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目的探讨男男性行为人群(MSM)“扩大艾滋病病毒(HIV)检测”策略实施的影响因素,提出上海市静安区MSM“扩大HIV检测”策略的实施建议。方法通过“滚雪球”、网络和MSM社区组织招募MSM,进行问卷调查和访谈;对各级艾滋病防治卫生服务提供者进行访谈,收集相关资料。结果经多因素Logistic回归分析后,MSM检测意愿的影响因素中,近六个月是否有男男性行为的比值比(OR)为2.323,95%可信区间(CI):1.041~5.186,是否知道哪里可以检测HIVOR为12.234,95%CI:6.047~24.750,是否想了解自己的HIV感染状况OR7.987,95%CI:2.875~22.188,文化程度OR为5.894,95%CI:1.762~19.712。MSM不愿意接受HIV检测的主要原因是,自认为无感染可能和怕隐私泄露,分别占75.9%(60/79)和40.5%(32/79)。“扩大HIV检测”策略实施的前提是宣传和动员。MSM对艾滋病治疗服务的信息缺失、HIV感染风险的错误评估和医疗机构人力资源的缺乏,阻碍了“扩大HIV检测”策略的实施。结论今后应通过多渠道,常态化开展有针对性且易被MSM接受的宣传动员,同时政府需加大投入,建设支持性的环境,积极推动MSM社区组织参与艾滋病防治工作,加强卫生人力资源和薪酬体系建设,推动“扩大HIV检测”策略的实施。
Objective To explore the influencing factors of implementation of MSM / HIV testing strategy and put forward the implementation suggestions of MSM “Expanding HIV testing ” strategy in Jing’an District of Shanghai. Methods The MSM was recruited through Snowball, the Web, and MSM community organizations for questionnaires and interviews, interviews with HIV health service providers at all levels and collection of relevant information. Results After multivariate Logistic regression analysis, among the influencing factors of MSM test intention, odds ratio (OR) was 2.323, 95% confidence interval (CI): 1.041 ~ 5.186 in the past six months, Where can I detect HIVOR 12.234,95% CI: 6.047 ~ 24.750, would like to know their HIV status OR7.987, 95% CI: 2.875 ~ 22.188, educational level OR was 5.894, 95% CI: 1.762 ~ 19.712. The main reason MSM was unwilling to undergo HIV testing was 75.9% (60/79) and 40.5% (32/79) respectively, since it thought it was possible to be non-infected and afraid of privacy leaks. “Expand HIV testing ” strategy is implemented on the premise of advocacy and mobilization. MSM’s lack of information on HIV treatment services, mis-assessment of the risk of HIV infection, and lack of human resources in healthcare facilities have hampered the implementation of the strategy of “expanding HIV testing.” Conclusion In the future, we should conduct targeted and easily advocacy mobilization through MSM through multiple channels and normalization. At the same time, the government needs to increase investment and build a supportive environment, and actively promote MSM community organizations to participate in AIDS prevention and control work, strengthen human resources for health and Pay system construction, promote “expand HIV testing ” strategy implementation.