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目的掌握襄阳市男男性行为人群(MSM)艾滋病病毒(HIV)新发感染影响因素,为制定防控措施提供依据。方法采用滚雪球法召集襄阳市MSM,对其进行艾滋病防治知识、行为等方面的问卷调查,检测HIV抗体、梅毒和丙型肝炎抗体。对数据进行描述性、单因素和多因素分析。结果襄阳市MSM人群HIV新感染率估算值为4.72%(95%CI=3.03%~6.42%)。单因素分析显示,年龄、本地居住时间、文化程度、艾滋病防治知识得分、最近一次同性肛交时使用安全套、最近六个月同性性行为坚持使用安全套、最近一年曾被诊断患过性病、最近一年接受同伴教育、梅毒感染共9个因素与艾滋病新发感染相关(P≤0.10)。多因素分析显示,最近六个月同性肛交时坚持使用安全套(OR=0.16,95%CI=0.05~0.54,P=0.00)是HIV新发感染的保护性因素,且影响最大。年龄大于等于60岁(OR=4.78,95%CI=0.92~24.75,P=0.04)、本地居住时间12个月以内(OR=4.36,95%CI=1.37~13.81,P=0.01)、文化程度初中及以下(OR=2.44,95%CI=1.05~5.70,P=0.04)、梅毒阳性(OR=4.44,95%CI=1.25~15.77,P=0.02)是危险因素。结论襄阳市MSM人群HIV新发感染率较高。应采取有效措施提高该人群安全套坚持使用率,加大对60岁及以上、本地居住时间12个月以内、文化程度初中及以下、梅毒阳性的MSM人群综合干预措施力度。
Objective To understand the influencing factors of new HIV infection in men who have sex with men (MSM) in Xiangyang and to provide the basis for prevention and control measures. Methods The method of snowballing was used to summon MSM in Xiangyang to conduct a questionnaire survey on HIV / AIDS prevention and treatment knowledge and behavior, and to test HIV antibody, syphilis and hepatitis C antibody. Descriptive, univariate and multivariate analyzes of the data. Results The estimated HIV prevalence of MSM in Xiangyang was 4.72% (95% CI = 3.03% ~ 6.42%). Univariate analysis showed that condom was used in congenital homosexual sex during the last homosexual anal sex test, and condom use was consistently observed in homosexuals in the last six months. The most recent one was STD Nine years of peer education and syphilis infection were associated with a new HIV infection (P ≤ 0.10). Multivariate analysis showed that condom use (OR = 0.16, 95% CI = 0.05-0.54, P = 0.00) persisted during same-sex anal sex in the last six months and was the protective factor of new HIV infection with the greatest impact. (OR = 4.78, 95% CI = 0.92- 24.75, P = 0.04), local resident time within 12 months (OR = 4.36, 95% CI = 1.37-13.81, P = 0.01), educational level (OR = 2.44, 95% CI = 1.05-5.70, P = 0.04), and syphilis positive (OR = 4.44,95% CI = 1.25-15.77, P = 0.02) were risk factors. Conclusion The incidence of new HIV infection in MSM population in Xiangyang City is high. Effective measures should be taken to increase the adherence rate of condom use to the population and increase the comprehensive intervention measures for MSM population aged 60 years and above, local residents within 12 months, junior high school education and below, and syphilis.