网络招募的男男性行为者HIV感染状况及影响因素分析

摘要

目的 分析基于网络平台招募的男男性行为(MSM)人群性行为特征及艾滋病病毒(HIV)血清学检测情况,分析相关影响因素.方法 通过网络招募近1年内有同性性行为的MSM,开展面对面的问卷调查,并采血进行HIV、梅毒和HCV抗体检测,采用logistic回归方法分析感染的相关影响因素.结果 共招募有效调查对象400名,中位数年龄27岁,未婚占65.25％;大专及以上学历占56.00％;总体知识知晓率为92.75％;最近一次与同性和异性发生性行为的安全套使用比例为78.96％和79.82％;HIV抗体阳性检出率为7.25％(29/400).多回归分析结果有统计学意义的变量包括年龄、知晓情况、与同性肛交安全套的使用、与异性性交安全套的使用、梅毒感染和性病感染.结论 基于网络招募的MSM危险性行为发生率和HIV感染率较高,安全套使用率低,应探索应用互联网开展有效的健康教育和检测动员,完善性病和艾滋病综合防治机制,采取有效针对措施加大对该人群干预力度.%Objective To understand the human immunodeficiency virus(HIV) infection status and features of sexual behavior among men who have sex with men (MSM) and receive voluntary counseling and serological testing appointed through a web-based registering system to analyze the related factors.Methods The MSM who have homosexual behavior in nearly a year were recruited for HIV,syphilis and hepatitis C virus (HCV) antibody assay in peripheral blood and a face-to-face questionnaire survey was conduct among them to obtain the information about their demographic characteristics and sexual behavior.Binary logistic regression model was used to identify the risk factors associated with HIV infection.Results A total of 400 MSM were enrolled in our study,the median age is 27 years old,the unmarried MSM accounted for 65.25％,56.00％ of them had high education level and the awareness rate of knowledge regarding HIV was 92.75％.The percentages of using condom at latest homosexual or heterosexual behavior were 78.96％ and 79.82％.The HIV incidence was 7.25％ (29/400).Age,condom use at each homosexual or heterosexual behavior,the awareness rate of knowledge regarding HIV,sexually transmitted disease (STD) infection,Treponema pallidum infection were associated with HIV infection.Conclusions MSM receiving web appointed HIV counseling and testing had high prevalence of risk behaviors and high HIV infection rate,but the rate of condom use was relatively low.It is necessary to strengthen the promotion of HIV test through web based appointment.The integrated mechanism for the prevention and control of STD and AIDS should be improved and effective target behavior intervention in MSM should be strengthened in our intervention programs.