目的 分析福州市双性性取向男男性行为人群(men who have sex with men,MSM)特征及HIV感染相关因素,为制定MSM的艾滋病防治策略提供参考依据.方法 2016-2021年通过网络招募现住址为福州,年龄15周岁以上,自认为双性性取向且近半年内曾与男性有过口交/肛交性行为的MSM,分析流行病学特征变化趋势和HIV感染风险因素.结果 2016-2021年共调查双性性取向MSM 1 691名,HIV抗体总阳性率4.55％.网络寻找性伴的比例由85.29％上升到 97.28％(x2趋势=22.174,P＜0.05);近半年肛交比例由 86.47％下降到 64.03％(x2趋势=38.236,P＜0.05);最近一次肛交使用安全套比例由85.71％下降到67.66％(x2趋势=15.078,P＜0.05);异性性行为坚持使用安全套比例由24.56％上升到40.52％(x2趋势=8.376,P＜0.05);吸毒比例由 1.18％下降到 0.27％(x2 趋势=4.926,P＜0.05);艾滋病知晓率由 95.29％下降到92.10％(x2趋势=6.964,P＜0.05);最近一年接受艾滋病干预服务比例由48.24％上升到89.92％(x2趋势=132.327,P＜0.05);既往接受HIV抗体检测比例由13.53％上升到30.25％(x2趋势=23.588,P＜0.05).多因素logistic回归分析结果显示,年龄、文化程度、是否发生异性性行为是HIV感染的影响因素,＞25岁年龄组感染风险是≤25岁组的2.339倍(95％CI:1.225～4.467);高中或中专、大专及以上感染风险分别是初中及以下0.435倍(95％CI:0.222～0.852)、0.516倍(95％CI:0.288～0.926);未发生异性性行为者感染风险是发生异性性行为者的2.642倍(95％CI:1.535～4.549).结论 福州双性性取向MSM不安全性行为比例和HIV感染风险较高,应加强互联网行为干预,降低HIV由高危人群向女性人群扩散的风险.
Characteristics and HIV infection related factors of men who have sex with men and bisexual sexual orientation in Fuzhou from 2016-2021
Objective To analyze the characteristics and HIV infection related factors of men who have sex with men and bisexual sexual orientation(MSM-BSO)for providing the reference to AIDS prevention in MSM.Methods The characteristics and trends as well as risk factors of HIV infection were analyzed by online recruiting MSM group whose current address was within Fuzhou,aged over 15 years old,thought they were bisexual,had oral/anal sex with men in the past six months from 2016 to 2021.Results A total of 1 691 MSM-BSO were surveyed,with the overall HIV antibody positive rate of 4.55％.The proportion of MSM-BSO looking for male partners through the Internet increased from 85.29％to 97.28％(x2 trend=22.174,P＜0.05).In the past six months,the proportion of anal sex decreased from 86.47％to 64.03％(x2 trend=38.236,P＜0.05);the proportion of using condom in anal sex every time decreased from 85.71％to 67.66％(x2 trend=15.078,P＜0.05);the proportion of heterosexual sex using condoms increased from 24.56％to 40.52％(x2 trend=8.376,P＜0.05);the proportion of drug abuse decreased from 1.18％to 0.27％(x2 trend=4.926,P＜0.05);the awareness rate of AIDS decreased from 95.29％to 92.10％(x2 trend=6.964,P＜0.05).The proportion of cases receiving AIDS intervention services in the past year increased from 48.24％to 89.92％(x2 trend=132.327,P＜0.05).The proportion of AIDS antibody testing in the past increased from 13.53％to 30.25％(x2 trend=23.588,P＜0.05).Multivariate logistic regression analysis results indicated that age,education attainment and heterosexual were the influencing factors of HIV infection.In the age group older than 25 years,the infection risk was 2.339 times that in the age group less than or equal to 25 years old(95％CI:1.225-4.467);the risk of HIV infection among the respondents with high school or technical secondary school education attainment and college or above education attainment was 0.435(95％CI:0.222-0.852)and 0.516(95％CI:0.288-0.926)times that among the respondents with junior high school or below education attainment,respectively;the risk of infection without heterosexual sex was 2.642(95％CI:1.535-4.549)times that with heterosexual sex.Conclusions The proportion of unsafe sexual behavior and the risk of HIV infection among MSM-BSO in Fuzhou were relatively high.It's necessary to strengthen the intervention on internet behaviors so as to reduce the risk of HIV infection spreading from high-risk groups to women.
HIVBisexual sexual orientationMen who have sex with menTrend characteristicsInfluencing factors
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