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目的了解宁夏男男性行为者的艾滋病病毒新发感染情况,并分析其影响因素及队列保持情况,为决策提供建议。方法采用前瞻性开放性队列研究方法,2011年4-6月建立队列,6个月及12个月后分别随访,问卷调查收集社会人口学、行为学等信息和艾滋病病毒检测情况。艾滋病新发感染率的影响因素采用COX回归分析。结果剔除本底招募中的18例艾滋病病毒抗体阳性,共调查符合条件的男男性行为者726例。随访组309例中,艾滋病病毒新发感染率为2.90/100人年(95%CI:1.45~5.80)。多因素分析艾滋病病毒新发感染的危险因素为近6个月4个以上性伴(HR=13.82,95%CI:6.55~24.10),保护因素为近1年接受过咨询检测(HR=0.04,95%CI:0.01~0.15)。肛交时使用安全套,接受艾滋病相关服务随访者较脱失者高。脱失人群未婚或离异的比例较高(P<0.05)。结论宁夏男男性行为人群中HIV发病率较发达地区低,存在不安全性行为,随访人群接受干预的比例较脱失人群高。应加大检测咨询为主的综合干预措施,遏制艾滋病在该人群的传播。
Objective To understand the new HIV infection among men who have sex with men (MSM) in Ningxia and to analyze its influencing factors and the status of cohort maintenance so as to provide suggestions for decision-making. Methods A prospective open cohort study was conducted. The cohort was established from April to June in 2011 and was followed up for 6 months and 12 months respectively. The questionnaires were collected for socio-demographic and behavioral information and HIV status. Influential factors of new HIV infection rate were analyzed by COX regression. Results Excluding the background of the recruitment of 18 cases of HIV-positive, a total of 726 men who met the criteria for the investigation. The follow-up group of 309 cases, the new HIV infection rate was 2.90 / 100 person-years (95% CI: 1.45 ~ 5.80). Multivariate analysis showed that the risk factors for new HIV infection were more than 4 sexual partners in the past 6 months (HR = 13.82, 95% CI: 6.55-24.10), and the protective factors were counseling and testing for nearly 1 year (HR = 0.04, 95% CI: 0.01 ~ 0.15). Condom use during anal intercourse and follow-up for HIV-related services was higher among those who lost their HIV status. The proportion of people who lost their loved ones was higher or divorced (P <0.05). Conclusions HIV prevalence among men who have sex with men in Ningxia is lower than that in developed areas, and there is unsafe sex. The proportion of follow-up population receiving intervention is higher than that of those with neglect. Comprehensive counseling and counseling-based interventions should be stepped up to stop the spread of AIDS in this population.