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目的了解绵阳市男男性行为者(MSM)的艾滋病(AIDS)相关知识、相关行为改变及艾滋病病毒(HIV)感染状况,为评价干预效果和制定防控策略提供依据。方法 2009-2014年每年4-6月,通过分类滚雪球、活动场所、网络等方法招募MSM 400人以上,由经过培训的专业人员逐一进行问卷调查,并采集血样检测HIV、丙型肝炎病毒(HCV)和梅毒抗体。结果 2009-2014年,共监测MSM 2450人,各年MSM的AIDS相关知识知晓率分别为91.71%、94.51%、96.84%、97.80%、97.25%、97.88%,呈逐年上升趋势(χ2=30.947,P<0.05);最近6个月与同性发生过肛交的比例分别为78.24%、85.44%、91.99%、91.69%、86.50%、88.92%,差异有统计学意义(χ2=30.947,P<0.05)。最近1次与同性肛交使用安全套率分别为73.51%、73.74%、80.47%、76.53%、78.03%、82.76%,呈逐年上升趋势(χ2=13.682,P<0.05);最近6个月与同性发生肛交每次都使用安全套的比例为45.36%、47.49%、52.24%、51.20%、47.98%、65.52%,呈逐年上升(χ2=38.190,P<0.05)。最近一年做过HIV检测的比例分别为50.26%、68.74%、66.26%、87.29%、59.50%、64.86%,差异有统计学意义(χ2=134.91,P<0.05)。HIV抗体阳性率分别为10.00%、6.68%、7.77%、6.36%、6.25%、6.60%,呈下降趋势(χ2=13.682,P<0.05);梅毒抗体阳性率分别为18.21%、7.42%、11.17%、9.78%、6.00%、7.55%,呈下降趋势(χ2=13.682,P<0.05);HCV抗体阳性率分别为0.28%、0、0.24%、0、0、0.71%,差异无统计学意义(χ2=5.67,P=0.339)。结论HIV在MSM中的蔓延于2010年以来已进入平台期,但该人群感染和传播HIV的危险因素仍广泛存在,应在保持现有有效干预模式的基础上,创新出新的干预模式,有效控制HIV的传播。
Objective To understand AIDS related knowledge, related behavior changes and HIV infection in MSM in Mianyang City, and to provide basis for evaluating intervention effect and making prevention and control strategies. Methods From April to June of each year from 2009 to 2014, more than 400 MSM were recruited by means of classification of snowballing, venues and networks. Questionnaires were conducted by trained professionals one by one and blood samples were collected for the detection of HIV, HCV ) And syphilis antibody. Results A total of 2450 MSM were monitored during 2009-2014. The awareness rate of AIDS-related knowledge of MSM was 91.71%, 94.51%, 96.84%, 97.80%, 97.25% and 97.88% respectively over the years, showing an increasing trend year by year (χ2 = 30.947, P <0.05). The rates of anal intercourse with homosexuals in the recent 6 months were 78.24%, 85.44%, 91.99%, 91.69%, 86.50% and 88.92% respectively, with significant difference (χ2 = 30.947, . The rate of condom use for the same sex anal intercourse was 73.51%, 73.74%, 80.47%, 76.53%, 78.03% and 82.76% respectively, showing an upward trend year by year (χ2 = 13.682, P <0.05) The proportions of condom used in anal intercourse were 45.36%, 47.49%, 52.24%, 51.20%, 47.98% and 65.52%, showing a year by year increase (χ2 = 38.190, P <0.05). The rates of HIV testing in the recent year were 50.26%, 68.74%, 66.26%, 87.29%, 59.50% and 64.86%, respectively. The difference was statistically significant (χ2 = 134.91, P <0.05). The positive rates of HIV antibodies were 10.00%, 6.68%, 7.77%, 6.36%, 6.25% and 6.60%, respectively (χ2 = 13.682, P <0.05) .The positive rates of HIV antibody were 18.21%, 7.42% and 11.17 (Χ2 = 13.682, P <0.05). The positive rate of HCV antibody was 0.28%, 0,0.24%, 0,0,0.71% respectively, with no significant difference (χ2 = 5.67, P = 0.339). Conclusion The HIV infection in MSM has reached a plateau since 2010, but the risk factors of HIV infection and transmission in this population are still widespread. Based on the existing effective intervention modes, new intervention modes should be innovated to be effective Control of HIV transmission.