PDF《-现场调查·》

・448・ 中华流行病学杂志2009年5月第30卷第5期chin J Epid锄iol,May2009,V01.

30,No,5 江苏省南京、苏州、扬州市男男性行为人群 HIV感染因素的配比病例对照研究 -现场调查・ 唐卫明 闰红静刘晓燕汪娜 张敏赵秀萍张军 李雷还锡萍羊海涛赵金扣 【摘要】 目的探讨影响男男性行为人群HⅣ传播的危险阂素.方法采用时间序列病例对照 研究的研究方法,病例为江苏省2008年5―7月在南京、苏州、扬州市同时开展的针对男男性行为者 (MsM)调查中发现的所有HⅣ感染者,对照为按照地区的入组时间进行l:4匹配的非感染者.调查 问卷以2008年国家男男性行为人群综合防治试点工作问卷为核心并根据当地情况增加一些变量;

采 用拟合条件logistic回归模型对数据进行单因素和多闪素分析.结果调查中共发现62例阳性感染 者.对照组匹配248名非感染者.单因素分析显示从未使用安全套、梅毒、性病相关症状及无保护性肛 交为HⅣ感染的危险因素,其0尺值分别为5.56(95%c,:1.82一16.96)、2.19(95%c,:1.18―4.05)、2.50 (95%c,:1.13.5.50)和3.13(95%c,:1.64.5.98):通过互联网寻找性伴及性角色为0是感染HIV的保 护性因素,其D刚直分别为O.47(95%c,:O.22―0.998)和O.67(95%c,:0.23~1.97).多因素分析显示患 梅毒、无保护性肛交、首次性行为年龄大是感染HIV的独立危险因素.其D尺值分别为2.28(95%c,: 1.05.4.94)、4.16(95%c,:1.63.lO.66)、1.1l(95%c,:1.04~1.18);

而双性恋为感染HIV的保护性阂素 (0尺=O.4l,95%c,:0.18~0.97).结论梅毒、无保护性肛交、首次发生男男性行为的年龄较大等因 素是感染HIv的危险阒素,性取向为双性是感染HIv的保护性因素. 【关键词】男男性行为者;

艾滋病病毒;

感染因素;

病例对照研究 F卵to璐ass∞iated with HIV infection amon2 men who have∞x诵th men in Nanjing.Suzhou and Yangzh伽:a l:4 matched c鼬e.control study 私ⅣG耽i-mi昭'

, ¨,v舶,曙币昭,UU Xi∞学肌, WANG N8,zHANG Mi晓.z}|Ao Xiu.pi}bg.zHANG jt'

n.Ll Lei.HUAN Xi-西ng.YANG Hni.t∞,zHAo 五n勘u.'

D印.九me眦矿印idem幻锄口以B汹t口础泐,№,彬ng肌如nz‰觇雎砂,№,彬ng210029,china cD,7邯po以i醒.眦胁r:Z肌0 l,i凡.如u.Email:iiIll(ouzhao@ho扛nail.com 【Abstract l ob.iective This study assessed the main f.actors associatcd with HIV infection锄ong meIl having sex with men(MSM).iIl order to provide evidellce for future intervention.Methods A case.conn.0l smdy was conducn喇锄ong HIV cases identjfied at the MSM survey in N硼jing,Suzllou and Y幻gzhou cities仔om May to July in 2008.Each HIV case was matched by

4 HlV negative MSM who panicipated consecutively right a舭r me HIV case was ident讯ed at the same s1】rvey,same time and in the same ci吼A national core MSM survey questioIlnaire was used with addition of variables of localinterest. Fitting conditional logistic re擘,ession model was即lplied for univariate and multivariate amlysis.R鹤ulb I'

l―ng me survey,62 HIV positive cases were identified姐d

248 controls were matched.Data丹om 岫ivariate analysis showed that. inconsistent condom use, syphilis infection,self reported sexually 仃ansmitted infection(STI)symptoms and/or si掣1s,unprotected anal sex(UAl)were risk factors,with D霞values of 5.56(95%c,:1.82一16.96),2.19(95%c,:1.18―4.05),2.50(95%c,:1.13―5.50)and 3.13 (95%C,:1.64―5.98)respectivelv.Online c11lising and receptive anal sex were protective fhtors with OR values鹊0.47(95% :O.22―0.998)and O.67(95% :O.23一1.97).111rough multiv撕ate a蚰lysis,it w勰found tllat syphilis,age of having ex口erienced first insertive sexual iIltercourse and UAl were risk factors to HIV仃ansmission.wim 0尺values of 2.28(95% :1.05―4.94),4.16(95%c,:1.63一10.66)锄d 1.1l (95%C,:1.04一1.18)respectively.Compared with non-anal sex,bisexual(0R=0.4l,95%(Y:0.18―0.97) behavior se锄ed a protected factor.Conclusion Sy_philis infection,UAI and self R事orted STI symptoms 锄曲r signs were risk f.actors reIated to HIV nansmission while bisexual seemed a pmtective白cto r. 【Key words】 Men who llave sex with men;