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目的了解南京市男男性行为人群(men who have sex with men,MSM)人类免疫缺陷病毒(human immunodeficiency virus,HIV)新发感染率及其影响因素。方法 2013年4~8月在江苏省疾病预防控制中心健康咨询中心门诊基线招募MSM,2013年10月~2014年2月对不同时间进入队列的研究对象进行6个月的随访后,同时加入新MSM。基线及随访阶段均进行问卷调查和HIV、梅毒、单纯疱疹病毒2型(herpes simplex virus 2,HSV-2)等血清学检测。结果基线共招募MSM 370名,HIV感染率为12.97%,在第6个月随访时,共随访到225人,随访阶段新入队列256名MSM,双向队列中MSM人群HIV新发感染率为8.40/100人年。多因素Cox回归分析显示,最近一年患过尖锐湿疣(HR=5.730,95%CI:1.351~24.312)、梅毒现症感染(HR=4.807,95%CI:1.838~12.573)均是HIV新发感染的危险因素。交互作用分析发现,尖锐湿疣合并梅毒或HSV-2感染时比单独或没有感染这两种性传播疾病(sexually transmitted disease,STD)时,HIV感染的风险大,且这三种STD分别与同伴教育存在时,同伴教育可降低STD原有的致HIV感染的风险。结论南京市MSM人群HIV新发感染率较高,且梅毒、尖锐湿疣等性传播疾病可增加HIV新发感染的风险。
Objective To investigate the prevalence of HIV infection and its influencing factors in men who have sex with men (MSM) in Nanjing. Methods From April to August 2013, MSM was recruited at the outpatient clinic of Center for Disease Control and Prevention of Jiangsu Province, and from June 2013 to February 2014, subjects who entered the cohort at different times were followed up for 6 months. MSM. Questionnaire investigation and HIV, syphilis, herpes simplex virus 2 (HSV-2) serological tests were performed at baseline and follow-up. Results A total of 370 MSMs were recruited at the baseline with a HIV prevalence of 12.97%. At the 6th month of follow-up, a total of 225 follow-up visits were performed. During the follow-up period, 256 new MSMs were recruited. The HIV infection rates of MSMs in the bidirectional cohort were 8.40 / 100 person-years. Multivariate Cox regression analysis showed that condyloma acuminatum (HR = 5.730, 95% CI: 1.351-24.312) and infection of syphilis (HR = 4.807, 95% CI: 1.838-12.573) Risk factors for infection. Interaction analysis found that condyloma acuminatum or HSV-2 infection than when infected with these two sexually transmitted diseases (sexually transmitted disease, STD), the risk of HIV infection, and these three STD and peer education When present, peer education can reduce the risk of STD-induced HIV infection. Conclusions The MSM population in Nanjing has a high rate of new HIV infection and sexually transmitted diseases such as syphilis and condyloma acuminatum may increase the risk of new HIV infection.