CAJ | 학술논문

目的：通过对上海市长宁区男男性行为（MSM）人群梅毒感染情况及其危险因素分析，为有效遏制梅毒等经性传播疾病疫情提供有针对性的干预措施。方法对经上海市长宁区疾病预防控制中心自愿咨询检测（VCT）门诊检测咨询的MSM进行面对面问卷调查，并分析其梅毒感染情况及危险因素。结果自2011年11月至2013年3月共调查符合要求的对象231例。经检测，231例调查对象中梅毒感染者56例，占24.24%，其中现症梅毒感染18例，占7.79%。经问卷调查分析得出尖锐湿疣感染者占7.36%（17/231）；18例现症梅毒感染者中，15例（83.33%）合并感染HIV，2例（11.11%）合并感染尖锐湿疣。经单因素分析发现，不同年龄、婚姻状态、文化程度和性伴情况，其梅毒感染情况不同，差异具有统计学意义（P均＜0.05）；经多因素非条件Logistic回归分析结果显示，性伴情况对梅毒感染有显著影响（OR=0.088，95%CI：0.029～0.272），有偶遇同性性伴的MSM梅毒感染率更高。结论到本区检测咨询的MSM梅毒感染率高，还存在一定比例的性病混合感染，有偶遇同性性伴的MSM梅毒感染率更高。应加大对有偶遇同性性伴的MSM人群的宣传力度，强调坚持每次使用安全套的重要性，树立高度的风险意识，让其克服侥幸心理，从而降低梅毒等经性传播疾病感染率。
목적：통과대상해시장저구남남성행위（MSM）인군매독감염정황급기위험인소분석，위유효알제매독등경성전파질병역정제공유침대성적간예조시。방법대경상해시장저구질병예방공제중심자원자순검측（VCT）문진검측자순적MSM진행면대면문권조사，병분석기매독감염정황급위험인소。결과자2011년11월지2013년3월공조사부합요구적대상231례。경검측，231례조사대상중매독감염자56례，점24.24%，기중현증매독감염18례，점7.79%。경문권조사분석득출첨예습우감염자점7.36%（17/231）；18례현증매독감염자중，15례（83.33%）합병감염HIV，2례（11.11%）합병감염첨예습우。경단인소분석발현，불동년령、혼인상태、문화정도화성반정황，기매독감염정황불동，차이구유통계학의의（P균＜0.05）；경다인소비조건Logistic회귀분석결과현시，성반정황대매독감염유현저영향（OR=0.088，95%CI：0.029～0.272），유우우동성성반적MSM매독감염솔경고。결론도본구검측자순적MSM매독감염솔고，환존재일정비례적성병혼합감염，유우우동성성반적MSM매독감염솔경고。응가대대유우우동성성반적MSM인군적선전력도，강조견지매차사용안전투적중요성，수립고도적풍험의식，양기극복요행심리，종이강저매독등경성전파질병감염솔。
Objective To analyze syphilis infections and risk factors among men who have sex with men (MSM) in Changning District of Shanghai and afford efifcient intervening measure of containing epidemic situation. Methods MSM to test and counsel from voluntary counseling and testing (VCT) in Changning CDC of Shanghai were interviewd with face to face questionnaires. The syphilis infections and risk factors were analyzed, restrospectively. Results A total of 231 MSM participated in the survey conducted from November 2011 to March 2013. Among the 231 participants, 24.24%(56/231) were sero-positive for syphilis infection with TP-ELISA test and 7.79% (18/231) for active syphilis. An overall prevalence of 7.36%(17/231) for condyloma acuminata (CA) was found with questionnaire survey. There were 15 (83.33%) cases for HIV-positive and 2 (11.11%) cases for CA-positive among 18 participatients with active syphilis. There were signiifcant differences between age, marriage, degree of education, sex partner and syphilis infection with single factor analysis (P all<0.05). Multivariate analysis revealed that syphilis infection was associated with different sex partner conditions. The rate of syphilis infection was higher among MSM who have occational homosexual partners (OR = 0.088, 95%CI: 0.029-0.272). Conclusions The rate of syphilis infection was high among MSM (particularly among MSM who have occational homosexual partner) to test and counsel from VCT in Shanghai Changning CDC. In future, we should manage to emphasis the importance of insisting on using condom every time, and let MSM establish consciousness of risk highly and overcome invulnerability.