in men. METHODS: Case-control study of heterosexual men with non-gonococcal urethral symptoms (cases) and without urethral symptoms (controls) attending Melbourne Sexual Health Centre, Australia. Sexual behaviour and condom use were measured by questionnaire. First stream urine was tested for potential pathogens: Chlamydia trachomatis (ligase chain reaction), Mycoplasma genitalium (polymerase chain reaction, PCR), Ureaplasma urealyticum (culture and PCR), and Streptococcus spp, Gardnerella vaginalis, and Haemophilus species (culture). Urethral smears from cases were examined for polymorphonuclear leucocytes. RESULTS: 80 cases and 79 controls were recruited over 4 months in 2002-3. 49 cases (61%) had urethritis by microscopic criteria, 17 (21%) had Chlamydia trachomatis (adjusted odds ratio (OR) 27 (95% confidence interval (CI): 3.4 to 222)), five (6%) had Mycoplasma genitalium (OR 6.1 (95% CI: 0.6 to 61)), and 11 (14%) had Gardnerella vaginalis (OR 9.0 (95% CI: 1.6 to 52)). Other organisms were not significantly associated with urethral symptoms. The presence of urethritis on urethral smear did not predict the presence of Chlamydia trachomatis (OR 1.7 (95% CI: 0.5 to 5.4)). Urethral symptoms were significantly associated with unprotected vaginal sex with more than one casual partner (OR 9.3 (95% CI: 1.3 to 65)) and unprotected anal sex with a regular partner in the past month (OR 3.5 (95% CI: 1.0 to 13)). CONCLUSION: Gardnerella vaginalis and unprotected anal sex may cause symptoms of non-gonococcal urethritis. Microscopy of the urethral smear to diagnose urethritis in this population does not help to identify which men with urethral symptoms require treatment for chlamydia.     

Sexual risk behavior of married men and women in Bangladesh associated with husbands' work migration and living apart

OBJECTIVES: This study aimed to ascertain the prevalence of sexual risk behavior among married men and women who had, or had not, lived apart from their spouse as a result of the husbands' work migration. METHODS: A cross-sectional survey was conducted among a random sample of 1,175 married women and 703 married men in 2 rural areas of Bangladesh. RESULTS: Extramarital sex was reported by 64.2% (95% confidence interval [CI] = 58.7-69.7) of 296 men and 8.6% (95% CI = 7.6-9.6) of 779 women who had lived apart from their spouse, 2 to 3 times higher than the proportions among those who had not lived apart (P <0.05). The proportions of men who reported sex with a female sex worker (50.7%; 95% CI = 45.0-56.4) or with another male (5.4%; 95% CI = 2.8-8.0), while living away, were double the proportions reporting they had done so before living away or among men who had not lived away (P <0.05). Only 2 men had ever used had a condom during sex with another male, and less than one third of men had used a condom during sex with a sex worker or during marital sex. CONCLUSIONS: The sexual risk behavior of married men living away from home may put themselves and their wives at risk for HIV infection and other sexually transmitted diseases.     

Increase in sexually transmitted infections among homosexual men in Amsterdam in relation to HAART

OBJECTIVES: We investigated if a rise in rectal gonorrhoea and early syphilis among men who have sex with men (MSM) in Amsterdam coincided with the introduction of highly active antiretroviral therapies (HAART) in July 1996 and determined risk factors for these sexually transmitted infections (STI). METHODS: Subjects were patients of the STI clinic of the municipal health service in Amsterdam. Surveillance data (1994-9) represented consultations (n=11 240) of MSM (n=6103). For analyses we used logistic regression. RESULTS: Comparing the periods before and after the introduction of HAART, the infection rate for rectal gonorrhoea increased from 4% to 5.4% (p=.001) and for syphilis, from 0.5% to 0.8% (p = 0.050). Independent risk factors for rectal gonorrhoea (younger age, western nationality, and concurrent infection with another STI) and for early syphilis (non-western nationality and concurrent infection with rectal gonorrhoea) did not change after HAART became available. For rectal gonorrhoea, however, the infection rate increased only among men who had exclusively homosexual contacts (OR 1.38, p<0.01), compared with bisexual men. For early syphilis, the infection rate increased only among men of western nationality (OR 3.38, p<0.01) compared to men of non-western nationality. CONCLUSIONS: Infection rates of rectal gonorrhoea and early syphilis increased, indicating a change in sexual behaviour, possibly as a result of the introduction of HAART. For now, it is important to find out how sexual behaviour is changing and to keep monitoring trends in STIs (including HIV) among MSM in Amsterdam.     

Unsafe sexual behavior and correlates of risk in a probability sample of men who have sex with men in the era of highly active antiretroviral therapy

OBJECTIVE: To assess the levels and correlates of potential exposure to and transmission of HIV in a contemporary, community-based probability sample of men who have sex with men (MSM). METHODS: In 2003, 311 sexually active MSM participated in a random-digit dial telephone survey in Seattle neighborhoods with a high prevalence of MSM. The primary outcomes were potential exposure to and transmission of HIV, defined as unprotected anal intercourse with a man of opposite or unknown HIV status in the preceding 12 months. RESULTS: Fourteen percent of respondents reported being HIV-positive, 77% reported being HIV-negative, and 8% had not been tested. Of 241 HIV-negative MSM, 25 (10%; 95% confidence interval [CI], 7-15%) were potentially exposed to HIV; among 45 HIV-positive MSM, 14 (31%; 95% CI, 20-46%) were potential HIV-transmitters. Among HIV-negative men, the strongest bivariate correlates of potential exposure to HIV were recent bacterial sexually transmitted disease (odds ratio [OR], 5.8), number of recent male sexual partners (OR, 1.01 per partner), recent sex at a bathhouse (OR, 9.1), and recent use of sildenafil (OR, 4.4), amyl nitrite (OR, 6.2), and methamphetamine (OR, 8.0). Among HIV-infected men, the strongest correlates of potential HIV transmission were recent use of amyl nitrite (OR, 3.1), number of recent male sex partners (OR, 1.07 per partner), and having a male spouse or domestic partner (OR, 0.3). CONCLUSIONS: Most MSM knew their HIV status and adopted safer sexual behaviors to reduce their risk of HIV acquisition or transmission. However, 10% of HIV-negative MSM and 31% of HIV-positive MSM recently engaged in behaviors that placed them at high risk for acquiring or transmitting HIV.