文章摘要
王莉娜,闫珂,于海英,黄鹏翔,王国永,廖玫珍,马伟.山东省男男性行为人群新型毒品滥用和HIV新发感染的相关因素分析[J].中华流行病学杂志,2022,43(10):1632-1638
山东省男男性行为人群新型毒品滥用和HIV新发感染的相关因素分析
Analysis of related factors of new-type drug use and recent HIV infection among men who have sex with men in Shandong province
收稿日期:2022-05-16  出版日期:2022-10-18
DOI:10.3760/cma.j.cn112338-20220516-00421
中文关键词: 男男性行为者  新型毒品  艾滋病病毒  新发感染
英文关键词: Men who have sex with men  New-type drugs  HIV  Recent infection
基金项目:山东省医药卫生科技发展计划(2019WS430,2019WS427)
作者单位E-mail
王莉娜 山东大学齐鲁医学院公共卫生学院流行病学系, 济南 250012  
闫珂 山东省疾病预防控制中心性病艾滋病防制所, 济南 250014  
于海英 山东省疾病预防控制中心性病艾滋病防制所, 济南 250014  
黄鹏翔 山东省疾病预防控制中心性病艾滋病防制所, 济南 250014  
王国永 山东省疾病预防控制中心性病艾滋病防制所, 济南 250014  
廖玫珍 山东省疾病预防控制中心性病艾滋病防制所, 济南 250014 liaomz161@126.com 
马伟 山东大学齐鲁医学院公共卫生学院流行病学系, 济南 250012 weima@sdu.edu.cn 
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中文摘要:
      目的 分析MSM新型毒品滥用和HIV新发感染的相关因素,为制定艾滋病防控措施提供参考依据。方法 2021年4-7月在山东省9个城市监测哨点招募MSM,每个城市招募样本量为400人。开展面对面问卷调查,收集MSM社会人口学特征、行为学和接受HIV干预服务等信息,采集血样进行HIV和梅毒抗体检测。采用限制性抗原亲和力酶联免疫法进行HIV新发感染检测,并计算HIV新发感染率指标。结果 共调查MSM 3 624人,年龄(32.70±9.33)岁,以≥30岁(59.52%,2 157/3 624)、高中及以下文化程度(55.99%,2 029/3 624)、未婚/离异/丧偶(57.70%,2 091/3 624)和性取向为同性恋者为主(86.26%,3 126/3 624)。最近6个月发生无保护肛交占32.95%(1 194/3 624);曾使用新型毒品占27.48%(993/3 613);HIV抗体阳性率为3.12%(113/3 624),HIV新发感染率为2.61%(95%CI:1.73%~3.49%)。多因素logistic回归分析结果显示,MSM新型毒品滥用的相关因素包括未婚/离异/丧偶(相比于已婚/同居,aOR=1.43,95%CI:1.22~1.69)、大专及以上文化程度(相比于高中及以下文化程度,aOR=1.47,95%CI:1.25~1.72)、主要寻找男性性伴场所为互联网/交友软件(相比于酒吧/浴池/公园等,aOR=1.76,95%CI:1.41~2.19)、最近6个月发生无保护肛交(相比于未发生无保护肛交,aOR=1.33,95%CI:1.13~1.57)、最近1年患过性病(相比于未患性病,aOR=2.77,95%CI:2.04~3.76)。MSM HIV新发感染的相关因素包括最近6个月发生无保护肛交(相比于未发生无保护肛交,aOR=2.51,95%CI:1.25~5.01)、最近1年未接受HIV干预服务(相比于接受HIV干预服务,aOR=3.89,95%CI:1.30~11.60)、梅毒阳性(相比于梅毒阴性,aOR=8.18,95%CI:2.98~22.48)、曾使用新型毒品(相比于未使用新型毒品,aOR=4.75,95%CI:2.32~9.70)。结论 山东省MSM新型毒品滥用现象较为普遍,新型毒品滥用会增加HIV新发感染风险。
英文摘要:
      Objective To understand the related factors of new-type drug use and recent HIV infection among men who have sex with men (MSM), and provide a reference for formulating targeted strategies for HIV/AIDS prevention and control.Methods MSM were recruited in sentinel surveillance sites of nine cities in Shandong province from April to July 2021, with a sample size of 400 in each city. A face-to-face questionnaire was conducted to collect demographic characteristics, high-risk behaviors, acceptance of HIV intervention services, etc. Blood samples were collected for HIV and syphilis antibodies detection. Limiting-antigen avidity enzyme immunoassay (LAg-Avidity EIA) was used to detect recent HIV infection, and the rate of recent HIV infection was calculated.Results 3 624 MSM were under study with the following characteristics as:aged (32.70±9.33) years old, the aged 30 and above (59.52%, 2 157/3 624), with high school education or below (55.99%, 2 029/3 624), being unmarried/divorced/widowed (57.70%, 2 091/3 624) and as having homosexual orientation (86.26%, 3 126/3 624) accounted for the more mainly. Of 32.95% (1 194/3 624) had same-sex unprotected anal sex in recent six months; 27.48% (993/3 613) ever used new-type drugs, and the HIV antibody positive rate was 3.12% (113/3 624). The recent HIV infection rate appeared as 2.61% (95%CI:1.73%-3.49%). The multivariable logistic regression analysis indicated that the related factors of new-type drug use were unmarried/divorced/widowed (compared with being married/cohabitating, aOR=1.43, 95%CI:1.22-1.69), educational level of college or above (compared with educational level of high school or below, aOR=1.47, 95%CI: 1.25-1.72), mainly through the Internet/dating software to find male sex partners (compared with mainly through bars/baths/parks and other places to find male sex partners, aOR=1.76, 95%CI:1.41-2.19). Those who had unprotected anal sex in the last six months (compared with no unprotected anal sex, aOR=1.33, 95%CI:1.13-1.57), had sexually transmitted diseases in the past year (compared with no sexually transmitted disease, aOR=2.77, 95%CI:2.04-3.76) were more likely to use new-type drugs. The multinominal logistic regression showed that MSM who had unprotected anal sex in the last six months (compared with no unprotected anal sex, aOR=2.51, 95%CI:1.25-5.01) or did not receive HIV intervention services in the past year (compared with those who received HIV intervention services, aOR=3.89, 95%CI:1.30-11.60), were syphilis positive (compared with syphilis negative, aOR=8.18, 95%CI:2.98-22.48), used new-type drugs (compared with those who did not use new-type drugs, aOR=4.75, 95%CI:2.32-9.70) had a higher risk of recent HIV infection.Conclusions New-type drugs have been widely used in MSM in Shandong province. The abuse of new-type drugs increases the risk of recent HIV infection.
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