中华皮肤科杂志 ›› 2022, Vol. 55 ›› Issue (12): 1078-1083.doi: 10.35541/cjd.20220345

• 论著 • 上一篇    下一篇

不同方式招募的男男性行为人群HIV感染高危性行为比较分析

张明辉    刘晓霞    叶鲁    胡成锋    王华    刘超    徐承平   

  1. 镇江市疾病预防控制中心艾滋病性病预防控制科，镇江  212004
  • 收稿日期:2022-05-16 修回日期:2022-10-09 发布日期:2022-12-05
  • 通讯作者: 徐承平 E-mail:745023527@qq.com
  • 基金资助:
    “十三五”国家科技重大专项（2018ZX10721102）；镇江市重点研发计划项目（SH2020029）

Analysis of high-risk behaviors related to HIV infection in men who have sex with men recruited by different methods

Zhang Minghui, Liu Xiaoxia, Ye Lu, Hu Chengfeng, Wang Hua, Liu Chao, Xu Chengping   

  1. Department of AIDS and STD Prevention and Control, Zhenjiang Municipal Center for Disease Control and Prevention, Zhenjiang 212004, Jiangsu, China
  • Received:2022-05-16 Revised:2022-10-09 Published:2022-12-05
  • Contact: Xu Chengping E-mail:745023527@qq.com
  • Supported by:
    "The 13th Five-Year Plan" National Science and Technology Major Projects（2018ZX10721102）; Key Research and Development Plan of Zhenjiang City （SH2020029）

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摘要： 【摘要】 目的 分析镇江市不同方式招募的男男同性性行为人群（MSM）的HIV感染高危性行为差异，为艾滋病的精准防控提供数据支持。方法 2020年4 - 6月通过疾病预防控制中心（CDC）自愿咨询检测（VCT）门诊和社区组织（CBO）两种方式在镇江范围内招募MSM人群作为研究对象，采用统一调查问卷收集目标人群的一般人口学特征、药物滥用、HIV检测史和高危性行为等信息。卡方检验或Fisher确切概率法检验分析不同途径招募的MSM人群之间相关特征的差异。结果 两种方式共招募641例MSM，其中CBO招募442例占68.95%，CDC招募199例占31.05%；CBO招募的MSM中，20岁以下占比（6.56%）显著高于CDC招募方式（1.01%，χ2 = 9.20，P = 0.002）；CDC 招募的MSM人群使用卫生专业机构和新型网络媒体接受毒品潜在危害信息宣教的比例分别为7.54% （15例）和16.58%（33例），均显著高于CBO组［3.39%（15例），χ2 = 5.28，P = 0.022；9.50%（42例），χ2 = 6.66，P = 0.010］。CBO招募的MSM群交性行为发生率为25.21%（30例），与女性发生无保护性行为的比例为47.51%（210例），均显著高于CDC招募组［7.50%（6例），χ2 = 10.13，P = 0.001；27.64%（55例），χ2 = 22.35，P < 0.001］，而CBO招募者中异性恋的比例（2.04%，9例）、不清楚性伴HIV感染状态的比例（22.40%，99例）、无保护肛交性行为发生率（39.82%，176例）均显著低于CDC招募的MSM人群［6.53%（13例），χ2 = 8.37，P = 0.004； 39.70%（79例），χ2 = 20.48，P < 0.001；57.29%（114例），χ2 = 16.90，P < 0.001］。 CBO招募的MSM曾经做过HIV检测的比例为74.43%（329例），最近1次HIV检测途径为CDC的比例为23.10%（76例），HIV感染率为5.20%（23例），均显著低于CDC组［80.90%（161例），χ2 = 3.19，P = 0.074；57.14%（92例），χ2 = 99.41，P < 0.001；13.07%（26例），χ2 = 21.85，P < 0.001］。结论 通过CBO和CDC两种方式招募的MSM人群在人口学、行为学上互补，具有一般MSM人群的代表性，应根据人群的不同特点制定艾滋病具体防控措施。

关键词: 性行为, 人员选用, 危险性行为, HIV, 物质相关性障碍, 男男性行为者, 招募方式

Abstract: 【Abstract】 Objective To analyze high-risk behaviors related to HIV infection in men who have sex with men （MSM） recruited by different methods in Zhenjiang city, and to provide a reference for precise prevention and control of acquired immunodeficiency syndrome （AIDS）. Methods From April to June in 2020, MSM in Zhenjiang city were recruited as research subjects through the center for disease control and prevention （CDC） voluntary counseling and testing （VCT） clinic and community-based organizations （CBOs）. Information such as demographic characteristics, drug abuse, HIV testing history and high-risk sexual behavior were collected through a unified questionnaire survey. Chi-square test or Fisher′s exact test was used to analyze differences in relevant characteristics of MSM recruited by different methods. Results A total of 641 MSM were recruited by the two methods, including 442 （68.95%） recruited from CBOs and 199 （31.05%） from CDC; the proportion of MSM aged under 20 years was significantly higher in the CBO group （6.56%） than in the CDC group （1.01%, χ2 = 9.20, P = 0.002）; the proportions of MSM receiving health education information on potential hazards of drug use from professional health institutions and new network media were significantly higher in the CDC group （7.54% ［15/199］, 16.58% ［33/199］, respectively） than in the CBO group （3.39% ［15/442］, χ2 = 5.28, P = 0.022; 9.50% ［42/442］, χ2 = 6.66, P = 0.010）. In terms of characteristics of sexual behavior, the CBO group showed significantly increased proportions of individuals having group sex （25.21%, 30 cases） and those having unprotected sexual intercourse with women （47.51%, 210 cases） compared with the CDC group （7.50% ［6 cases］, χ2 = 10.13，P = 0.001; 27.64% ［55 cases］, χ2 = 22.35，P < 0.001, respectively）, but significantly decreased proportions of heterosexuals （2.04%, 9 cases）, individuals unknowing about the HIV status of sexual partners （22.40%, 99 cases） and those having unprotected anal sex with men （39.82%, 176 cases） compared with the CDC group （6.53% ［13 cases］, χ2 = 8.37, P = 0.004; 39.70% ［79 cases］, χ2 = 20.48, P < 0.001; 57.29% ［114 cases］, χ2 = 16.90, P < 0.001, respectively）. Compared with the CDC group, the CBO group showed significantly decreased proportions of individuals ever having an HIV test （74.43% ［329 cases］ vs. 80.90% ［161 cases］, χ2 = 3.19, P = 0.074） and those getting the latest HIV test from CDC （23.10% ［76 cases］ vs. 57.14% ［92 cases］, χ2 = 99.41, P < 0.001）, as well as decreased prevalence of HIV infection （5.20% ［23 cases］ vs. 13.07% ［26 cases］, χ2 = 21.85, P < 0.001）. Conclusions The MSM recruited from CBO and CDC are complementary in terms of demographics and behaviors, and can represent the general MSM population. Specific prevention and control measures for AIDS should be taken according to different characteristics of the MSM population.

Key words: Sexual behavior, Personnel selection, Unsafe sex, HIV, Substance-related disorders, Men who have sex with men, Recruitment method