天津市男男性途径感染HIV者新近感染因素分析

目的 了解天津市经男男性途径感染人类免疫缺陷病毒（human immunodeficiency virus，HIV）者中新近感染状况及相关影响因素。方法 收集2013-2015年天津市经男男性途径感染HIV者人口学资料，采用BED捕获酶联免疫法（BED capture enzyme immunoassay，BED-CEIA）进行新近感染判定，计算HIV-1新近感染比例。采用单因素和多因素非条件Logistic回归方法分析新近感染影响因素。结果 2013-2015年天津市累积报告发现经男男性途径感染HIV者1 474例，495例被判定为新近感染，HIV-1新近感染率为45.7%。3年间HIV-1新近感染者人口学构成基本保持稳定（均有P>0.05）。多因素分析显示，25岁以下年龄组（OR=1.639，95%CI:1.089~2.466）、高中（OR=1.460，95%CI:1.059~2.013）和大学（OR=1.392，95%CI:1.003~1.931）文化程度、学生（OR=1.984，95%CI:1.144~3.442）感染者是HIV-1新近感染的可能性更高；通过自愿检测咨询（OR=3.658，95%CI:2.393~5.590）、性病门诊（OR=3.784，95%CI:2.262~6.329）、男男性行为者（men who have sex with men，MSM）专题调查（OR=4.021，95%CI:2.700~5.987）和无偿献血者筛查（OR=5.192，95%CI:2.775~9.712）发现的感染者为新近感染的可能性较高。结论 天津市经男男性途径感染HIV者中新近感染比例较大，应重点加强对25岁以下、高中及以上文化程度和学生中MSM主动监测，并采取更具针对性的宣传干预措施，以减少二代传播。

Prevalence of recent HIV-1 infection and its influencing factors among HIV-positive men who have sex with men in Tianjin from 2013 to 2015

Objective To investigate the status of recent HIV-1 infection among HIV-positive men who have sex with men (MSM) in Tianjin and the associated factors. Methods General demographic information of newly reported HIV/AIDS cases transmitted through homosexual contact was collected from 2013 to 2015, and HIV blood samples were detected to identify recent HIV-1 infection using IgG-capture BED-enzyme immunoassay (BED-CEIA), then the annual proportion of recent HIV-1 infection was calculated. Factors associated with recent HIV-1 infection were analyzed by the univariate and multivariate unconditional Logistic regression. Results A total of 1 474 HIV/AIDS cases transmitted through homosexual contact were reported in Tianjin from 2013 to 2015, and 495 recent HIV-1 infection cases were identified, the rate was 45.7%. Demographic characteristics of recent HIV-1 infection cases were similar from 2013 to 2015(all P>0.05). Multivariate Logistic regression analysis showed that patients who aged <25 years (OR=1.639, 95% CI:1.089-2.466) and students (OR=1.984,95% CI:1.144-3.442) were more likely to be newly infected. The cases who had a high school education level (OR=1.460,95% CI:1.059-2.013) or college education level (OR=1.392, 95% CI:1.003-1.931) were more likely to be newly infected than those who had a primary school education. Compared with being identified by hospitals, the recent HIV-1 infections were more likely to be found through voluntary counseling and testing (OR=3.658, 95% CI:2.393-5.590), STD admission to hospital (OR=3.784, 95% CI:2.262-6.329), men who have sex with men (MSM) investigation (OR=4.021, 95% CI:2.700-5.987) and unpaid blood donation (OR=5.192, 95% CI:2.775-9.712). Conclusions Proportion of recent infection was at a high level among HIV-positive MSM in Tianjin. It is necessary to strengthen the promotion of HIV active surveillance, and intervention should be focused on MSMs at young age, with higher education levels and students, in order to reduce the secondary transmission.