重庆市男男性行为者中异性性行为和HIV感染情况及其影响因素分析

李春梅; 贾玉江; 丁贤彬; 刘建波; 萧燕

Abstract

李春梅,贾玉江,丁贤彬,刘建波,萧燕.重庆市男男性行为者中异性性行为和HIV感染情况及其影响因素分析[J].Chinese journal of Epidemiology,2009,30(9):882-886

重庆市男男性行为者中异性性行为和HIV感染情况及其影响因素分析

HⅣinfectiOIlS and heterosexual behaviors among men who have SeX with men in Chongqing municipality。China

Received:March 07, 2009 Revised:October 11, 2007

DOI：

KeyWord: 男男性行为者异性性行为高危行为

English Key Word: Men who have sex with men Men who have sex witIl both men and women Risk behaviors

FundProject:第五轮中国全球基金艾滋病项目(CHN．506．G06．H)

Author Name	Affiliation	E-mail
LI Chunmei	Hebei Medical University, Shiiiazhuang 050019, China
JIA Yujiang	Vandebilt University. USA
DING Xianbin	重庆市疾病预防控制中心	xianbinding@yahoo．com．cn
LIU Jianbo	Hebei Medical University, Shiiiazhuang 050019, China
XlA0 Yan	中国疾病预防控制中心艾滋病性病预防控制中心

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Abstract:

目的了解男男性行为(MsM)人群中有异性性行为者(MSM，Ⅳ)和无异性性行为者(MSM／M)的特征、HIV和梅毒的流行情况及HIV感染的影响因素。方法通过问卷调查收集人口学、行为学、艾滋病知识、HIV相关服务接受情况及既往性传播感染(STI)的信息，并采血进行梅毒和HIV检测。结果共收集有效问卷1691份。MSM／W人群占21．6％，HIV感染率为16．1％，显著高于MSM／M人群的9．4％(P<0．001)。MSM／W人群感染HIV的独立影响因素包括离异／丧偶(AOR=14．8，95％CI：3．1～71．6)、多个同性性伴(AOR=5．4，95％CI：1．8-16．3)、无保护性同性肛交性行为(AOR=4．6，95％CI：1．5．13．9)及梅毒感染(AOR=4．4，95％C／：1．1-17．3)。MSM／M人群感染HⅣ的独立影响因素包括低文化程度(AOR=2．6，95％CI：1．6-4．5)、大龄(26．35岁讹<26岁，AOR=2．0，95％(7／：1．3～3．3；>35岁VS．<26岁，AOR=1．9，95％Ci：1．1-3．5)、浴澍桑拿招募(AOR=2．5，95％CI：1．1-5．6)、梅毒感染(AOR=1．9，95％CI：1．0-3．4)、多个同性性伴(AOR=1．8，95％CI：1．1～2．9)和既往STI感染(AOR=1．7，95％C1：1．0～2．7)。MSM人群发生异性性行为的独立相关因素包括在婚／同居(AOR=6．5，95％CI：4．4-9．8)、性取向自我认同为双性恋／异性恋(AOR=3．9，95％C1：2．8-5．5)、首个性伴性别为女性(AOR=2．2，95％CI：1．5-3．O)、不知晓艾滋病(AOR=1．9，95％CI：1．1-3．2)、招募来源为酒吧／夜总会／茶吧阻0月=1．6，95％CI：1．0。2．6)、首次性行为年龄大(AOR=O．6，95％CI：0．4～0．8)、未卖性(AOR=O．5。95％CI：0．3-1．0)以及mV感染(AOR=1．7，95％CI：1．1～2．7)。结论重庆市MSMYW人群HIV感染率较高，存在高危行为，该人群可能在MSM和异性性伴之间起着传播HIV的潜在桥梁作用，可能使HIV从高危人群向一般人群扩散。

English Abstract:

Objecfive To understand the prevalence and risk factors for both HⅣinfection and prevalence rates of syphilis infection among men who exclusively have sex with mell(MSM／M)or with both men and women(MSM，W)in Chongqing municipality。China．Methods Cross-sectional studies were conducted in Chongqing．Structured questionnaire．based interviews were conducted to provide information about demographic characteristics，behavior，HIV related healthservices and sexual transmitted infections(STIs)．Blood samples were tested for HIV and syphilis infections．Results Of 169l participants．21．6％were MSM/W．th HⅣprevalence as 16．1％ which was significantly higher than that among MSM／M(9．4％．P35 years VS．<26 years)，being recmited from bath house／sauna(AOR=2．5。95％：1．1～5．6)syphilis infection(AOR=1．9，95％CI，：1.0-3.4)，multiplemale sex partners(AOR=1．8，95％CI，：1．1-2．9)，and STIs infection(A0R=1．7，95％CI，：1．0-2．7)．Heterosexual behaviors independently associated with married／cohabiting(AOR=6．5．95％(Y：4．4-9．8)，self-identifiedbisexual／heterosexual(AOR=3．9，95％CI：2．8-5．5)，first lifetime female sex partners(AOR=2．2，95％C／：1．5-3．O)，lack of HIV related knowledge(ADR=1．9，95％C，：1．1-3．2).being recruited from bars／night clubs／tea bars(AOR=1．6。95％C，：1．0-2．6)，older age at sex debut(AOR=O．6，95％c，：0．4-0．8)。not ofering sex for money for analintercourses in the past six months(AOR=O．5，95％C7：0．3-1．O)and HIV infection(ADR=1．7，95％C7：1．1-2．7)．Conclusion HIV prevalence had reached a high level among men who have sex with men and women in Chongqing．China．Multiple sex partners and other high risk behaviors when having SeX with men or women among MSM／W represented a unique risk group within the population of MSM that might have bridged the HIV transmission between HIV high risk group and generaI population．More attention need to be specifically paid to prevent HIV transmit from HIV hight risk group to general population．

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