HIV阳性MSM人群梅毒感染状况及影响因素调查

目的 了解男男性途径的HIV感染者/病人合并梅毒感染的情况,分析其影响因素。方法 经知情同意,对2017年1月至4月期间,在北京市某医院内由社区组织随访的男男性途径的HIV感染者/病人进行问卷调查,并采血进行梅毒血浆反应素快速试验(RPR)和梅毒螺旋体明胶颗粒凝集试验(TPPA),分析方法为〖XC小五号.EPS;P〗检验,单因素logistic回归。结果 385例HIV阳性MSM完成问卷调查和血清学检查,RPR和TPPA阳性111例,梅毒感染率为28.8%,其中RPR滴度≥1∶8的梅毒感染者为14.0%(54/385)。报告近3个月有过性行为比例为63.1%(243/385),其中性伴数＞2的占32.9%(80/243),37.4%(91/243)近3个月内有过1~5次男男群交性行为,37.9%(92/243)自述近3个月使用过rush。近3个月,发生过肛交性行为(OR=1.66,P=0.037)、性伴数多(OR=1.94,P=0.020)、性行为时无法坚持每次使用安全套(OR=22.14,P＜0.001)、最近一次发生肛交性行为时未使用安全套(OR=19.73,P=0.002)是合并梅毒感染的危险因素。结论 男男性途径的HIV感染者/病人梅毒感染率较高、高危性行为发生较多。

Syphilis infection and its influencing factors among HIV positive MSM population

Objective To understand the prevalence of syphilis among HIV infected men who have sex with men(MSM)and to analyze its influencing factors. Methods From January to April 2017,a questionnaire interview with informed consent was conducted on MSM known HIV positive who were followed up by community-based organizations in a hospital in Beijing.Their blood samples were collected for rapid syphilis plasma test(RPR)and treponema pallidum gelatin particle agglutination test(TPPA).Data were analyzed by chi-square test and univariate logistic regression. Results Among the 385 HIV-positive MSM who completed the questionnaire and serological tests,111 were positive for RPR and TPPA,with a syphilis infection rate of 28.8%,and 14.0%(54/385)of those infected with RPR titer≥1∶8.The proportion of sexual behaviors in the past three months was 63.1%(243/385),of which 32.9%(80/243)had sexual partners>2 and 37.4%(91/243)had 1~5 times men and men group sex,and 37.9%(92/243)reported rush using in the past three months.In the past three months,anal sex(OR=1.66,P=0.037),multi-sexual partner(OR=1.94,P=0.020),not sticking to a condom every time when having sex(OR=22.14,P<0.001)and not using condoms during the last anal sex(OR=19.73,P=0.002)were risk factors for syphilis infection. Conclusion MSM known HIV positive have higher rates of syphilis infection and unsafe sexual behaviors.