CAJ | 학술논문

目的：了解我国MSM人群HIV、梅毒感染状况、高危行为等变化趋势，为制定干预策略提供依据。方法2010-2013年，在哨点监测期内以重复横断面调查的方法对MSM人群进行监测，分析其人口学特征、高危行为状况、HIV和梅毒抗体阳性率水平及其变化趋势。结果2010-2013年共监测MSM 149848人。其中，12.3%来自浴池（A组）、30.1%来自网络招募（B组）、其他来源占57.5%（C组），历年样本来源构成相似。A组最近6个月肛交性行为时坚持使用安全套的比例最低，从2010年的30.2%上升至2013年的37.8%，B组从34.7%上升至42.9%，C组从35.3%上升至43.1%，趋势检验P＜0.01。HIV抗体阳性率A组最高，分别从2010年的7.8%上升至2013年的9.2%、B组从5.0%上升至6.8%、C组从5.6%上升至6.5%，趋势检验P＜0.01；梅毒抗体阳性率A组最高，分别从2010年的13.2%下降至2013年的9.5%、B组从6.1%下降至5.7%、C组从8.7%下降至6.2%，趋势检验P＜0.01。监测对象中，21～40岁年龄组占77.1%，41～50岁占9.4%，＞50岁占2.8%。＞50岁年龄组的HIV和梅毒抗体阳性率均最高，分别为10.1%和13.6%。结论近年来MSM人群HIV感染状况上升趋势明显。其中，来自浴池和高年龄组MSM的HIV感染状况更为严重，应重点对该两组MSM人群有效干预。
목적：료해아국MSM인군HIV、매독감염상황、고위행위등변화추세，위제정간예책략제공의거。방법2010-2013년，재초점감측기내이중복횡단면조사적방법대MSM인군진행감측，분석기인구학특정、고위행위상황、HIV화매독항체양성솔수평급기변화추세。결과2010-2013년공감측MSM 149848인。기중，12.3%래자욕지（A조）、30.1%래자망락초모（B조）、기타래원점57.5%（C조），력년양본래원구성상사。A조최근6개월항교성행위시견지사용안전투적비례최저，종2010년적30.2%상승지2013년적37.8%，B조종34.7%상승지42.9%，C조종35.3%상승지43.1%，추세검험P＜0.01。HIV항체양성솔A조최고，분별종2010년적7.8%상승지2013년적9.2%、B조종5.0%상승지6.8%、C조종5.6%상승지6.5%，추세검험P＜0.01；매독항체양성솔A조최고，분별종2010년적13.2%하강지2013년적9.5%、B조종6.1%하강지5.7%、C조종8.7%하강지6.2%，추세검험P＜0.01。감측대상중，21～40세년령조점77.1%，41～50세점9.4%，＞50세점2.8%。＞50세년령조적HIV화매독항체양성솔균최고，분별위10.1%화13.6%。결론근년래MSM인군HIV감염상황상승추세명현。기중，래자욕지화고년령조MSM적HIV감염상황경위엄중，응중점대해량조MSM인군유효간예。
Objective To understand the trends on HIV and syphilis infections,as well as on risk behaviors and intervention among MSM in China from 2010 to 2013 so as to provide information for the development of intervention strategies for MSM. Methods Study population involved MSM who were recruited for the national HIV sentinel surveillance between 2010 and 2013. Demographic information,HIV related risk behaviors,and results on HIV and syphilis infections were described and trend analysis was performed. Results Between 2010 and 2013,the total number of MSM under survey was 149 848. As for sources of the studied population,12.3% of them were from public bathrooms (Group A),30.1% from internet (Group B),and 57.5% were others (Group C). Proportions of three groups were similar between 2010 and 2013. The proportion of always using condom in the last six months increased from 30.2%to 37.8%,from 34.7%to 42.9%and from 35.3%to 43.1%in group A,B or C( trend:P<0.01),from 2010 to 2013. The proportion of using condom in group A was the lowest among the three groups. The prevalence rate of HIV increased from 7.8%in 2010 to 9.2%in 2013 among group A,from 5.0%in 2010 to 6.8%in 2013 among group B,from 5.6%in 2010 to 6.5%in 2013 among group C(trend:P<0.01). The prevalence rate of syphilis decreased from 13.2% in 2010 to 9.5% in 2013 among group A,from 6.1% in 2010 to 5.7% in 2013 among group B,from 8.7% in 2010 to 6.2% in 2013 among group C (trend:P<0.01). In this MSM population,77.1%of them were at age 21-40,9.4%were at age 41-50 and 2.8%were older than 50 years of age. Both the prevalence rates of HIV and syphilis were the highest-10.1%and 13.6%,among age group of over 50s,respectively. Conclusion HIV prevalence among MSM increased rapidly in the last four years,especially in older age groups and from public bathrooms. More intervention efforts should be targeting on MSM with the above mentioned characters.