摘要目的 分析2012—2019年深圳队列调查研究的男男性行为者(men who have sex with men, MSM)梅毒感染情况,为降低本地区该人群梅毒感染率开展有效的干预措施提供数据参考。 方法 以2012—2019年深圳MSM不同队列调查研究如时空场所抽样(time-location sampling, TLS)、同伴推动抽样(respondent driven sampling, RDS)、自愿咨询检测门诊抽样(voluntary counseling and testing, VCT)、跨境人群调查、阴性人群随访等研究对象,采集静脉血进行梅毒抗体筛查检测。使用χ2检验和二分类logistic回归对MSM的梅毒感染率进行单因素和多因素统计学分析。 结果 2012—2019年共检测MSM 20 358例,平均年龄(28.99±7.94)岁,梅毒抗体总检出阳性率为13.4%。2012年MSM梅毒的感染率最高为19.3%,其后逐年呈先下降后上升趋势,各年份之间的梅毒感染率差异有统计学意义(χ2趋势=119.05,P<0.001)。≥50岁的MSM人群梅毒感染率为最高(33.6%),<20岁的为最低(7.8%),而30~岁、40~岁、≥50岁各年龄段和<20岁的梅毒感染率有显著性差异(P值均<0.001)。跨境人群调查MSM的梅毒感染率为最高(21.4%);阴性人群随访、RDS和VCT的感染率较高,分别为15.4%、14.2%和14.1%;TLS的感染率为最低(11.6%)。VCT的感染率是TLS的1.240倍(P值<0.001),RDS、阴性人群随访和跨境人群调查感染率分别是TLS的1.158,1.209,2.023倍(P值均<0.05)。在TLS人群中,有商业性行为的感染率(5.0%)低于无商业性行为的(18.3%)(χ2=347.73,P<0.001)。 结论 2012—2019年深圳市MSM人群梅毒感染率呈逐年下降趋势,TLS调查的梅毒感染率较低,>40岁组阳性病例占比上升明显,应重点关注>40岁MSM人群的梅毒防控。
Abstract：Objective To analyze the status of syphilis infection in the cohort investigation among men who have sex with men (MSM) in Shenzhen from 2012 to 2019, and to provide data references for taking effective intervention measures to reduce syphilis infection rate in this population in this region. Methods We selected MSM in different cohort surveys, including time-location sampling (TLS), respondent-driven sampling (RDS), voluntary counseling and testing (VCT) outpatient sampling, cross-border population survey and follow-up of negative population, in Shenzhen during 2012-2019 to serve as the research subjects. Venous blood was collected for syphilis antibody screening test. Univariate and multivariate statistical analyses were performed for syphilis infection rate of MSM by chi-squared test and dichotomous logistic regression. Results A total of 20,358 MSM were detected from 2012 to 2019, and the average age was (28.99±7.94) years, with the total positive rate of syphilis antibody being 13.4%. The highest infection rate of syphilis in the MSM in 2012 was 19.3%, thereafter the infection rate decreased firstly and then increased year by year, with statistically significant differences in the infection rates of syphilis among different years (χ2trend=119.05, P<0.001). The syphilis infection rate was found to be the highest among MSM aged 50 years or above (33.6%), but the lowest among MSM aged 20 years or below (7.8%). There were statistically significant differences in the syphilis infection rates among MSM aged 30- years, 40- years, 50 years or above, and less than 20 years (all P<0.001). The syphilis infection rate of MSM in cross border population was the highest (21.4%), followed by the negative population (15.4%), RDS (14.2%) and VCT (14.1%). The syphilis infection rate of MSM in TLS was the lowest (11.6%). The syphilis infection rate in VCT population was 1.240 times that in TLS population (P<0.001). Compared with TLS population, the syphilis infection rates in RDS, negative population, cross border population were 1.158, 1.209 and 2.023 times, respectively (all P<0.05). Among TLS population, the infection rate was lower in MSM with commercial sex than in MSM without commercial sex (5.0% vs. 18.3%, χ2=347.73, P<0.001). Conclusion The syphilis infection rate of MSM is Shenzhen during 2012-2019 showed a downward trend year by year. The syphilis infection rate of MSM surveyed by TLS was relatively low. The proportion of positive cases in MSM aged over 40 years increased significantly. Therefore, special attention should be paid to MSM aged over 40 years in syphilis prevention and control.
甘永霞, 李浩, 赵锦, 黎桂连, 谭唯, 石向东, 王晓辉, 杨峥嵘. 2012—2019年深圳男男性行为者不同队列调查的梅毒感染情况分析[J]. 实用预防医学, 2021, 28(7): 822-825.
GAN Yong-xia, LI Hao, ZHAO Jin, LI Gui-lian, TAN Wei, SHI Xiang-dong, WANG Xiao-hui, YANG Zheng-rong. Analysis of syphilis infection status in different cohort surveys among MSM in Shenzhen, 2012-2019. , 2021, 28(7): 822-825.
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2021, Vol. 28 
