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目的了解中国八个城市男男性行为人群(MSM)中,不同性角色的人口学、性行为特点,以及艾滋病病毒(HIV)、梅毒、Ⅱ型生殖器单纯疱疹(HSV-2)的感染状况,分析其影响因素,为开展针对性的干预活动提供信息。方法采用分类滚雪球法招募MSM,使用统一的问卷调查人口学、行为学信息,并采集静脉血液进行血清学检测。采用χ2检验对比不同性角色的一般情况、性行为特征以及HIV、梅毒、HSV-2感染率,使用SPSS Statistics进行统计学分析。结果共调查MSM 3 509人,其中262人过去6个月未发生过肛交性行为,20人未回答性角色情况,实际将符合条件的3 227名MSM纳入分析。按过去6个月肛交中性行为角色分为3组,仅有主动插入行为(简称1号);仅有被动插入行为(简称0号);既有主动插入,又有被动插入行为(简称0.5号)。1号组983人(30.5%),0号组621人(19.2%),0.5号组1 623人(50.3%)。三组在最近6个月的男性性伴人数、安全套使用频率、与男性买卖性史、与女性有性交史上差异有统计学意义(P<0.01)。在最近一次肛交安全套使用率、毒品使用史、包皮环切史方面,三组间差异无统计学意义(P=0.413,P=0.348,P=0.105)。0号组HIV感染率为12.2%(95%CI:9.7%～14.8%),0.5号组10.3%(95%CI:8.8%～11.8%),1号组最低为4.4%(95%CI:3.1%～5.7%),三组间差异有统计学意义(P<0.001)。梅毒的感染率1号、0.5号、0号三组比较接近(10.0%、10.6%、10.9%),差异无统计学意义(P=0.279)。HSV-2感染率0号组最低(8.1%),1号组居中(10.5%),0.5号组最高(11.8%),三组的差异有统计学意义(P=0.038)。结论 MSM不同性角色人群在行为学特征上的差异,使其在感染性病艾滋病的风险上不同,应根据各自的特点,开展针对性的干预措施。
Objective To understand the demographic and sexual characteristics of different sexes and the prevalence of HIV, syphilis and type 2 genital herpes (HSV-2) among MSM in eight cities of China Its influencing factors, provide information for carrying out targeted interventions. Methods The snowball method was used to recruit MSM. Demographic and behavioral data were collected using a uniform questionnaire. Venous blood was collected for serological testing. Chi-square test was used to compare the general situation of different sexual roles, sexual characteristics and HIV, syphilis, HSV-2 infection rates, using SPSS Statistics for statistical analysis. Results A total of 3,509 MSM were investigated. Among them, 262 had no anal intercourse in the past 6 months and 20 did not answer sexual roles. In fact, 3 227 eligible MSM were included in the analysis. According to the past 6 months, the role of sexual intercourse in anal sex is divided into 3 groups, with only active insertion (abbreviation 1); only passive insertion (abbreviation 0); both active insertion and passive insertion number). 983 (30.5%) in Group 1, 621 (19.2%) in Group 0, and 1 623 (50.3%) in Group 0.5. The three groups in the past six months, the number of male partners, the frequency of condom use, and sex history of men, sexual intercourse with women was statistically significant (P <0.01). There was no significant difference among the three groups in the recent history of condom use, drug use history and circumcision history (P = 0.413, P = 0.348, P = 0.105). HIV infection rates in group 0 were 12.2% (95% CI: 9.7% to 14.8%), 0.5% in group 10.3 (95% CI: 8.8% to 11.8% 3.1% ~ 5.7%), the difference between the three groups was statistically significant (P <0.001). The infection rate of syphilis was close to (10.0%, 10.6%, 10.9%) on the 1st, the 5th and the 0th, the difference was not statistically significant (P = 0.279). HSV-2 infection rate was lowest in group 0 (8.1%), group 1 (10.5%) and group 0.5 (11.8%). There was significant difference among the three groups (P = 0.038). Conclusion Differences in the behavioral characteristics of MSM population with different sexual roles make them different in the risk of contracting STD and AIDS. Specific interventions should be carried out according to their respective characteristics.