目的 了解北京市女女性行为人群(WSW)性行为特点及性传播疾病(STD)感染状况.方法 于2010年9月至2011年4月,在北京市女同非政府组织、沙龙、酒吧等主要WSW活动场所,采用滚雪球方法招募WSW共150名,并开展人口学特征、性行为特征、STD病原体感染状况、就诊情况等调查.采集调查对象静脉血、阴道拭子、宫颈拭子标本进行HIV抗体、乙型肝炎病毒表面抗原、丙型肝炎病毒抗体、梅毒抗体、单纯疱疹病毒-2型(HSV-2)抗体、淋球菌(NG)、沙眼衣原体、加德纳菌(GV)、阴道毛滴虫(TV)、霉菌检测.结果 150名调查对象的年龄范围为19 ～46岁,20～29岁者占82.67％ (124/150),未婚者占54.00％(81/150),76.67％(115/150)的为大专或本科学历,70.67％(106/150)的为外地户籍.66.66％(100/150)的自我认定是同性恋,28.00％(42/150)的认为自己是双性恋.第一次同性性行为年龄为11 ～30岁.在过去1年里女性性伴中位数为1名,有2名及以上女性性伴者占33.78％ (50/148).20.27％ (30/148)的WSW使用过性器具,其中,66.67％ (20/30)的使用性器具时从未或有时使用安全套.91.22％ (135/148)的以手-阴蒂接触和手-阴道接触为同性性行为的主要方式.最近1年有12.00％(18/150)与男性发生过性行为,最近1次与男性发生性行为时有50.00％(9/18)的使用了安全套.最近1年异性性行为时从未或有时使用安全套者占66.67％(12/18).最近1年有1名调查对象以收费方式为男性提供过性服务,且其最近1年每次性行为时均使用了安全套.最近1年有45.33％ (68/150)的调查对象出现过STD症状,仅有36.76％( 25/68)的到综合医院就诊.调查对象病原体总感染率为34.67％(52/150).经血清学检测,NG、GV感染率均为16.11％(24/149),霉菌感染率为8.72％(13/149),衣原体感染率为4.03％ (6/149),TV感染率为0.67％(1/150),各有1名检出乙型肝炎病毒、丙型肝炎病毒及梅毒螺旋体阳性,无HIV、HSV-2抗体检出.结论 北京市WSW中存在多性伴和异性性行为的现象,有超过1/3的调查对象感染了STD.%Objective To study sexual behavioral characteristics,infection status of HIV and sexually transmitted infections (STDs) among women who have sex with women (WSW) in Beijing.Methods A total of 150 WSWs were recruited by snowball sampling in several main types of activity sites of WSW ( including NGOs,salons,bars,etc.) in Beijing during September 2010 to April 2011.Information on demographic tactors,sexual behavioral characteristics,infection status of STDs,and use of medical care were collected by questionnaire investigation.Serum samples,vaginal and cervical swabs were taken for each subject to test HIV,hepatitis B ( HBV ),hepatitis C ( HCV ),syphilis,herpes simplex virus ( HSV ),neisseria gonorrhoeae,chlamydia trachoma,bacterial vaginosis,trichomonas vaginalis and mycotic vaginitis.Results The age range of the subjects was from 19 to 46 years old.Approximately 82.67％(124/150) of them aged 20 to 29 years old,and 54.00％ (81/150) were unmarried.Approximately 76.67％ ( 115/150 ) had an education level of college degree or above,and 70.67％ ( 106/150 ) were migrants.Approximately 66.66％ (100/150) of the subjects considered themselves as homosexual,28.00％(42/150) as bisexual.The age at first homosexual sex ranged from 11 to 30 years old.The median of number of female sex partners in last 1 year was 1,and 33.78％ (50/148) of the subjects had 2 or more female sex partners.Approximately 20.27％ ( 30/148 ) of the subjects applied sex instruments,of which 66.67％(20/30) never or seldom used condoms.Hand-clitoris and hand-vagina contacts were the main types of woman-to-woman sex,accounting for 91.22％ (135/148).12.00％ (18/150) of the subjects had sex with men during last year.Among them,50.00％ (9/18) used condoms at last heterosexual sex,and 66.67％( 12/18 ) never or seldom used condoms at last heterosexual sex in past 1 year.One subject provided paid sex service for men.and used condoms every time.In the past one year,45.33％ (68/150) of the subjects had symptoms of STDs,but only 36.76％ ( 25/68 ) of them sought medical care.The infection rate of STDs was 34.67 ％ (52/150).The infection rates of NG and GV were both 16.1 1％ ( 24/149 ),and those of mycotic vaginitis,chlamydia trachoma,and TV were 8.72％ ( 13/149 ),4.03％ ( 6/149 ),and 0.67％ ( 1/150 ),respectively.The numbers of subjects tested positive for HBV,HCV,and syphilis were all 1.No subjects were found HIV positive or HSV-2 positive.Conclusion Multiple sexual partners and heterosexual sex behavior were common among WSW in Beijing.More than 1/3 of the subjects were infected with STD.
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