| 郭巍,李一,周宁,吴国辉,常文辉,还锡萍,惠珊,佟雪,郭燕,于茂河,卢戎戎,欧阳琳,董丽芳,李华,李建军,刘晓燕,刘岩琳,罗超,卫晓丽,黄晓丹,崔岩.男男性行为人群艾滋病病毒新发感染风险的队列研究[J].Chinese journal of Epidemiology,2018,39(1):16-20 |
| 男男性行为人群艾滋病病毒新发感染风险的队列研究 |
| Risk factors related to HIV new infections among men who have sex with men in a cohort study |
| Received:July 05, 2017 |
| DOI：10.3760/cma.j.issn.0254-6450.2018.01.003 |
| KeyWord: 男男同性性行为 艾滋病病毒 新发感染 危险因素 性角色 助性剂 |
| English Key Word: MSM HIV New infection Risk Factors Anal intercourse type Poppers |
| FundProject: |
| Author Name | Affiliation | E-mail | | Guo Wei | National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206 | | | Li Yi | Center for Disease Control and Prevention in Heilongjiang Province, Harbin 150036 | | | Zhou Ning | Center for Disease Control and Prevention in Tianjin, Tianjin 300011 | | | Wu Guohui | Center for Disease Control and Prevention in Chongqing, Chong qing 400042 | | | Chang Wenhui | Center for Disease Control and Prevention in Shaanxi Province. Xi'an 710054 | | | Huan Xiping | Center for Disease Control and Prevention in Jiangsu Province, Nanjing 210009 | | | Hui Shan | Center for Disease Control and Prevention in Heilongjiang Province, Harbin 150036 | | | Tong Xue | Center for Disease Control and Prevention in Heilongjiang Province, Harbin 150036 | | | Guo Yan | Center for Disease Control and Prevention in Tianjin, Tianjin 300011 | | | Yu Maohe | Center for Disease Control and Prevention in Tianjin, Tianjin 300011 | | | Lu Rongrong | Center for Disease Control and Prevention in Chongqing, Chong qing 400042 | | | Ouyang Lin | Center for Disease Control and Prevention in Chongqing, Chong qing 400042 | | | Dong Lifang | Center for Disease Control and Prevention in Shaanxi Province. Xi'an 710054 | | | Li Hua | Center for Disease Control and Prevention in Shaanxi Province. Xi'an 710054 | | | Li Jianjun | Center for Disease Control and Prevention in Jiangsu Province, Nanjing 210009 | | | Liu Xiaoyan | Center for Disease Control and Prevention in Jiangsu Province, Nanjing 210009 | | | Liu Yanlin | Center for Disease Control and Prevention at Harbin City, Harbin 150056 | | | Luo Chao | Center for Disease Control and Prevention at Harbin City, Harbin 150056 | | | Wei Xiaoli | Center for Disease Control and Prevention at Xi'an City, Xi'an 710054 | | | Huang Xiaodan | Center for Disease Control and Prevention at Xi'an City, Xi'an 710054 | | | Cui Yan | National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206 | ycui@chinaaids.cn |
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| Abstract: |
| 目的 了解与分析影响MSM人群HIV新发感染的危险因素。方法 通过MSM队列研究，随访调查目标人群在随访期间HIV相关行为暴露情况，进而通过广义估计方程，分析该人群HIV新发感染影响因素。结果 2013－2015年对4 305名HIV阴性MSM进行了随访观察。网络交友的MSM发生被动插入性肛交的比例和肛交坚持使用安全套的比例高于会所酒吧和浴池交友的MSM。随访研究期间HIV平均阳转密度为4.3/100人年，被动接受肛交性行为者发生HIV新发感染的风险是主动插入方的2.20倍（95%CI：1.49～3.24）；使用助性剂（aRR＝1.55， 95%CI：1.10～2.17）、不能坚持使用安全套（aRR＝2.24，95%CI：1.62～3.08）和梅毒感染（aRR＝2.95，95%CI：2.00～4.35）是HIV新发感染的主要危险因素；而控制了其他因素后，3种交友方式与HIV新发感染的关联不再有统计学意义。结论 MSM人群中造成HIV流行的因素较为复杂，亟需多角度开展研究，为制定有针对性的防治措施提供依据。 |
| English Abstract: |
| Objectives To analyze and understand the risk factors related to HIV new infections among men who have sex with men (MSM). Methods A longitudinal observational study among MSM was conducted to collect information on HIV related behaviors and sero-conversion. Univariate and multivariate generalized estimating equations (GEE) were used to discuss the risk factors for HIV new infection. Results A total number of 4 305 MSM were followed during 2013-2015. Among those self-reported MSM who are seeking partners on the Interner tended to have higher proportion on receptive anal intercourse and consistent condom use during anal intercourse than the subgroups seeking their partners in gay bars or bathrooms. HIV incidence among followed MSM during the study period appeared as 4.3/100 person years, with adjusted RR (aRR) of HIV infection for receptive anal intercourse as group 2.20 (95%CI:1.49-3.24) times than that of insertion anal intercourse group. Those who used rush-poppers (aRR=1.55, 95%CI:1.10-2.17), unprotected anal intercourse (aRR=2.24, 95%CI:1.62-3.08), and those with syphilis infection (aRR=2.95, 95%CI:2.00-4.35) were also risk factors for HIV new infections. After controlling other factors, the relationship between the ways of seeking partners and HIV new infection was not statistical significant. Conclusion Risk factors for HIV new infection among MSM appeared complex and interactive, suggesting that further studies are needed to generate tailored strategies for the prevention of HIV epidemic among MSM population. |
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