| 陈恩品,尹寒露,顾静,王旭雯,邹华春,孟晓军.男男性行为人群中男性性工作者HIV感染状况及影响因素分析[J].中华流行病学杂志,2020,41(10):1697-1702 |
| 男男性行为人群中男性性工作者HIV感染状况及影响因素分析 |
| HIV infection and associated factors of male sex workers among men who have sex with men |
| 收稿日期:2020-02-14 出版日期:2020-10-27 |
| DOI：10.3760/cma.j.cn112338-20200214-00100 |
| 中文关键词: 性取向 男性性工作者 艾滋病病毒 危险行为 影响因素 |
| 英文关键词: Sex orientation Male sex workers HIV Risk behaviors Associated factors |
| 基金项目:国家自然科学基金（81703278）；江苏省卫健委面上项目（Y2018013）；无锡市卫健委科研项目（QNRC033，ZDXK009，M202012）；江南大学公共卫生研究中心项目（JUPH201840） |
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| 中文摘要: |
| 目的 了解男男性行为人群男性性工作者（MSW）HIV感染状况及影响因素，为制定针对性干预措施提供依据。方法 2019年5－7月，在MSM社会组织协助下，选择无锡市市区MSM主要活动场所，采用方便抽样方法招募MSW研究对象。开展横断面调查，问卷调查收集研究对象相关信息并进行HIV和梅毒抗体检测。采用EpiData 3.0和SPSS 17.0软件整理数据和统计学分析。结果 MSW研究对象500例，其中异性恋者占48.6%（243/500），同性恋者占51.4%（257/500），HIV感染率为5.4%（27/500），其中异性恋者和同性恋者HIV感染率分别为3.3%（8/243）和7.4%（19/257），差异有统计学意义（χ2=4.112，P=0.043）。最近3个月肛交以被动方为主，异性恋者和同性恋者分别为11.5%（28/243）和28.0%（72/257）；最近3个月发生异性性行为的异性恋者和同性恋者分别为98.4%（239/243）和15.6%（40/257）；最近3个月未检测HIV的异性恋者和同性恋者分别为44.9%（109/243）和20.6%（53/257），差异均有统计学意义（P<0.001）。多因素logistic回归分析结果显示，MSW异性恋者感染HIV的危险因素包括年龄≥30岁（aOR=7.54，95% CI：2.53~37.11）、肛交未坚持使用安全套（aOR=3.76，95% CI：1.15~12.23）、有酒后肛交（aOR=10.91，95% CI：2.29~51.87）和梅毒抗体检测阳性（aOR=8.23，95% CI：1.29~52.51）；MSW同性恋者感染HIV的危险因素包括肛交未坚持使用安全套（aOR=2.94，95% CI：1.17~7.37）、有群交（aOR=4.08，95% CI：1.05~15.81）、未做过HIV检测（aOR=6.58，95% CI：2.01~18.06）和梅毒抗体检测阳性（aOR=4.55，95% CI：1.15~18.06）。结论 MSW中的异性恋者和同性恋者HIV感染率均较高，两类人群的高危行为差异明显，应采取不同的预防干预措施。 |
| 英文摘要: |
| Objective This study aimed to discover the HIV infection and associated factors among male sex workers (MSW) who provide sexual services for men. Data from this study thus can be used to provide evidence for designing related intervention programs. Methods In this observational study, MSW were recruited from May to July, 2019 in KTV venues in Wuxi, China. A questionnaire was used to collect information with blood sample collected and tested for HIV and syphilis. EpiData 3.0 and SPSS 17.0 software were used to clean up data and statistical analysis. Results A number of 500 MSW were involved including 243 (48.6%) heterosexual and 257 (51.4%) homosexual MSW. The overall HIV prevalence was 5.4%(27/500) among all the MSW. there were significant differences between the HIV prevalence rates, the heterosexual MSW (3.3%, 8/243) and the homosexual MSW (7.4%, 19/257)(χ2=4.112, P=0.043). In the past 3 months, 28.0% (72/257) of the homosexual MSW mainly engaged in receptive anal sex which was higher than 11.5%(28/243) of the heterosexual MSW. Compared to 15.6% (40/257) of the homosexual MSW who engaged in heterosexual behavior, a higher proportion of 98.4% (239/243) was noticed among the heterosexual MSW. Higher percentage (44.9%, 109/243) appeared among the heterosexual MSW who had not been tested for HIV than the homosexual MSW (20.6%, 53/257). Results from logistic regression multivariate analysis showed that age ≥30 (aOR=7.54, 95% CI: 2.53-37.11), having unprotected anal sexual practice (aOR=3.76, 95% CI:1.15-12.23), having anal sex after drinking alcohol (aOR=10.91, 95% CI: 2.29-51.87) and syphilis tested positive (aOR=8.23, 95% CI:1.29-52.51) were risk factors associated with HIV infection among the heterosexual MSW. Having unprotected anal sexual behavior (aOR=2.94, 95% CI: 1.17-7.37), having group anal sex (aOR=4.08, 95% CI:1.05-15.81), without record on HIV testing (aOR=6.58, 95% CI: 2.01-18.06) and syphilis tested positive (aOR=4.55, 95% CI: 1.15-18.06) were risk factors associated with HIV among the homosexual MSW. Conclusions High HIV prevalence was discovered among both heterosexual and homosexual MSW in Wuxi, China. Differences in sexual behaviors between these two groups should be considered when designing targeted HIV intervention programs for these populations. |
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