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目的了解北京市男男性行为者(MSM)人类免疫缺陷病毒(HIV)和梅毒的感染情况与影响因素。方法 2011年7月～2011年12月在北京招募MSM,进行本底调查,符合队列纳入标准者第3和6个月随访调查;使用平板电脑一对一问卷调查;快速检测试剂检测HIV和梅毒螺旋体抗体;统计分析使用SAS 9.2统计软件包,影响因素分析单因素采用χ2检验或Fisher确切概率法,P<0.05的变量纳入多因素logistic回归模型分析。结果本底共招募500名MSM/HIV和梅毒感染率分别为5.60%(28/500)和26.40%(132/500);多因素logistic回归分析显示:与HIV感染有统计学意义的因素有:最近一年未做过HIV抗体检测或不知晓检测结果 (OR=2.57,95%CI:1.16～5.68)、第一次与男性发生性行为年龄≤18岁(OR=2.45,95%CI:1.07～5.62)、最近3个月发生过肛交的男性人数>3人(OR=2.83,95%CI:1.25～6.42);梅毒感染的独立影响因素为年龄>30岁(OR=1.68,95%CI:1.13～2.52)、最近3个月发生过肛交的男性人数>3人(OR=1.83,95%CI:1.15～2.92)。395名MSM进入队列,6个月随访队列保持率为88.10%(348/395),HIV和梅毒螺旋体血清抗体阳转率分别为5.36/100人年(95%CI=2.19～8.53)和8.13/100人年(95%CI=3.53～12.73)。结论北京市MSM人群HIV/梅毒感染率及新发感染率均维持在较高水平,需要对MSM细分,以提供更有针对性的宣教及行为干预;MSM知晓检测结果与接受检测同样重要,可尝试在HIV检测咨询机构推广HIV快速检测试剂以提高检测结果知晓率。
Objective To understand the infection status and influencing factors of human immunodeficiency virus (HIV) and syphilis in men who have sex with men (MSM) in Beijing. Methods MSM was recruited in Beijing from July 2011 to December 2011. The follow-up investigation was conducted at the 3rd and 6th months after inclusion in the cohort. One-on-one questionnaires were surveyed using a tablet computer. Rapid detection reagents were used to detect HIV and syphilis Spirochete antibody; statistical analysis using SAS 9.2 statistical package, analysis of influencing factors single factor using the χ2 test or Fisher exact test, P <0.05 variables multivariate logistic regression model analysis. Results The background of infecting 500 MSM / HIV and syphilis were 5.60% (28/500) and 26.40% (132/500), respectively. Multivariate logistic regression analysis showed that the statistically significant factors of HIV infection were: HIV antibody test or unknown test result (OR = 2.57, 95% CI: 1.16-5.68) was the most recent year, and the first sexual intercourse with males was less than 18 years old (OR = 2.45, 95% CI: 1.07 ~ 5.62). The number of males who had anal intercourse in the last 3 months was> 3 (OR = 2.83, 95% CI: 1.25-6.42). The independent influencing factors of syphilis infection were age> 30 years (OR = 1.68,95% CI : 1.13 ~ 2.52). The number of males who had anal intercourse in the last 3 months was> 3 (OR = 1.83, 95% CI: 1.15-2.92). 395 MSM were enrolled in the cohort. The 6-month follow-up cohort retention rate was 88.10% (348/395). The seroconversion rates of HIV and Treponema pallidum were 5.36 / 100 years (95% CI = 2.19-8.53) and 8.13 / 100 person-years (95% CI = 3.53 ~ 12.73). CONCLUSIONS: HIV / syphilis infection rate and new infection rate in Beijing MSM population are maintained at a high level, MSM subdivision is needed to provide more targeted mission and behavioral interventions; MSM knows that the test results are as important as the detection of MSM, HIV testing counseling agencies can try to promote HIV rapid detection reagents to improve test results awareness.