秦皇岛市MSM的HIV、TP、HCV感染状况及影响因素

目的了解秦皇岛市男男性行为人群（MSM）的艾滋病病毒（HIV）、梅毒螺旋体（TP）、丙型肝炎病毒（HCV）感染状况和相关影响因素,提出有针对性的防控性病艾滋病的干预建议。方法 2009-2012年连续4年采用自愿招募和滚雪球的方法,通过自愿咨询检测（VCT）门诊和开展外展干预活动,对第一次接受艾滋病咨询检测的MSM进行问卷调查和血清学检测。结果 4年共招募MSM 1043人。70.76%（738/1043）的人通过网络寻找性伴,4年间,艾滋病知识知晓率、接受艾滋病干预服务和接受HIV检测人数均逐年上升（P〈0.01）。近6个月,898人（86.10%）有过同性肛交行为,其中坚持使用安全套率为42.76%;34.63%（311/898）有过异性性行为,安全套坚持使用率为36.98%;9.02%（81/898）有过商业性性行为,安全套坚持使用率为53.09%。HIV、TP、HCV平均感染率分别为5.75%（60/1043）、7.19%（75/1043）、0.19%（2/1043）,HIV、TP感染率呈逐年上升趋势（P〈0.05）。多因素分析结果显示：文化程度相对低、在当地居住时间短、曾感染过性病是HIV、TP感染率的危险因素;年龄较大的MSM,TP感染的风险更大。结论秦皇岛市MSM HIV、TP感染率较高,应重点加强对年轻MSM的宣传干预力度,切实提高安全意识和安全行为,同时推广网络宣传干预;而在年龄大、已婚的MSM,则应加强TP筛查并提供方便、可及的诊疗服务。在开展性病艾滋病防治宣传的同时不应忽视丙型肝炎防治知识的宣传。

The situation and influencing factors of HIV/TP/HCV infection in men who have sex with men in Qinhuangdao

Objective To understand HIV,TP and HCV infection status and related factors among men who have sex with men（MSM）in Qinhuangdao and to propose advice targeted sexually transmitted disease（STD）/acquired immunodeficiency syndrome（AIDS）prevention and control.Methods For four consecutive years from 2009-2012,questionnaire and serological testing were provided to MSM firstly receiving HIV consulting testing at VCT clinics and during outreach intervention activities.They were voluntarily recruited by the method of snowball.Results 1043 MSM were recruited for the past 4years,70.76%（738/1043）of participants looked for partners through the internet.The rates of HIV knowledge awareness,persons receiving HIV intervention services and the number of HIV testing increased gradually（P〈0.01）in four years.The rate of consistent condom use in the last 6months in homosexual anal sex,heterosexual sex and commercial sex were 42.76%（898,86.10%）,36.98%（311/898,34.63%）and 53.09%（81/898,9.02%）,respectively.The prevalence of HIV,syphilis and HCV were 5.75%（60/1043）,7.19%（75/1043）and 0.19%（2/1043）,respectively.There were rising trends on HIV and syphilis prevalence（P〈0.05）.Multivariate analysis showed that low educational level,locally lived for a short time and history of sexually transmitted diseases（STD）were the risk factors of HIV and syphilis infection.The Older the MSM,the higher the risk of syphilis infection.Conclusion In Qinhuangdao there were high infection rates of HIV and syphilis among MSM.Strengthen intervention and internet intervention among young MSM population should be taken,in order to effectively improve safety awareness and behavior.Syphilis screening and convenient and accessible medical services should be promoted in old married MSM,and the publicizing of hepatitis C knowledge should not be ignored while promoting the prevention and control of STD and AIDS.