CAJ | 학술논문

目的了解中国6个省(自治区、直辖市)的16个城区的男男性行为人群(MSM)的梅毒感染情况及其影响因素.方法于2007年在开展绘制MSM活动场所地理分布图及人群规模估计的基础上,用分类的非概率抽样方法在MSM中开展横断面调查;通过问卷调查收集人口学、危险行为以及梅毒感染等信息.用SPSS软件对数据进行单因素及多因素Logistic回归分析.结果 2007年共收集4211份有效问卷.所调查的MSM平均年龄为28岁,自报为同性恋占66.7%,未婚占72.5%,高中及其以上教育程度占76.4%.近6个月MSM的性行为调查结果显示:8.7%有10个以上的男性性伴,5.6%曾买男性性服务,11.3%曾为男性提供商业性服务,18.9%曾与女性发生过性关系,与男性肛交性行为中的安全套坚持使用率仅为36.3%.所调查MSM的梅毒感染率为10.6%.多因素Logistic回归分析结果显示:年龄＞25岁[调整OR(AOR)=1.7,95%CI:1.3～2.0]、本市户籍(AOR=1.3,95% CI:1.0～1.7)、调查地区、酒吧/公园招募对象(AOR=1.3,95% CI:1.1～1.7)、买男性性服务(AOR=1.5,95% CI:1.0～2.1)、男男肛交行为中不坚持使用安全套(AOR=1.2,95% CI:1.0～1.5)和自报性病史(AOR=1.3,95% CI:1.0～1.7)是梅毒感染的独立相关变量.结论 16个城区MSM的梅毒感染率已达一定水平、男男商业性服务及不安全性行为的流行率较高,亟待加强MSM的梅毒防治工作,包括梅毒和HIV筛查、推广使用安全套等综合干预措施.
목적 료해중국6개성(자치구、직할시)적16개성구적남남성행위인군(MSM)적매독감염정황급기영향인소.방법 우2007년재개전회제MSM활동장소지리분포도급인군규모고계적기출상,용분류적비개솔추양방법재MSM중개전횡단면조사;통과문권조사수집인구학、위험행위이급매독감염등신식.용SPSS연건대수거진행단인소급다인소Logistic회귀분석.결과 2007년공수집4211빈유효문권.소조사적MSM평균년령위28세,자보위동성련점66.7%,미혼점72.5%,고중급기이상교육정도점76.4%.근6개월MSM적성행위조사결과현시:8.7%유10개이상적남성성반,5.6%증매남성성복무,11.3%증위남성제공상업성복무,18.9%증여녀성발생과성관계,여남성항교성행위중적안전투견지사용솔부위36.3%.소조사MSM적매독감염솔위10.6%.다인소Logistic회귀분석결과현시:년령＞25세[조정OR(AOR)=1.7,95%CI:1.3～2.0]、본시호적(AOR=1.3,95% CI:1.0～1.7)、조사지구、주파/공완초모대상(AOR=1.3,95% CI:1.1～1.7)、매남성성복무(AOR=1.5,95% CI:1.0～2.1)、남남항교행위중불견지사용안전투(AOR=1.2,95% CI:1.0～1.5)화자보성병사(AOR=1.3,95% CI:1.0～1.7)시매독감염적독립상관변량.결론 16개성구MSM적매독감염솔이체일정수평、남남상업성복무급불안전성행위적류행솔교고,극대가강MSM적매독방치공작,포괄매독화HIV사사、추엄사용안전투등종합간예조시.
Objective To examine the prevalence of and risk factors for syphilis among men who have sex with men (MSM) in 16 cities/districts, 6 provinces in China. Methods Based on a previous survey on the entertainment place and population size of MSM, a cross-sectional study was conducted in 2007 using non-probability sampling method among MSM in 16 cities/districts in China.Information about the demography,risk behavior and syphilis infection was collected through questionnaires from MSM. Univariate and multivariate stepwise logistic regression model was constructed to evaluate independent factors associated with syphilis. Results A total of 4211 participants were recruited. The mean age of these participants was 28 years. Among them, 66.7% were self identified as homosexual, 72.5% were unmarried, and 76.4% had an education beyond senior middle school; in the past 6 months, 8.7% had sexual contact with more than 10 male sex partners, 5.6% had ever paid for male sex service, 11.3% had provided commercial sex service to males, and 18.9% had sexual contact with females, while condom was consistently used in only 36.3% of male-to-male anal sexual behavior. Syphilis was diagnosed in 10.6% of these participants. The risk factors independently associated with syphilis included being older than 25 years (adjusted OR = 1.7; 95% CI:1.3-2.0), local residency (adjusted OR = 1.3; 95% CI: 1.0-1.7), being recruited from a bar or a park (adjusted OR = 1.3; 95% CI: 1.1-1.7), having ever paid for a male sex service(adjusted OR = 1.5; 95% CI: 1.0-2.1),inconsistent condom use during male-to-male anal sexual behavior(adjusted OR = 1.2; 95% CI: 1.0-1.5 ), self reported sexually transmitted infection history (adjusted OR = 1.3; 95% CI: 1.0-1.7). Conclusions There is a high prevalence of syphilis in MSM in the 16 Chinese cities where male-to-male commercial sex service and unsafe sexual behavior are common. Further efforts are urgently needed to scale-up the prevention of and treatment program for syphilis among MSM, which should include syphilis and HIV screening as well as education on the use of condom.