八城市男男性行为人群不同性角色高危行为及HIV梅毒 生殖器疱疹感染状况分析

目的了解中国八个城市男男性行为人群(MSM)中,不同性角色的人口学、性行为特点,以及艾滋病病毒(HIV)、梅毒、Ⅱ型生殖器单纯疱疹(HSV-2)的感染状况,分析其影响因素,为开展针对性的干预活动提供信息。方法采用分类滚雪球法招募MSM,使用统一的问卷调查人口学、行为学信息,并采集静脉血液进行血清学检测。采用χ2检验对比不同性角色的一般情况、性行为特征以及HIV、梅毒、HSV-2感染率,使用SPSS Statistics进行统计学分析。结果共调查MSM 3 509人,其中262人过去6个月未发生过肛交性行为,20人未回答性角色情况,实际将符合条件的3 227名MSM纳入分析。按过去6个月肛交中性行为角色分为3组,仅有主动插入行为(简称1号);仅有被动插入行为(简称0号);既有主动插入,又有被动插入行为(简称0.5号)。1号组983人(30.5%),0号组621人(19.2%),0.5号组1 623人(50.3%)。三组在最近6个月的男性性伴人数、安全套使用频率、与男性买卖性史、与女性有性交史上差异有统计学意义(P<0.01)。在最近一次肛交安全套使用率、毒品使用史、包皮环切史方面,三组间差异无统计学意义(P=0.413,P=0.348,P=0.105)。0号组HIV感染率为12.2%(95%CI:9.7%～14.8%),0.5号组10.3%(95%CI:8.8%～11.8%),1号组最低为4.4%(95%CI:3.1%～5.7%),三组间差异有统计学意义(P<0.001)。梅毒的感染率1号、0.5号、0号三组比较接近(10.0%、10.6%、10.9%),差异无统计学意义(P=0.279)。HSV-2感染率0号组最低(8.1%),1号组居中(10.5%),0.5号组最高(11.8%),三组的差异有统计学意义(P=0.038)。结论 MSM不同性角色人群在行为学特征上的差异,使其在感染性病艾滋病的风险上不同,应根据各自的特点,开展针对性的干预措施。

HIV,syphilis and HSV-2 prevalence in relation to receptive,insertive and both sex roles among MSM in eight cities of China

Objective To understand HIV,syphilis and HSV-2 prevalence in relation to receptive,insertive and both sex roles among MSM in eight cities in China.Methods MSM were recruited by snowball sampling,the same questionnaire was used to acquire the information of demography and sexual behaviors,and blood samples were tested for HIV,syphilis and HSV-2.The results were analyzed with SPSS Statistics.Results A total of 3509 MSM were investigated,262 MSM were excluded without anal intercourse and 20 were excluded without answering the question of sex role during the past 6 months.A total of 3227 MSM meeting the standard were classified into 3 groups according to anal sex behaviors(insertive,receptive and both) during the past 6 months.The insertive group had 983 MSM(30.5%),the receptive group had 621 MSM(19.2%),both insertive and receptive group had 1623 MSM(50.3%).The number of sex with male partners,the frequency of condom use,the experience of sex trade(buying or selling) with men,the rate of having sex with women among the 3 groups were obviously different(P<0.01).The condom use in the last sex,rates of insertive,receptive and both sex,the rates of drug use and circumcision were insignificant among the 3 groups(P=0.413,P=0.348,P=0.105).The HIV infection rates were different significantly(P<0.001)in the 3 groups,the rate in the receptive group was 12.2%(95%CI 9.7%-14.8%),the rate in both the receptive and insertive group was 10.3%(95%CI 8.8%-11.8%),and the rate in the insertive group was 4.4%(95%CI 3.1%-5.7%).The syphilis infection rates in the insertive,receptive and both insertive and receptive group were 10.0%,10.6% and 10.9%,respectively,and the rates were very close among the 3 groups(P=0.279).The HSV-2 infection rates in the 3 groups were obviously different(P=0.038),that in the receptive group was lower(8.1%),that in the insertive group was middle(10.5%),and that in the both insertive and receptive group was higher(11.8%).Conclusion Different sex roles have different demographics and different behaviors,rendering different risks for HIV and sexually transmitted diseases.It is necessary to carry out specific interventions based on the characteristics of different groups.