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深圳市男男性行为者间性传播疾病感染现况及影响因素分析
引用本文:郭艳, 张肖, 杨朝军, 马娜, 戴洁, 董莉娟, 张小斌, 张钰滢, 张琬悦, 陈敏, 苏兴芳, 陈会超. 云南省男男性行为人群沙眼衣原体、淋球菌和梅毒感染现状及影响因素分析[J]. 中国公共卫生, 2023, 39(3): 379-383. DOI: 10.11847/zgggws1139461
作者姓名:郭艳  张肖  杨朝军  马娜  戴洁  董莉娟  张小斌  张钰滢  张琬悦  陈敏  苏兴芳  陈会超
作者单位:1.云南省疾病预防控制中心性病艾滋病防制所,昆明,650022;2.昆明医科大学公共卫生学院;3.云南省艾滋病研究所
摘    要:  目的  了解云南省男男性行为人群(MSM)沙眼衣原体(CT)、淋球菌(NG)和梅毒感染现状,探索云南省MSM人群CT、NG和梅毒感染的影响因素,为制定性传播感染防治策略提供依据。  方法   2020年1 — 12月,通过滚雪球抽样在云南省14个州(市)招募男男性行为者,共招募1298名MSM。采集尿液、咽拭子和直肠拭子以及血液标本进行CT/NG核酸扩增检测和梅毒检测。使用logistic回归模型分析CT、NG和梅毒感染影响因素。  结果   1298名MSM调查者中,CT、NG、梅毒的感染率分别为9.9 %、3.1 %、3.2 %。直肠拭子CT的阳性率最高(6.0 %,61/1023),咽拭子NG的阳性率最高(1.8 %,22/1190)。多因素分析结果显示,滇中地区(OR = 4.217,95 % CI = 1.611~11.04)和滇西北地区(OR = 3.521,95 % CI = 1.357~9.136)、初中及以下文化程度(OR = 2.333,95 % CI = 1.427~3.813)的MSM感染CT的风险更高,初中及以下文化程度(OR = 2.935,95 % CI =1.265~6.812)、通过互联网/交友软件寻找性伴(OR = 2.64,95 % CI = 1.019~6.836)的MSM感染NG的风险更高,最近1年有性病史(OR = 43.983,95 % CI = 19.31~100.182)的MSM感染梅毒的风险更高。  结论  云南省MSM人群CT、NG和梅毒感染率处于较高水平,应加强对MSM人群的综合干预,建议对存在高危性行为的MSM进行CT、NG和梅毒筛查。

关 键 词:男男性行为者  沙眼衣原体  淋球菌  梅毒  影响因素  性传播感染
收稿时间:2022-06-13

HIV incidence among men who have sex with men after diagnosis with sexually transmitted infections
GUO Yan, ZHANG Xiao, YANG Chao-jun, . Prevalence and influencing factors of Chlamydia trachomatis, Neisseria gonorrhoeae and Treponema pallidum infection among men who have sex with men in Yunnan province, 2020: a cross-sectional survey[J]. Chinese Journal of Public Health, 2023, 39(3): 379-383. DOI: 10.11847/zgggws1139461
Authors:GUO Yan  ZHANG Xiao  YANG Chao-jun
Affiliation:1.Department of STDs /AIDS Prevention and Control, Yunnan Provincial Center for Disease Control and Prevention, Kunming, Yunnan Province 650022, China
Abstract:  Objective  To investigate the prevalence and influencing factors of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Treponema pallidum (TP) infection among men who have sex with men (MSM) in Yunnan province for providing evidence to develop strategies on sexually transmitted infection prevention and control.  Methods  Totally 1 400 MSM aged 15 – 65 years and with insertive oral or anal sex during past one year were recruited with snowball sampling in 14 prefectures/cities of Yunnan province in 2020. Face-to-face questionnaire interview, sampling of b1ood, urine, and pharyngeal/rectal swab specimens for tests of CT, NG and TP infection were carried out among the MSM. Logistic regression model was adopted in analyses on influencing factors of the infections.   Results  Among the 1 298 MSM with valid information, the detection rates were 9.9% (number of positive cases: 129), 3.1% (40) and 3.2% (42) for CT, NG and TP infection, respectively, with the highest positive rate (6.0%, 61/1 023) of CT infection for rectal swab specimens and that (1.8%, 22/1 190) of NG infection for pharyngeal swab specimens. The results of multivariate logistic regression analysis showed that the MSM living in central region (odds ratio [OR] = 4.217, 95% confidence interval [95% CI]:1.611 – 11.04) or northwestern region (OR = 3.521, 95% CI: 1.357 – 9.136) compared to living in northeastern of the province and the MSM with the education of junior high school and below (versus college and above: OR = 2.333, 95% CI: 1.427 – 3.813) were more likely to have CT infection; the results also revealed that with the education of junior high school and below (versus college and above: OR = 2.935, 95% CI: 1.265 – 6.812) and seeking sexual partners via internet/dating applications (versus through other routes: OR = 2.64, 95% CI: 1.019 – 6.836) were risk factors for NG infection, and suffering from sexually transmitted diseases in past one year was a risk factor (OR = 43.983, 95% CI: 19.31 – 100.182) for TP infection.   Conclusion  Among MSM in Yunnan province, the prevalence of CT, NG and TP infection were relatively high, suggesting that comprehensive intervention measures, including screening on the infections among high-risk individuals, should be strengthened in the MSM.
Keywords:men who have sex with men  Chlamydia trachomatis  Neisseria gonorrhoeae  Treponema pallidum  influencing factor  sexually transmitted infection
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