| 张祖样,宋丽军,陈会超,金晓媚,肖民扬,李雪华,付丽茹,施玉华,陈敏.2018-2024年云南省男男性行为人群HIV新发感染及相关因素分析[J].中华流行病学杂志,2026,47(3):528-533 |
| 2018-2024年云南省男男性行为人群HIV新发感染及相关因素分析 |
| Analysis on recent HIV infection and related factors in men who have sex with men in Yunnan Province, 2018-2024 |
| 收稿日期:2025-06-03 出版日期:2026-03-19 |
| DOI：10.3760/cma.j.cn112338-20250603-00369 |
| 中文关键词: 男男性行为人群|艾滋病病毒|抗体阳性|新发感染 |
| 英文关键词: Men who have sex with men|HIV|Antibody positive|Recent infection |
| 基金项目:国家科技重大专项（2018ZX10715006） |
| 作者 | 单位 | E-mail | | 张祖样 | 云南省疾病预防控制中心(云南省预防医学科学院), 昆明 650599
云南省公共卫生与生物安全重点实验室, 昆明医科大学公共卫生学院, 昆明 650500 | | | 宋丽军 | 云南省疾病预防控制中心(云南省预防医学科学院), 昆明 650599 | | | 陈会超 | 云南省疾病预防控制中心(云南省预防医学科学院), 昆明 650599 | | | 金晓媚 | 云南省疾病预防控制中心(云南省预防医学科学院), 昆明 650599 | | | 肖民扬 | 云南省疾病预防控制中心(云南省预防医学科学院), 昆明 650599 | | | 李雪华 | 云南省疾病预防控制中心(云南省预防医学科学院), 昆明 650599 | | | 付丽茹 | 云南省疾病预防控制中心(云南省预防医学科学院), 昆明 650599 | | | 施玉华 | 云南省疾病预防控制中心(云南省预防医学科学院), 昆明 650599 | shiyuhua@yncdc.cn | | 陈敏 | 云南省公共卫生与生物安全重点实验室, 昆明医科大学公共卫生学院, 昆明 650500 | chenminyx@126.com |
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| 中文摘要: |
| 目的 了解云南省男男性行为人群（MSM）的HIV新发感染情况，为高危人群艾滋病防治策略制定和防治效果评估提供参考。方法 采用横断面研究设计，2008-2024年每年4-6月在MSM中开展HIV新发感染监测，使用限制性抗原亲和力酶联免疫法进行HIV新发感染检测。采用年变化百分比和平均年变化百分比（AAPC）描述HIV抗体阳性率和HIV新发感染率的变化趋势，采用非条件logistic回归模型分析HIV新发感染的相关因素。应用Excel 2020软件整理数据，应用SPSS 19.0软件进行统计学分析。结果 2018-2024年共完成MSM的HIV检测样本11 524人份，HIV抗体阳性率为5.68%（655/11 524），HIV抗体阳性率由2018年的5.98%下降至2024年的4.38%（AAPC=-5.23%，P0.001）；完成HIV新发感染检测样本174人份，判定为HIV新发感染者94例，HIV新发感染率为2.38%（1.85%~2.80%），由2018年的5.31%下降至2024年的0.71%（AAPC=-31.34%，P=0.005），以20~29岁、未婚、云南省户籍、大专及以上文化程度、汉族、本地居住时间6个月、通过网络或社交软件寻找性伴为主。MSM的HIV新发感染的正相关因素包括不知晓艾滋病相关知识（aOR=2.92，95%CI：1.18~7.22）、最近半年肛交未坚持使用安全套（aOR=8.19，95%CI：5.15~13.01）、有吸毒行为（aOR=4.74，95%CI：1.04~21.48）、最近1年未做过HIV检测（aOR=1.79，95%CI：1.07~2.99）。结论 2018-2024年云南省MSM的HIV抗体阳性率和HIV新发感染率呈下降趋势，建议加强青年人的警示性宣传和健康教育，持续开展MSM高危行为干预和HIV新发感染监测。 |
| 英文摘要: |
| Objective To understand recent HIV infection and related factors in men who have sex with men (MSM) in Yunnan Province from 2018 to 2024, and provide references for the development of AIDS prevention and control strategies and the evaluation of prevention and control effects in populations at high risk. Methods A cross-sectional study design was adopted to conduct recent HIV infection surveillance in local MSM from April to June 2008 to 2024, and restriction antigen affinity enzyme-linked immunosorbent assay (LAg-Avidity EIA) was used for recent HIV infection detection. The annual percentage change and average annual percentage change (AAPC) were used to describe the change trends of HIV positive rate and the rate of recent HIV infection, and unconditional logistic regression model was used to analyze the related factors of recent HIV infection. The data were processed by using Excel 2020 and analyzed by using software SPSS 19.0. Results From 2018 to 2024, a total of 11 524 HIV tests in MSM were completed, and HIV positive rate was 5.68% (655/11 524). The HIV positive rate decreased from 5.98% in 2018 to 4.38% in 2024 (AAPC=-5.23%, P0.001). A total of 174 samples for recent HIV infection cases were tested, and 94 cases were identified as recent HIV infection. The recent HIV infection rate was 2.38% (1.85%-2.80%), which decreased from 5.31% in 2018 to 0.71% in 2024 (AAPC=-31.34%,P=0.005). The target group were mainly individuals aged 20 to 29, the unmarried, those living in Yunnan, those with a college degree or above, those in Han ethnic group, those having local residence for at least six months, and those seeking sexual partners through the Internet or social media. The positive correlation factors for recent HIV infection in MSM included poor awareness of AIDS related knowledge (aOR=2.92, 95%CI: 1.18-7.22) and failure to consistently use condoms at anal sex in past six months (aOR=8.19, 95%CI: 5.15-13.01), drug use (aOR=4.74, 95%CI: 1.04-21.48), and no HIV test in last year (aOR=1.79, 95%CI: 1.07-2.99). Conclusions From 2018 to 2024, the HIV positive rate and recent HIV infection rate showed downward trends in MSM in Yunnan. It is suggested to strengthen disease warning and health education for young people, and continuously carry out high-risk behavior intervention for MSM and monitoring of recent HIV infections. |
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