温州市主动求询男男性接触者人群ＨＩＶ 感染状况和影响因素分析

摘要：目的　了解温州市主动到艾滋病自愿咨询检测门诊（ｖｏｌｕｎｔａｒｙｃｏｕｎｓｅｌｉｎｇａｎｄｔｅｓｔｉｎｇ，ＶＣＴ）求询的
男男性接触者（ｍｅｎ ｗｈｏｈａｖｅｓｅｘ ｗｉｔｈ ｍｅｎ，ＭＳＭ） 人群艾滋病病毒（ｈｕｍａｎｉｍｍｕｎｏｄｅｆｉｃｉｅｎｃｙｖｉｒｕｓ，
ＨＩＶ）感染状况及其影响因素，为今后制定防控措施提供依据。方法　对２０１１－２０１３年主动到温州市所有
ＶＣＴ 门诊接受咨询检测的ＭＳＭ 人群的基本信息及检测情况进行统计分析，描述性分析ＭＳＭ 人群的人口
学特征，高危行为特点及ＨＩＶ 感染情况，χ
２ 检验、多因素非条件ｌｏｇｉｓｔｉｃ回归分析不同人口学特征人群的
ＨＩＶ 感染率差异，犘＜０．０５为差异有统计学意义。结果　本研究中１６００ 名主动求询ＭＳＭ 中青壮年占
８５．３８％ （１３６６／１６００），未婚占６５．１９％ （１０４３／１６００），高中及以上占６７．００％ （１０７２／１６００）。近３ 年
ＨＩＶ 抗体阳性检出率为８．６９％，总体呈现出上升趋势；梅毒阳性检出率为４．３１％。单因素分析显示，年
龄（χ
２＝７．１６，犘＝０．０３）、婚姻状况（χ
２＝６．３４，犘＝０．０４）、文化程度（χ
２＝８．１６，犘＜０．０１）、既往接受
ＨＩＶ 检测（χ
２＝１０．００，犘＜０．０１）、梅毒感染（χ
２＝１２．２４，犘＜０．０１）与ＨＩＶ 感染相关。多因素ｌｏｇｉｓｔｉｃ回
归分析显示，文化程度高中及以上ＨＩＶ 感染风险较初中及以下的低（犗犚＝０．６４，９５％ 犆犐：０．４５～０．９１）；
既往有接受过ＨＩＶ 检测比未接受过检测者感染ＨＩＶ 的风险高（犗犚＝１．６４，９５％ 犆犐：１．１５～２．３４）；梅毒
感染可以增加ＨＩＶ 感染的风险（犗犚＝２．３８，９５％ 犆犐：１．２７～４．４５）。结论　温州市主动求询ＭＳＭ 人群中
ＨＩＶ 抗体阳性检出率较高，应该充分利用ＶＣＴ 点的窗口作用，对ＭＳＭ 人群开展有效、深入的咨询检测
服务和人文关怀，降低ＭＳＭ 人群ＨＩＶ 感染的风险。
关键词：自愿咨询检测；男男性接触者；艾滋病病毒；影响因素
中图分类号：Ｒ５１２．９１　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１４）０５ ０４０４ ０４

HIV infection and its influencing factors among MSM undergoing VCT in Wenzhou city

Objective To understand HIV infection and its influencing factors among men who have sex with men（MSM）undergoing HIV voluntary counseling and testing（VCT）in Wenzhou,and to provide evidence for developing future prevention and control strategies. Methods Data including basic information and laboratory testing information of MSM who underwent VCT services in VCT clinics in Wenzhou from 2011 to 2013were collected and analyzed.Chi-square test and multivariate logistic regression analysis were used for data statistical analysis. Results A total of 1 600 MSM were enrolled in the study and 85.38% were young adults,unmarried MSM accounted for 65.19%and 67.00% had high school and above diplomas.The positive rate of HIV antibody was 8.69%in recent three years with an upward trend in general.The positive rate of syphilis was 4.31%.Single factor analysis showed that age（χ2=7.16,P=0.03）,marital status（χ2=6.34,P=0.04）,education（χ2=8.16,P0.01）,HIV testing history（χ2=10.00,P0.01）and syphilis infection（χ2=12.24,P0.01）were associated with HIV infection.Multivariate logistic regression analysis revealed MSM with high school and above diplomas（OR=0.64,95%CI：0.45-0.91）and not receiving HIV testing（OR=1.64,95%CI：1.15-2.34）were less likely to get HIV infection.While,those with syphilis infection were at high risk（OR=2.38,95% CI：1.27-4.45）. Conclusions The positive rate of HIV antibody among MSM undergoing VCT is relatively high in Wenzhou.Therefore,VCT service should be expanded among MSM to decrease the risk of HIV infection.