深圳市2012—2019年男男性行为者HIV感染分析

目的 调查2012—2019年深圳市男男性行为者（men who have sex with men,MSM）HIV感染情况,为针对性开展精准干预提供数据支持。方法 对深圳市MSM应用时空场所抽样、同伴推动抽样、自愿咨询检测门诊抽样、阴性人群随访、跨境调查等不同抽样方法对深圳市MSM开展调查,并采集静脉血,进行HIV筛查及补充检测。使用χ²检验和二分类Logistic回归进行HIV感染的单因素和多因素统计学分析。结果 2012—2019年共检测20 358例MSM,年度检测2 273~2833例。年龄13~77岁,中位数M（P₂₅,P₇₅）为27（23,33）岁,平均（28.99±7.94）岁。HIV总体阳性率8.74%。2013年感染率最高达到12.00%,2019年降低至4.81%（趋势χ²=145.33,P<0.001）。2013年HIV感染率是2012年的1.206倍（P<0.05）,但2015—2019年各年度HIV感染率均低于2012年（P<0.001）。40~<50岁感染率最高为12.69%,20-<30岁感染率最低为7.44%。<20岁、30~<40岁、40~<50岁和≥50岁各年龄段HIV感染率分别是20~<30岁年龄段的1.456、1.381、1.940、1.634倍（P<0.001）。时空场所抽样和阴性人群随访的感染率最低均为7.50%,自愿咨询检测和跨境人群调查的感染率较高,分别为11.06%和12.86%。同伴推动抽样和自愿咨询检测人群HIV感染率是时空场所抽样人群的1.298和1.657倍（P<0.001）。在时空场所抽样人群中,无商业性行为人群的感染率（13.06%）远高于有商业性行为人群的感染率（2.06%）（P<0.001）。结论 深圳市MSM人群HIV感染率在2013年达到峰值以后逐年下降,且时空场所抽样感染率较低。

HIV infection analysis among men who have sex with men in Shenzhen,2012-2019

Objective To investigate and analyze the situation of HIV infection in Shenzhen MSM from 2012 to 2019,in order to provide data support for further targeting precise intervention.MethodsBlood samples were collected from Shenzhen MSM recruited by various sampling methods of time-location sampling(TLS),respondent-driven sampling(RDS),voluntary counseling&testing(VCT),follow up of negative population,and cross-border population survey.HIV screening and supplementary testing were applied.Chi-square test and binary Logistic regression were used for statistical analysis.Results Totally 20358 MSM were tested from 2012 to 2019,with annual tests from 2273 to 2833.The average age was(28.99±7.94)years,in the range from 13 to 77,with median age(P25,P75)of 27(23,33).HIV total positive rate was 8.74%.The infection rate was 12.00%in 2013,and 4.81%in 2019(trendχ2=145.33,P<0.001).The HIV infection rate in 2013 was 1.206 times of that in 2012(P<0.05),and the HIV infection rates in 2015-2019 were all lower than that in 2012,respectively(all P<0.001).The infection rate was highest as 12.69%in 40-<50 age group,and lowest as 7.44%in 20-<30.Compared with 20-<30 age group,the HIV infection rate in age group of<20,30-<40,40-<50 and≥50 was 1.456,1.381,1.940,1.634 times,respectively(all P<0.001).The infection rates were 7.50%,7.50%,11.06%and 12.86%in TLS,follow up,VCT and cross-border,respectively.Compared with TLS,the HIV infection rate in RDS and VCT was 1.298 and 1.657 times,respectively(all P<0.001).The infection rate of non-commercial sex group(13.06%)was much higher than that of commercial sex group(2.06%)(P<0.001).Conclusion The HIV infection rate in Shenzhen MSM peaked in 2013 and declined later,as well as the infection rate was relatively low in time-location samples.