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目的了解西安市男男性行为人群(MSM)中艾滋病病毒(HIV)感染的流行病学特征和梅毒感染情况。方法采集2010-2012年西安市疾病预防控制中心确证的、经男男同性传播的HIV阳性者的外周静脉血5mL,进行梅毒实验室检测;同时完成流行病学问卷调查,行为学调查重点包括性行为特征、吸毒史、献血史等。结果调查HIV抗体阳性的男男性行为者240例,年龄集中在20~40岁(占71.2%),未婚居多(占60.4%),文化程度较高(高中/中专以上学历占79.2%),职业分布多样,艾滋病(AIDS)相关知识知晓率为96.7%。行为学特征比较复杂:61.3%有双性性行为,累计平均性伴数5人,每次性行为坚持使用安全套比例仅为20.4%。已婚调查对象中,有22.8%(13/57)在感染后与配偶间性行为不使用安全套。所有对象均否认有吸毒史,10%有使用兴奋剂/催欲药史;25%有献血史;38.8%在感染前定期进行HIV抗体检测。性取向或情感倾向显示:57.9%为同性,32.5%为双性,4.2%异性,5.4%表示不确定。梅毒阳性率为17.5%。结论西安市HIV抗体阳性的MSM普遍存在“知-行”分离现象,具有双性性行为、多性伴、安全套使用率低及梅毒感染率高等特点。今后应继续加强艾滋病宣传教育和行为干预,及早发现并规范治疗梅毒,遏制该人群中艾滋病的流行。
Objective To understand the epidemiological characteristics of HIV infection and syphilis infection among men who have sex with men (MSM) in Xi’an. Methods A total of 5 mL of peripheral venous blood from HIV-positive men and women who were sexually transmitted by MSM from 2010 to 2012 in Xi’an Municipal Center for Disease Control and Prevention was collected for laboratory testing of syphilis. At the same time, a questionnaire survey on epidemiology was conducted with behavioral investigation focusing on Behavioral characteristics, drug abuse history, blood donation history. Results 240 cases of HIV-positive men who had masculine gender were investigated. Their age ranged from 20 to 40 years old (71.2%), mostly unmarried (60.4%), higher education (79.2% with high school / technical secondary school education) Occupational distribution of diverse, AIDS-related knowledge awareness was 96.7%. Behavioral characteristics are more complicated: 61.3% had bisexual sexual behavior, and the average number of sexual partners was 5, with only 20.4% of them insisting on using condoms each time. Among the married subjects, 22.8% (13/57) did not use condom after sexual intercourse with their spouses. All subjects denied a history of drug abuse, 10% had doping / drug abuse history; 25% had a blood donation history; 38.8% performed HIV antibody testing regularly before infection. Sexual orientation or sentiment tendencies showed that 57.9% were same sex, 32.5% were sex, 4.2% were heterosexual, and 5.4% were indefinite. Syphilis positive rate was 17.5%. Conclusion HIV-positive MSM in Xi’an generally has the phenomenon of “know-line” separation, with the characteristics of bisexual behavior, multiple sexual partners, low condom use rate and high syphilis infection rate. In the future, HIV / AIDS publicity and education and behavioral interventions should continue to be strengthened to detect and standardize the treatment of syphilis as soon as possible to curb the AIDS epidemic among this population.