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目的了解辽宁省大、中城市男男性接触者(MSM)的HIV感染现状及其二代传播风险,为艾滋病防控提供参考信息。方法于2008年4-6月对辽宁省6个大中城市的MSM进行横断面调查,通过访谈式问卷调查MSM人群的高危行为等特征,采集静脉血检测HIV-1和梅毒螺旋体抗体。结果 2 074名MSM参加了调查,HIV和梅毒的感染率分别为4.8%(100/2 074)和8.9%(184/2 074);过去6个月中,其平均男性性伴数为5.8人,与固定性伴、商业性伴和偶遇性伴的安全套使用率依次为43.3%(899/2 074)、65.0%(286/440)和68.5%(1 421/2 074);51.6%(1071/2 074)的MSM曾与女性发生过性行为,其中与女性性伴最近一次性行为中安全套使用率为50.3%(294/585);多因素Logistic回归分析结果表明,梅毒感染(OR=4.6,95%CI=2.3～9.2)、被动肛交偶尔使用安全套(OR=2.8,95%CI=1.4～5.5)、最近6个月男性性伴数≥10个(OR=2.0,95%CI=1.0～3.8)和学历低(OR=1.8,95%CI=1.0～3.3)为HIV感染的独立危险因素。结论辽宁省MSM的HIV和梅毒感染率已达到较高水平;其异性性行为比例较高且安全套使用率较低,应及时采取措施降低HIV和梅毒经MSM向一般人群二代传播的风险。
Objective To understand the status of HIV infection and the risk of second-generation transmission among MSM in large and medium-sized cities in Liaoning Province and provide reference information for AIDS prevention and control. Methods From April to June 2008, MSM cross-sectional surveys were conducted on six large and medium-sized cities in Liaoning Province. Interviews were conducted to investigate the high-risk behavior of MSM population. Venous blood samples were collected for the detection of HIV-1 and Treponema pallidum antibodies. Results 2 074 MSM participated in the survey. The infection rates of HIV and syphilis were 4.8% (100/2 074) and 8.9% (184/2 074) respectively. In the past 6 months, the average number of male partners was 5.8 , Condom usage rates with fixed partners, commercial partners and occasional partners were 43.3% (899/2 074), 65.0% (286/440) and 68.5% (1 421/2 074) respectively; 51.6% (1071 / 2 074) had sexual intercourse with women. Among them, 50.3% (294/585) had condom use in the most recent sexual intercourse with female sexual partners. Multivariate Logistic regression analysis showed that syphilis infection (OR = 4.6 (OR = 2.8,95% CI = 1.4-5.5), and the number of male sexual partners ≥10 in the last 6 months (OR = 2.0, 95% CI = 1.0 ~ 3.8) and low education (OR = 1.8,95% CI = 1.0 ~ 3.3) were independent risk factors for HIV infection. CONCLUSIONS HIV and syphilis infections have reached a high level in MSM in Liaoning province. The proportion of heterosexual behaviors is high and the rate of condom use is low. Measures should be taken to reduce the risk of HIV and syphilis transmission from MSM to the second generation of the general population.