VCT门诊MSM人群的艾滋病知识行为及感染状况调查分析

目的 通过调查了解芜湖市艾滋病自愿咨询检测（Voluntary Counseling and Testing, VCT）门诊就诊的男男性行为人群（men who have sex with men, MSM）艾滋病知识、行为及感染状况。 方法 利用自制的MSM人群调查问卷，在知情同意的情况下由咨询员对2019年内前来芜湖市疾控中心VCT门诊的263名MSM求询者进行问卷调查，对其采集血液5ml进行艾滋病的抗体检测。采用多因素非条件logistic回归的逐步向前法分析安全套使用和艾滋病感染状况的相关因素。 结果 调查对象的艾滋病和梅毒知识知晓率分别是89.73%和72.62%，自述有特殊同性性癖好的有85人（32.32%）。最近6个月调查对象与同性发生过口交和肛交性行为、与固定和临时同性性伴发生肛交性行为、发生同性群交性行为和商业性行为过程中每次都用安全套比例分别只有22.63%（43/190）和40.72%（90/221）、33.82%（69/204）和38.51%（62/161）、25.81%（8/31）和35.48%（11/31）。多因素logistic回归分析结果显示文化程度较高的（ OR =2.669, 95% CI =1.459~4.883）、未与异性发生性行为的（ OR =2.431, 95% CI = 1.051~5.622）和艾滋病知识越知晓（ OR =4.035, 95% CI = 1.119~14.551）的调查对象最近6个月肛交性行为过程中坚持使用安全套比例可能性越高。调查对象的艾滋病感染率为11.03%，多因素logistic回归分析结果显示流动的MSM人群（ OR =5.155, 95% CI = 1.663~15.980），首次同性性行为的年龄越高的（ OR =1.027, 95% CI = 1.027~1.130），有异装癖（ OR =12.996, 95% CI =1.942~86.985）、恋童癖（ OR =4.629, 95% CI =1.255~17.068）和恋老癖（ OR =4.784, 95% CI =1.312~17.438）等特殊性癖好的艾滋病感染可能性越高。 结论 芜湖市疾控中心VCT门诊MSM求询者艾滋病感染率高，安全套使用率低，对艾滋病和梅毒的知晓率不高，感染风险较高，应借助VCT门诊平台加强艾滋病的宣教干预工作。

AIDS related knowledge and behavior and infection status among MSM in VCT clinic

Abstract: Objective To investigate the knowledge and behavior about AIDS and infection status of men who have sex with men ( MSM) in AIDS Voluntary Counseling and Testing ( VCT) clinics in Wuhu City. Methods With the informed consent，using the self － made questionnaire on MSM，the consultants of VCT room conducted in － depth interviews and questionnaire son 263 MSM seekers who came to VCT clinic of municipal center for disease control and prevention in 2019. 5ml of blood was collected for HIV antibody detection. The factors related to condom use and HIV infection status were analyzed by stepwise forward method of multivariate non － conditional Logistic regression. Results The knowledge rates of AIDS and syphilis of the respondents were 89. 73% and 72. 62% ，and 85 people ( 32. 32% ) reported having special homosexual habits. In the last 6months，only 22. 63% ( 43 /190) and 40. 72% ( 90 /221) of the respondents used condoms every time during oral sex and anal sex with the same sex. In the past 6 months，the percentages of respondents who insisted on using condoms for every anal sex with fixed homosexual partners and temporary homosexual partners were 33. 82% ( 69 /204) and 38. 51% ( 62 /161) . The rate of condom use among homosexual group sex and commercial sex was 25. 81% ( 8 /31) and 35. 48% ( 11 /31) respectively. Multivariate Logistic regression analysis showed that respondents who had a high level of education ( OR = 2. 669，95% CI =1. 459 ～ 4. 883) did not have sex with the opposite sex ( OR = 2. 431，95% CI = 1. 051 ～ 5. 622) ，and were more aware of HIV knowledge( OR = 4. 035，95% CI = 1. 119 ～ 14. 551) were more likely to insist on using condoms during anal sex in the last 6 months. The HIV positive rate of the respondents was 11. 03% . Multivariate Logistic regression analysis showed that the likelihood of HIV infection was higher among mobile MSM populations ( OR = 5. 155，95% CI = 1. 663 ～ 15. 980) ，older people who first engaged in homosexual sex ( OR = 1. 027，95% CI = 1. 027 ～ 1. 130) ，and those with specific proclivities such as transvestism ( OR = 12. 996，95% CI = 1. 942 ～ 86. 985 ) ，paedophilia ( OR = 4. 629，95% CI = 1. 255 ～ 17. 068 ) and gerontophilia ( OR = 4. 784，95% CI = 1. 312 ～ 17. 438) . Conclusion MSM seekers in VCT clinic in Wuhu City have highHIV infection rate，low condom use rate，low awareness rate of AIDS and syphilis，and high risk of infection. Therefore，theVCT clinic platform should be used to strengthen its AIDS publicity and behavior intervention work.