CAJ | 학술논문

目的了解北京市男男性行为者(MSM)的HIV和梅毒螺旋体血清抗体阳转情况及其影响因素. 方法在北京市以社区为基础招募HIV阴性的MSM共525名,以一对一的方式进行问卷调查,收集人口学和行为学情况资料,在第6、12个月进行随访,并采集血样进行HIV和梅毒螺旋体抗体检测,初筛均采用ELISA法,确证分别采用蛋白印迹(WB)和凝集法. 结果基线共调查550名,HIV和梅毒螺旋体血清抗体阳性率分别为4.5%(25/550)和29.3%(161/550),HIV血清抗体阴性队列525名,随访12个月,队列保持率为87.0%(457/525),HIV和梅毒螺旋体血清抗体阳转率分别为3.37/100人年和9.32/100人年.近3个月同性性行为后冲洗直肠者阳转率为7.11/100人年,未冲洗者为0.76/100人年,冲洗与HIV血清抗体阳转相关(HR=9.23,95%CI=2.08～40.88).近3个月在公园、公厕或浴池寻找男性性伴者阳转率为41.77/100人年,无该行为者阳转率为7.97/100人年;近3个月同性性行为后冲洗直肠者阳转率为16.17/100人年,无该行为者阳转率为4.92/100人年;近3个月在公园、公厕或浴池寻找男性性伴(HR=4.67,95%CI=1.77～12.34)和近3个月同性性行为后冲洗直肠(HR=3.09,95%CI=1.40～6.83)与梅毒螺旋体血清抗体阳转相关. 结论北京市MSM的HIV和梅毒螺旋体血清抗体阳转情况十分严重,主要影响因素为同性性行为后冲洗直肠、到公园等场所寻找男性性伴.
목적 료해북경시남남성행위자(MSM)적HIV화매독라선체혈청항체양전정황급기영향인소. 방법 재북경시이사구위기출초모HIV음성적MSM공525명,이일대일적방식진행문권조사,수집인구학화행위학정황자료,재제6、12개월진행수방,병채집혈양진행HIV화매독라선체항체검측,초사균채용ELISA법,학증분별채용단백인적(WB)화응집법. 결과 기선공조사550명,HIV화매독라선체혈청항체양성솔분별위4.5%(25/550)화29.3%(161/550),HIV혈청항체음성대렬525명,수방12개월,대렬보지솔위87.0%(457/525),HIV화매독라선체혈청항체양전솔분별위3.37/100인년화9.32/100인년.근3개월동성성행위후충세직장자양전솔위7.11/100인년,미충세자위0.76/100인년,충세여HIV혈청항체양전상관(HR=9.23,95%CI=2.08～40.88).근3개월재공완、공측혹욕지심조남성성반자양전솔위41.77/100인년,무해행위자양전솔위7.97/100인년;근3개월동성성행위후충세직장자양전솔위16.17/100인년,무해행위자양전솔위4.92/100인년;근3개월재공완、공측혹욕지심조남성성반(HR=4.67,95%CI=1.77～12.34)화근3개월동성성행위후충세직장(HR=3.09,95%CI=1.40～6.83)여매독라선체혈청항체양전상관. 결론 북경시MSM적HIV화매독라선체혈청항체양전정황십분엄중,주요영향인소위동성성행위후충세직장、도공완등장소심조남성성반.
Objective To study the incidence and risk factors of HIV and syphilis seroconversion among men who have sex with men(MSM) in Beijing. Methods A total of 550 MSM were recruited on the basis of community and followed up after 6 and 12 months in Beijing.Each subject was investigated by only one investigator at one time to collect information on demographics and behaviors.Blood samples were collected to test HIV and syphilis seroconversion.ELISA was used for screening test,west blotting(WB) and Particle agglutination were used for confirmatory test. Results A total of 550 MSM investigated,among which 4.5% (25/550) were HIV-positive and 29.3% (161/550) were syphilis-positive.For 525 HIVnegative MSM,87.0% (457/525) retained during the 12-month investigation.Seroincidences for HIV and syphilis were 3.37/100 person-years (95% CI = 1.66-5.08) and 9.32/100 person-years (95% CI =5.87-12.77) respectively.HIV seroconversions for those who performed and did not perform rectal douching after homosexual anal intercourse in the past 3 months were 7.11/100 and 0.76/100 person-years respectively.Multivariate Cox regression analysis revealed that rectal douching after homosexual anal intercourse in the past 3 months(HR=9.23,95%CI =2.08-40.88) was significantly associated with HIV seroconversion.Syphilis seroconversions for those who met male sex partners in parks,public washrooms or bathhouses in the past 3 months were 41.77/100 and 7.97/100 person-years respectively.Syphilis seroconversions for those who performed and did not perform rectal douching after homosexual anal intercourse in the past 3 months were 16.17/100 and 4.92/100 person-years respectively.In the past 3 months,meeting male sex partners in parks,public washrooms or bathhouses (HR=4.67,95% CI = 1.77-12.34) and performing rectal douching after homosexual anal intercourse (HR = 3.09,95% CI=1.40-6.83) were significantly associated with syphilis seroconversion. Conclusion The seroconversions of HIV and syphilis during the follow-up visits in this MSM cohort study in Beijing were very serious,and that the associated factors for seroconversions were rectal douching after homosexual anal intercourse and meeting male sex partners in parks,public washrooms or bathhouses.