文章摘要
宋丹丹,张洪波,王君,王晓冬,刘奇,韩德琳,戴丽萍,佘敏,汪敏,董振鑫.广州和成都市男男性行为兼异性性行为者的HIV感染状况及性行为特征[J].中华流行病学杂志,2012,33(4):368-373
广州和成都市男男性行为兼异性性行为者的HIV感染状况及性行为特征
The prevalence of HIV infection and sexual behaviors among men who have sex with men and women in Chengdu and Guangzhou, China
收稿日期:2011-08-31  出版日期:2014-09-09
DOI:
中文关键词: 男男性行为者;男男性行为兼异性性行为者;艾滋病病毒感染者/艾滋病患者
英文关键词: Men who have sex with men;Men who have sex with men and women;HIV/AIDS
基金项目:2010年度艾滋病应用性研究项目(2010146)
作者单位E-mail
宋丹丹 安徽医科大学公共卫生学院, 合肥 230032  
张洪波 安徽医科大学公共卫生学院, 合肥 230032 zhb62@yahoo.com.cn 
王君 安徽医科大学公共卫生学院, 合肥 230032  
王晓冬 成都同乐健康咨询服务中心  
刘奇 广州市小奇文化传播有限公司  
韩德琳 成都市疾病预防控制中心  
戴丽萍 广州市越秀区疾病预防控制中心  
佘敏 安徽医科大学公共卫生学院, 合肥 230032  
汪敏 安徽医科大学公共卫生学院, 合肥 230032  
董振鑫 安徽医科大学公共卫生学院, 合肥 230032  
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中文摘要:
      目的 了解中国男男性行为兼异性性行为者(MSMW)的HIV感染状况及其与男性和女性的性行为特征.方法 采用“滚雪球”方法在广州和成都市各招募300名MSMW为研究对象,进行问卷调查(社会人口学特征、最近6个月男性性伴种类和特征、男男性行为及安全套使用状况、最近12个月异性性伴种类和特征、异性性行为及安全套使用状况)和HIV抗体检测.结果 共600名MSMW接受问卷调查和HIV检测,HIV感染率和检出率分别为26.2%和8.5%;最近6个月有28.0%的调查对象拥有≥5名男性性伴,肛交行为时每次使用安全套者占44.2%,最近3次和最近1次男男肛交性行为使用安全套者分别为52.3%和63.0%;最近12个月有86.0%的调查对象与女性发生性行为,其中配偶、婚前女友、婚外情人、女性偶然性伴和女性商业性伴的比例分别为65.0%、27.2%、1.5%、12.7%和4.5%,约1/3的调查对象异性性行为时坚持每次使用安全套,36.5%在最近3次异性性行为时均不使用安全套.最近6、12个月成都市MSMW男男性行为时每次使用安全套分别为55.7%和38.3%,均高于广州市(32.7%和25.3%).HIV阳性者中,与男性发生肛交性行为者为91.1%,最近6个月与男性发生肛交行为时每次使用安全套者为49.7%,最近3次和最近1次男男肛交性行为使用安全套者分别为60.5%和69.4%;最近12个月有82.8%阳性调查者与异性发生过性行为,42.0%每次性行为坚持使用安全套,最近3次性行为使用安全套者占47.8%.最近6、12个月,既往检测HIV阳性MSMW从不使用安全套同性和异性性行为的比例(分别为4.3%和12.9%)均低于本次检测HIV阳性MSMW(22.0%和46.3%).结论 MSMW人群的HIV感染率已经处于较高水平,并存在较高比例的无保护男性肛交性行为和女性阴道性交行为,该人群在HIV跨性别传播中的桥梁作用可能加快HIV在普通人群中的蔓延.
英文摘要:
      Objective To understand the status of HIV infection and sexual behaviors with men and women among men who have sex with men and women (MSMW) and documented for HIV epidemic among men who have sex with men to the general population.Methods 300 participants were recruited by using "snowballing" sampling in Chengdu and Guangzhou,respectively.Participants completed the questionnaire and HIV test.The questionnaire included social demographic characteristics,number of male sexual partners,sexual behaviors and condom use in the past 6 months.Relations with female sexual partners,vaginal intercourse and condom use in the past 12 months were also studied.Results Of the 600 oarticioants,the overall prevalence of HIV infectionwas 26.2% and the detection rate of HIV-positives in this survey was 8.5%.In the past 6 months 28.0% of the participants had 5 or more male sexual partners and the percentage of MSMW who had used condoms consistently during anal sex intercourse with men,was 44.2%.Of the participants,52.3% had used condoms in the last three anal sex events and 63.0% in the last event.In the past 12 months,86.0% of the participants who had vaginal sex with female partners and the proportions of MSMW who had wife,girlfriend,lover,female casual partner and female commercial partner were 65.0%,27.2%,1.5%,12.7%,4.5%,respectively.About a third of the MSMW had always used condoms when having vaginal sex in the past 12 month.In the last three vaginal sex events,the proportion of participants who had never used condoms was 36.5%.In the past 6 months,55.7% of the MSMWs had used condoms consistently during anal sex with men in Chengdu,which was higher than those MSMW in Guangzhou (32.7%).In the past 12 months,the proportion of MSMW who had used condoms consistently during vaginal sex was 38.3%,which was higher than MSMW of Guangzhou (25.3%).Among those HIV-positive MSMWs,91.1% had anal sex with men in the past 6 months and 49.7% HIV-positive MSMW had used condoms consistently during anal sex with men.The number of HIV-positive MSMW who had used condoms in the last or last three anal sex events with men,accounted for 60.5% and 69.4%,respectively.In the past 12 months,82.8% of the HIV-positive participants had vaginal sex with women.Of the HIV-positive participants,42.0% used condoms consistently and the percentage of HIV-positive MSMWs who used condom during last three vaginal sexes was 47.8%.In the past 6 months,the percentage (4.3%) of MSMW who were HIV-positive prior to the survey and never used condoms during anal sex with men was lower than the percentage (22.0%) of MSMW who were HIV-positive found in this survey.In the past 12 months 12.9% of the MSMW who were HIV positive prior to the survey never used condoms when having vaginal sex event,which was lower than MSMW (46.3%) who were HIV positive in this survey.Conclusion The prevalence of HIV infection had reached a quite high level and with high rates of unprotected anal sex with men and vaginal sex with women among MSMWs,indicating that the inherent bridging aspect of MSMW might accelerate the spreading of HIV infection to the general population.
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