青岛市男男性行为人群新型毒品滥用者HIV新发感染队列研究

李培龙; 黄贵花; 朱丽敏; 宋鑫; 傅泳; 葛琳; 汤后林; 李东民

Abstract

李培龙,黄贵花,朱丽敏,宋鑫,傅泳,葛琳,汤后林,李东民.青岛市男男性行为人群新型毒品滥用者HIV新发感染队列研究[J].Chinese journal of Epidemiology,2023,44(12):1950-1955

青岛市男男性行为人群新型毒品滥用者HIV新发感染队列研究

A cohort study of HIV infection in club drug abusers among men who have sex with men in Qingdao

Received:April 02, 2023

DOI：10.3760/cma.j.cn112338-20230402-00203

KeyWord: 男男性行为人群新型毒品 HIV感染队列

English Key Word: Men who have sex with men Club drug HIV infection Cohort

FundProject:国家科技重大专项（2017ZX10201101-002-005）

Author Name	Affiliation	E-mail
Li Peilong	Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Huang Guihua	Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Zhu Limin	Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Song Xin	Qingdao Municipal Center for Disease Control and Prevention, Qingdao 266033, China
Fu Yong	Qingdao Municipal Center for Disease Control and Prevention, Qingdao 266033, China
Ge Lin	Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Tang Houlin	Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Li Dongmin	Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China	lidongmin@chinaaids.cn

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Abstract:

目的了解与分析青岛市MSM新型毒品滥用者HIV新发感染情况，为该人群开展艾滋病预防工作提供参考。方法采用开放式队列研究方法，从2017年3月开始，由社会组织通过滚雪球抽样招募HIV阴性的MSM新型毒品滥用者，建立开放队列，并每6个月进行一次随访调查，观察终点为2022年7月31日。按照队列研究样本量计算公式估计样本量为436人。调查内容包括人口学特征、性行为特征、艾滋病知识知晓情况、新型毒品滥用情况和HIV检测情况等信息。以随访中出现HIV新发感染为结局因变量，同时，以研究对象进入队列至出现HIV新发感染的时间作为时间因变量，采用Cox比例风险回归模型分析MSM新型毒品滥用者HIV新发感染的影响因素。结果共招募MSM新型毒品滥用者987人，纳入随访队列826人。HIV新发感染者46人，队列随访累积观察时间1 960.68人年，HIV新发感染率为2.35/100人年。多因素Cox回归分析显示，<30岁（aHR=3.04，95%CI：1.62~5.71）、外省户籍（aHR=2.29，95%CI：1.20~4.39）、线下交友（aHR=4.62，95%CI：2.05~10.41）、同性性伴数>4个（aHR=3.06，95%CI：1.59~5.88）、性交时安全套破损（aHR=2.24，95%CI：1.21~4.17）和性交时出血（aHR=2.56，95%CI：1.31~5.03）的MSM新型毒品滥用者更有可能发生HIV新发感染。结论青岛市MSM新型毒品滥用者HIV新发感染率总体较低，但该人群知行分离的现象严重，HIV感染风险较高。HIV新发感染的影响因素包括低年龄、外省户籍、线下交友、多性伴、性交时安全套发生破损和出血，应加强开展该人群行为干预的工作。

English Abstract:

Objective To understand and analyze the incidence of HIV infection in club drug abusers among men who have sex with men (MSM) in Qingdao and provide a reference for the prevention and intervention of this population. Methods From March 2017 to July 2022, club drug abusers among MSM who are HIV-negative were recruited by snowball sampling of MSM social organizations in Qingdao, a prospective cohort was established, and a follow-up survey was conducted every six months, with the sample size estimated to be 436. The survey contents included demographic characteristics, sexual characteristics, AIDS knowledge awareness, club drug abuse, HIV testing, and other information. HIV infection was the outcome-dependent variable, and the interval between the recruitment into the cohort and the HIV infection was the time-dependent variable. Cox proportional hazards regression analysis was conducted to identify the related factors for HIV infection. Results A total of 987 participants of club drug abusers among MSM were recruited during the baseline survey and 826 eligible participants were enrolled in this cohort. A total of 46 HIV infection cases were found, and the cumulative follow-up time was 1 960.68 person-years. The incidence of HIV infection was 2.35/100 person-years. The multivariate Cox regression analysis showed that <30 (aHR=3.04, 95%CI: 1.62-5.71) non-Shandong residents (aHR=2.29,95%CI:1.20-4.39) found their partners through offline (aHR=4.62,95%CI:2.05-10.41), homosexual sexual partners >4 (aHR=3.06,95%CI:1.59-5.88), condom broken during sex (aHR=2.24,95%CI:1.21-4.17) and hemorrhage sexual intercourse (aHR=2.56,95%CI:1.31-5.03) were significantly associated with HIV infection in this cohort. Conclusions The incidence of HIV infection in club drug abusers among MSM in Qingdao is generally low, but knowledge and practice have separated, and the risk of HIV infection is high. The related factors of HIV infection included younger age, non-Shandong residents, finding their partners offline, multiple sexual partners, condom break during sex, and hemorrhage sexual intercourse; HIV-related behavioral intervention should be strengthened.

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