Behavioral characteristics and factors influencing HIV infection among MSM in Wenzhou City, Zhejiang Province, 2017-2021
YE Zhen-miao1, WU Mao-mao1, ZHU Hai-xia2, ZHANG He-mei1, ZHAO Li-na1, CHEN Xiang-yang1, SU De-hua1, WANG Da-yong1, HU Wen-xue1, SUN Bao-chang1
1. Wenzhou Municipal Center for Disease Control and Prevention, Wenzhou, Zhejiang 325000, China; 2. Wenzhou Municipal Public Hospital Management Center, Wenzhou, Zhejiang 325000, China
摘要目的 了解2017—2021年浙江省温州市男男性行为人群(men who have sex with men,MSM)HIV感染现状及相关行为特征,为制定有效的艾滋病防控措施提供科学依据。方法 于2017—2021年采用非概率抽样的方法获得调查对象,使用统一的哨点监测问卷进行调查,收集并分析研究对象人口学、行为学特征、艾滋病知识知晓等信息,通过多因素logistic回归分析探讨HIV感染影响因素。结果 2017—2021年共调查MSM 2 000人,年龄30～49岁占50.40%,外省户籍占51.15%,未婚占60.80%,寻找性伴方式通过互联网/交友软件占66.60%,艾滋病知识总体知晓率93.30%,5年间呈现增长趋势(χ2趋势=7.051,P=0.008)。最近6个月与同性发生肛交性行为、与同性发生商业性行为、与异性发生性行为比例分别为72.35%、3.11%、14.95%,安全套坚持使用率分别为57.01%、55.56%、32.78%,最近六个月、最近一次与同性发生肛交性行为时安全套坚持使用率均呈现上升趋势(P<0.001)。既往接受HIV检测比例为50.20%,5年间呈下降趋势(χ2趋势=14.634,P<0.001)。HIV抗体阳性率、梅毒抗体阳性率、HCV抗体阳性率分别为6.35%、1.90%、0.05%,5年间差异均无统计学意义(P>0.05)。多因素logistic回归分析显示MSM中自愿咨询检测者、外省户籍、最近一年被诊断患过性病、梅毒感染是HIV感染危险因素,知晓艾滋病知识、最近六个月同性肛交性行为坚持使用安全套、最近一次同性肛交性行为使用安全套是HIV感染保护因素(P<0.05)。结论 2017—2021年温州市MSM HIV抗体阳性率仍处于高水平,艾滋病相关危险行为持续存在,亟需加强宣传干预力度,采取有针对性的措施,提高安全套坚持使用率,控制HIV在该人群中的传播。
Abstract：Objective To understand the current status of human immunodeficiency virus (HIV) infection and related behavioral characteristics among men who have sex with men (MSM) in Wenzhou City, Zhejiang Province from 2017 to 2021, and to provide a scientific basis for formulating effective AIDS prevention and control measures. Methods From 2017 to 2021, the non-probabilistic sampling method was used to obtain the survey subjects, and a uniform sentinel monitoring questionnaire was employed to conduct the survey. The subjects' demographic and behavioral characteristics and awareness of AIDS knowledge were collected and analyzed. Factors affecting HIV infection were explored by multivariate logistic regression analysis. Results A total of 2,000 MSM were surveyed in 2017-2021. 50.40% of them were aged 30-49 years, 51.15%had a household registration in other provinces, 60.80% were unmarried, and 66.60% looked for sexual partners through Internet or dating software. The overall awareness rate of AIDS knowledge was 93.30%, showing an increasing trend during the 5-year period (χ2trend=7.051, P=0.008). Theproportions ofhomosexualanal sex, commercialhomosexualsex and heterosexual sex in the previous six months were 72.35%, 3.11% and 14.95%, respectively, with the condom adherence rates being 57.01%, 55.56% and 32.78%, respectively. The condom adherence rate of homosexual anal sex in the recent six months and the last time showed an upward trend during the 5-year period (P<0.001). The proportion of previous HIV test was 50.20%, displaying a downward trend across the 5-year period (χ2trend=14.634, P<0.001). The positive rates of HIV antibody, syphilis antibody and HCV antibody were 6.35%, 1.90% and 0.05%, respectively, and no statistically significant difference was found in the 5-year period (P>0.05). Multivariate logisticregression analysis revealed that VCT clients, household registration in other provinces, having been diagnosed with sexually transmitted diseases in the last year and syphilis infection were risk factors for HIV infection, while having AIDS knowledge, persistence in using condoms in homosexual anal sex in the last six months, condom use in the last homosexual anal sex were protective factors for HIV infection (P<0.05). Conclusion The HIV antibody positive rate of MSM in Wenzhou City in 2017-2021 was still at a high level, and AIDS-related risk behaviors continued to exist. It is therefore urgent to strengthenpropaganda and intervention, take targeted measures, improve condom persistence rate and control HIV transmission in this population.
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2022, Vol. 29 
