深圳市南山区MSM个体性网络大小对感染梅毒的影响

目的了解深圳市男男性行为者(men who have sex with men,MSM)个体性网络大小及其对感染梅毒的影响,为男男性行为者采取干预措施降低梅毒感染风险提供新的视角。方法 2014—2016年深圳市南山区慢性病防治院采用外展干预和男同彩虹门诊相结合的方式对男男性行为者开展匿名自填式问卷调查,收集男男性行为者基本人口学、行为学、性网络特征及梅毒知识知晓情况,开展HIV、梅毒检测,通过卡方检验、Logistic回归探索该人群性行为、性网络与梅毒的相关性。结果共调查429名男男性行为者,梅毒检测阳性率9.1%。平均年龄(27.2±5.8)岁;汉族占98.1%;文化程度大专以上占70%;户籍是外省的占一半以上;约50%在深圳居住时间在半年以内;梅毒预防知识知晓率较低,仅70.2%。个体性网络大小做单因素分析,年龄(P=0.009)、文化程度(P=0.012)、在深居住时间(P=0.002)、最近6月与男性发生肛交时安全套的使用情况(P=0.041)、梅毒知识知晓情况(P=0.047)均与最近6月个体性网络大小情况有统计学意义。梅毒感染单因素分析文化程度、最近6月个体性网络大小、最近6月与男性发生肛交时安全套使用情况与感染梅毒有统计学意义;多因素分析显示个体性网络大小为15人以上(adjusted OR=3.383,95%CI=0.997~23.030)是感染梅毒的危险因素;最近6月与男性发生肛交时每次使用安全套(adjusted OR=0.059,95%CI=0.011~0.305)是感染梅毒的保护因素。结论 MSM人群是梅毒的一个易感人群,感染梅毒会增加感染HIV的风险,预防HIV和梅毒需同步。性网络作为传播HIV/STI桥梁的同时也是预防的关键,通过性网络建立同伴健康教育干预方法是预防性病的重要措施。

Relationship between egocentric sexual network size and syphilis of men who have sex with men in Nanshan District,Shenzhen

Objective To understand the egocentric sexual networks size of men who have sex with men(MSM) in Shenzhen and its impact on the syphilis,to provide a new perspective for intervening to reduce their risk.Methods Participants completed an anonymous self-administered questionnaire,which were conducted by means of outreach intervention and MSM rainbow outpatient clinics in Shenzhen Nanshan Center for Chronic Disease Control in 2014-2016.Collected informations on basic demographic,behavioral,sexual networks and syphilis prevention and treatment knowledge among MSM.The participants underwent HIV and syphilis testing after interview.Using the chi-square test,Logistic regression to explore the relationship between sexual behaviors,sexual networks characteristics and syphilis.Restlts A total of 429 MSM were investigated,the prevalence of syphilis was 9.1％.The average age (27.2 ± 5.8) years;the Han nationality accounted for 98.1％;the proportion of college / university or above was 70％;household registration was more than half of Guangdong Province;nearly 50％ residence time in Shenzhen less than six months;the eligible rate of syphilis prevention knowledge was low,only 70.2％.Univariate analysis of egocentric network size revealed that age (P=0.009) 、educational status (P=0.012) 、residence time in Shenzhen (P=0.002) 、the frequency of condom use when have anal sex with males in the last six months (P=0.041)and syphilis prevention knowledge awareness (P=0.047) were statistically significant with the individual sexual networks size.Univariate analysis of syphilis suggested that the educational level,egocentric network size in the last six mouth,the frequency of condom use when have anal sex with males in the last six months were associated with syphilis.Multivariate analysis showed that egocentric network size was more than 15 (adjusted OR=3.383,95％CI=0.997-23.030) increased syphilis infection risk;condom was used each time in the last 6 months with anal sex with males (adjusted OR=0.059,95％CI=0.011-0.305) was a protective factor for syphilis infection.Conclusion MSM is a susceptible population of syphilis and infected syphilis will increase the risk of HIV infection,so prevention of HIV and syphilis need to be synchronized.Sexual network as bridge to disseminate HIV/STD (sexually transmitted disease) and meanwhile it is the key to prevention of these contagions.It is also an important measure to prevent STD through the establishment of peer health education interventions.