上海市50岁以上 MSM 人群 HIV 和梅毒的感染率及影响因素

摘要

目的：研究上海市50岁以上男男性行为人群（MSM）HIV 和梅毒感染率及其影响因素。方法于2011年5月—2013年4月采取滚雪球的方法在上海市招募50岁以上老年 MSM，进行问卷调查以及 HIV 和梅毒血清学抗体检测。结果共有165人接受调查，平均年龄（58．7±7．5）岁，81．8％本地户籍，61．8％在婚。99．4％研究对象曾有过男性一夜情行为，97．0％一生中有2个或2个以上男性性伴，62．4％在过去半年有超过1个以上男性性伴。HIV 感染率为10．9％，多因素 Logistic 回归分析显示，每天喝酒，一生中男性性伴个数超过51个，男男性关系时只做“0”或“0”和“1”都做较只做“1”更易感染 HIV。梅毒感染率为15．8％，多因素 Logistic 回归分析显示第一次与男性发生性行为或亲密行为年龄在30岁以后、一生中男性性伴个数超过10个更易感染梅毒。但是最近半年男男性行为时每次都坚持使用安全套的较从不使用或偶尔使用的感染梅毒的风险小。结论50岁以上老年 MSM的 HIV 和梅毒 HSV-2感染率高，应加强老年 MSM人群艾滋病性病相关知识宣传、危险性行为干预及艾滋病性病检测，以控制艾滋病性病在该人群中的传播和蔓延。%Objective To explore the prevalence and influencing factors of HIV and syphilis among men who have sex with men (MSM)aged 50 years or above in Shanghai.Methods MSMaged 50 years or above were recruited through snow-ball sampling method from May 2011 to April 2013 in Shanghai.All subjects were interviewed with an anonymous ques-tionnaire,and took blood-test for HSV-2 and HIV antibodies.Results A total of 165 participants were included.The aver-age age was (58.7 ±7.5) years.81.8% of them were local residents of Shanghai,61.8% of them were currently mar-ried.99.4% of them had ever causal sex behavior with men,97.0% of them had two or more male sex partners before and 62.4% of them had two or more male sex partners in the last 6 months.The prevalence of HIV infection was 10.9%.Multiple logistic regression analysis indicated that those who drank alcohol every day,had totally 51 or more male sex partners before, and took the insertive sexual role during anal sex were significantly more likely to be infected with HIV.The prevalence of syphilis infection was 15.8%.Multiple logistic regression analysis indicated that those had first sex or intimate behaviors with man at 31 years or later,had totally 11 or more male sex partners before,and didn’t consistently use condoms in the last 6 months were more likely to be infected with syphilis.Conclusion The prevalence of HIV and syphilis infection were high a-mong elderly MSMin Shanghai.Prevention efforts including education on HIV /sexually transmitted infecttions (STI)knowl-edge,behavioral interventions on risk sexual behaviors,and HIV /STI testing should be strengthened among elderly MSMto control HIV /STI transmission.