| 朱晓艳,王国永,廖玫珍,李亚君,张娜,李玲,杨兴光,黄鹏翔,黄涛,康殿民.自报异性性传播HIV感染者中男男性行为人群特征及抑郁症状相关因素分析[J].中华流行病学杂志,2022,43(10):1639-1644 |
| 自报异性性传播HIV感染者中男男性行为人群特征及抑郁症状相关因素分析 |
| Characteristics and depressive symptoms among self-reported HIV infection through heterosexual transmission men who have sex with men |
| 收稿日期:2022-02-26 出版日期:2022-10-18 |
| DOI：10.3760/cma.j.cn112338-20220226-00153 |
| 中文关键词: 艾滋病病毒 男男性行为者 感染途径 抑郁 |
| 英文关键词: HIV Men who have sex with men Route of infection Depression |
| 基金项目:山东省医药卫生科技发展计划（2019WS427，2019WS430，2019WS438）；山东省人文社会科学课题（2021-ZXJK-18） |
| 作者 | 单位 | E-mail | | 朱晓艳 | 山东省疾病预防控制中心艾滋病防制所, 济南 250014 | | | 王国永 | 山东省疾病预防控制中心艾滋病防制所, 济南 250014 | | | 廖玫珍 | 山东省疾病预防控制中心艾滋病防制所, 济南 250014 | | | 李亚君 | 山东省疾病预防控制中心艾滋病防制所, 济南 250014 | | | 张娜 | 山东省疾病预防控制中心艾滋病防制所, 济南 250014 | | | 李玲 | 山东省疾病预防控制中心艾滋病防制所, 济南 250014 | | | 杨兴光 | 山东省疾病预防控制中心艾滋病防制所, 济南 250014 | | | 黄鹏翔 | 山东省疾病预防控制中心艾滋病防制所, 济南 250014 | | | 黄涛 | 山东省疾病预防控制中心艾滋病防制所, 济南 250014 | | | 康殿民 | 山东省疾病预防控制中心艾滋病防制所, 济南 250014 | dmkang66@163.com |
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| 中文摘要: |
| 目的 分析自报异性性传播HIV感染者中MSM特征及抑郁症状相关因素，为HIV感染者实施个性化管理提供参考依据。方法 采用横断面调查设计，2019年9-12月在山东省济南市、青岛市、潍坊市和临沂市选取≥15岁、自报异性性传播的男性HIV感染者作为研究对象，通过一对一访谈核实其感染途径，对核实后实际为MSM，按照1∶1匹配在当地选择年龄范围差≤3岁、自报为男男性行为传播的HIV感染者作为对照组，开展问卷调查，内容包括人口学及行为特征、流行病学调查中心抑郁量表（CES-D）、领悟社会支持量表（PSSS），分析其特征和抑郁症状的相关因素。结果 自报感染途径为异性性传播的男性HIV感染者373例中，复核后实际为男男性行为传播的占39.7%（148/373），年龄（40.3±12.0）岁，已婚/同居占41.9%（62/148），确证HIV前做过检测占27.0%（40/148），同性性伴数≥2人占71.6%（106/148），有抑郁症状的占55.4%（82/148）。多因素分析结果显示，在自报异性性传播HIV感染者的MSM中，确证前未做过HIV检测、确证前同性性伴数≥2人、首次发生同性性行为年龄 > 30岁和有抑郁症状者，更有可能隐瞒真实的感染途径；抑郁症状与身体健康状况、社会支持情况和职业状况稳定的因素相关。结论 在自报异性性传播的男性HIV感染者中，有一定比例实际为男男性行为传播的感染途径，并存在多性伴及双性性行为的高危行为，抑郁症状的比例较高。需加强随访的感染途径复核，开展针对性的心理和行为干预。 |
| 英文摘要: |
| Objective To understand the characteristics and depressive status of men who have sex with men (MSM) who self-reported HIV infection through heterosexual transmission and to provide evidence for personalized management of HIV infected people.Methods A cross-sectional survey was carried out in Shandong province from September to December in 2019. Male HIV patients aged ≥ 15 years who self-reported HIV infection through heterosexual transmission were selected to verify the route of infection by one-to-one interview in Ji'nan, Qingdao, Weifang and Linyi cities of Shangdong province. According to the 1:1 ratio, local HIV patients with age difference ≤ 3 years who self-reported MSM were selected as controls. A questionnaire survey was conducted, including data on demographic characteristics, behavior status, CES-D and PSSS. The related factors of the depressive symptoms and characteristics were analyzed.Results A total of 373 male HIV patients were interviewed, and 39.7%(148/373) were confirmed as MSM after reexamination. The interviewers were:aged (40.3±12.0) years old, 41.9% (62/148) married/cohabiting. 27.0% (40/148) had been tested before HIV diagnosis, 71.6% (106/148) had homosexual partners ≥ 2 and 55.4% (82/148) had depressive symptom. Multivariate analysis showed that the MSM without HIV testings before diagnosis, had homosexual partners ≥ 2 before diagnosis, had first homosexual behavior at the age > 30 years old and with depressive symptoms were more likely to conceal the true infection route. The incidence of depression among MSM who self-reported HIV infection through heterosexual transmission was related to physical health status social support and occupational stability.Conclusions Some male HIV persons self-reported as being heterosexually transmitted were really transmitted through homosexual behavior. There were high-risk behaviors such as multiple partners and intersex among this group, and with high incidence of depression. It is necessary to encourage the reexamination program during follow-up and target on psychological and behavioral interventions, continuously. |
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