摘要目的 针对男男性接触人群( men who have sex with men)的干预效果进行评估研究,为调整干预策略提供建议。 方法在艾滋病高危行为综合干预前2014年9月和干预后2015年9月深圳市龙岗区分别调查了461、513 名MSM,比较分析艾滋病高危行为综合干预前后调查的MSM人群知识、行为、HIV 、HCV和梅毒感染率变化趋势。 结果 干预后MSM人群艾滋病防治知识知晓率明显上升(χ2=38.53,P=0.00),过去1年接受干预服务的比例明显上升(χ2=198.40,P=0.00),过去1年接受艾滋病检测服务的比例明显上升(χ2=127.08,P=0.00),最近一次与男性发生肛交时每次安全套使用率也由2014 年的53.10%上升至2015 年的62.02%(χ2=7.78,P=0.01),最近6个月与男性发生肛交时安全套使用率也由2014 年的50.10%上升至2015 年的59.84%(χ2=9.31,P=0.00)。HIV/HCV/梅毒感染率差异均无统计学意义,尽管从2014到2015年,HIV感染率由15.40%降至12.67%(χ2=1.51,P=0.23),HCV感染率由0.87%降至0.58%(χ2=0.27,P=0.71),梅毒感染率由13.75%升至20.86%(χ2=1.92,P=0.17)。结论 2015年深圳市龙岗区MSM人群接受艾滋病高危行为综合干预后艾滋病防治知识认知水平较高,接受干预和检测服务的比例明显上升,安全套使用率显著提高,但HIV感染率无明显下降,且HIV感染率一直处于较高水平,MSM人群艾滋病防控形势严峻,开展针对MSM人群的持续有效的综合干预是目前艾滋病防控工作的重点和难点。
Abstract:Objective To evaluate the effectiveness of targeted interventions among men who have sex with men (MSM) so as to put forward suggestions for adjusting AIDS intervention strategies. Methods We investigated 416 MSM before comprehensive intervention on AIDS high-risk behavior (in September, 2014) and 513 MSM after the intervention (in September,2015)in Longgan District, and comparatively analyzed the change of knowledge, behavior and the infection rates of HIV, HCV and syphilis among them before and after the intervention. Results After the intervention, the awareness rate of AIDS prevention and treatment knowledge (χ2=38.53, P=0.00) as well as the proportions of intervention acceptance(χ2=198.40, P=0.00) and accepting HIV testing services(χ2=127.08, P=0.00)in the last year were all significantly increased. From 2014 to 2015, the condom using rate in the last homosexual anal intercourse increased from 53.10% to 62.02% (χ2=7.78, P=0.01). The condom using rate in homosexual anal intercourse in the last 6 months increased from 50.10% to 59.84% (χ2=9.31, P=0.00). No statistically significant differences were found in the infection rates of HIV, HCV and syphilis, althoughthe infection rate of HIV declined from 15.40% to 12.67% (χ2=1.51, P=0.23) and of HCV from 0.87% to 0.58% (χ2=0.27, P=0.71), and the infection rate of syphilis increased from 17.35% to 20.86% (χ2=1.92,P=0.17). Conclusions After the comprehensive intervention on AIDS high-risk behavior, the awareness of AIDS prevention and treatment knowledge , the proportions of accepting the intervention and HIV testing services as well as the condom using rate among MSMin Longgang District, Shenzhen City in 2015are increased significantly. But the HIV infection rate of HIV shows no significant decline and remains at a high level. The situation of AIDS prevention and control among MSM in Longgang District is serious. Implementation ofcontinuous and effective interventionamong MSM is the key point of HIV/AIDS prevention and control.
李晓霞, 龙清平,覃佩兰,刘海文, 叶伟雄, 陈健, 王伟绿, 陈小燕. 2014-2015年深圳龙岗区男男性接触人群艾滋病高危行为综合干预效果评价[J]. 实用预防医学, 2017, 24(6): 680-683.
LI Xiao-xia, LONG Qing-ping, QIN Pei-lan, LIU Hai-wen, YE Wei-xiong, CHEN Jian, WANG Wei-lyu CHEN Xiao-yan. Evaluation on the effectiveness of comprehensive intervention on AIDS high-risk behavioramong MSM in Longgang District,Shenzhen City, 2014-2015. , 2017, 24(6): 680-683.
[1] He N,Wong FY,Huang ZJ,et al.Substanceand HIV risks among male heterosexual and money boy migrants in Shanghai,China [J].AIDS Care,2007,19(1):109-115. [2] 谭文倩,赵俊仕,刘志胜,等.长沙市2012-2014年男男性接触人群HIV感染趋势分析[J].实用预防医学,2015,22(8):912-914. [3] Ruan SM,Yang H,Zhu YW,etal.HIV prevalence and correlates of unprotected anal intercourse among men who have sex with men,Jinan,China[J].AIDS Behav, 2008,12(3):469-475. [4] 曹淦,管文辉,吴小刚,等.某同性恋浴室男男性接触者HIV /梅毒感染状况的研究[J].南京医科大学学报,2007,27(6):637-640. [5] 蓝光华,刘伟,朱秋映,等.广西外来男男性接触人群艾滋病监测结果分析[J].应用预防医学,2009,15(3):168-170. [6] 马小燕, McFarkandWilli,张启云,等.男男性接触人群HIV感染趋势分析[J].中国公共卫生,2007,23(11):1352-1354. [7] 丁贤彬,冯连贵,萧燕,等.重庆市男男性行为人群干预效果评价[J].热带医学杂志,2010,10(3):323-326. [8] 王毅,张洪波,张光贵,等.绵阳市男男性行为人群艾滋病性病健康教育及行为干预效果研究[J].预防医学情报杂志,2008,24(12):962-967. [9] 史同新,张北川,李秀芳,等.对男男性接触AIDS 高危行为健康干预研究[J].中国艾滋病性病,2003,9(6):365-367. [10] 龙清平,覃佩兰,黄振豪,等.某会所MSM人群HIV聚集性感染调查与影响因素研究[J].实用预防医学,2012,19(12):1903-1906.