论文部分内容阅读
调查2011~2015年中国宁夏银川地区男男性行为人群MSM(Men who have sex with men,MSM)HIV-1感染率和新发感染率的变化趋势,为高危特殊人群干预防治提供科学策略。2011~2015年在银川地区进行MSM哨点监测,调查MSM人群社会人口学信息、性行为情况、艾滋病预防服务覆盖和近1年HIV检测情况等,采用趋势χ2检验进行趋势分析;MSM确证结果为HIV-1阳性样本进行BED检测,计算新发感染率并进行χ2检验。2011~2015年在银川地区每年均调查MSM人群400例,HIV感染率分别为3.8%(95%Cl:2.3%~5.6%)、7.3%(95%CI:5.1%~12.3%)、5.5%(95%Cl:3.5%~8.0%)、6.0%(95%Cl:4.6%~8.6%)和8.3%(95%C1:6.4%~12.6%),未见有上升趋势(P=0.335);梅毒感染率分别为7.0%(95%CI:5.8%~10.2%)、6.3%(95%CI:4.1%~10.0%)、5.5%(95%CI:4.3%~7.9%)、6.8%(95%CI:5.3%~12.9%)和5.0%(95%Cl:4.0%~7.7%),未见有上升趋势(P=0.315);最近6个月与同性发生肛交行为的MSM中,安全套的使用率从2011年的40.8%下降至2015年的11.5%;最近6个月与同性发生商业性行为的比例从2011年的16.0%至2015年的15.0%,而在同性商业性行为中安全套的使用率从85.9%上升至90.0%,最近6个月与异性发生性行为的MSM中,从2011年41.5%至2015年24.3%,呈逐年减少趋势,与异性发现性行为安全套的使用率从38.0%下降至7.2%。2011~2015年新发感染率分别为2.88%(95%CI:0.36%~5.40%)、5.70%(95%CI:2.17%~9.23%)、5.19%(95%CI:1.97%~8.41%)、5.73%(95%CI:2.35%~9.12%)、5.28%(95%CI:2.01%~8.55%),卡方检验显示,P>0.05(χ2=2.478,P=0.629),差异无统计学意义。银川地区MSM人群HIV感染率和新发感染率保持稳定态势;MSM人群存在严重的认知行为分离现象,MSMW人群是艾滋病防治中的重点难点人群。
To investigate the change trend of HIV-1 infection rate and new infection rate among men who have sex with men (MSM) in Ningxia Yinchuan from 2011 to 2015, and to provide scientific strategies for intervention and prevention in high-risk special population. MSM sentinel surveillance was conducted in Yinchuan from 2011 to 2015 to investigate the socio-demographic information, sexual behavior, coverage of HIV prevention services and HIV testing in the MSM population in the past two years. The trends χ2 test was used to analyze the trends. MSM confirmed that HIV-1-positive samples were tested for BED, new infections were calculated and chi-square test was performed. From 2011 to 2015, 400 MSM patients were investigated in Yinchuan every year, with HIV prevalence rates of 3.8% (95% Cl: 2.3% -5.6%), 7.3% (95% CI: 5.1% -12.3%) and 5.5% (95% Cl: 3.5% -8.0%), 6.0% (95% Cl: 4.6% -8.6%) and 8.3% (95% C1: 6.4% ~ 12.6% ; The prevalence of syphilis was 7.0% (95% CI: 5.8% -10.2%), 6.3% (95% CI: 4.1% -10.0%), 5.5% (95% CI: 5.3% -12.9%) and 5.0% (95% Cl: 4.0% -7.7%). There was no upward trend (P = 0.315). In the MSM with same-sex anal intercourse during the last 6 months, Condom use dropped from 40.8% in 2011 to 11.5% in 2015; the proportion of business sex with the same sex in the last 6 months rose from 16.0% in 2011 to 15.0% in 2015, while in same-sex business practices Condom use increased from 85.9% to 90.0%. In the last 6 months, MSM among MSM with heterosexual activities dropped from 41.5% in 2011 to 24.3% in 2015, showing a trend of declining year by year. The rate of condom use From 38.0% to 7.2%. The rates of new infections in 2011-2015 were 2.88% (95% CI: 0.36% ~ 5.40%), 5.70% (95% CI: 2.17% ~ 9.23%) and 5.19% (95% CI: 1.97% ~ 8.41% ), 5.73% (95% CI: 2.35% -9.12%), 5.28% (95% CI: 2.01% ~ 8.55%). The chi-square test showed that P> 0.05 Statistical significance. HIV infection rate and new infection rate of MSM population in Yinchuan remained stable; MSM population had serious cognitive behavioral segregation; MSMW population was the most important and difficult population in AIDS prevention and treatment.