CAJ | 학술논문

目的分析HIV阳性男男性行为人群(MSM)接受艾滋病相关检测随访和治疗服务状况,及影响接受抗病毒治疗的因素.方法于2013年1-6月,选取成都、重庆、广州市为调查场所,采用"滚雪球"的方法招募调查对象.纳入标准:18岁以上,有男男性行为,已确认HIV阳性,居住在成都、重庆或广州市.本研究共纳入调查对象501例,其中,成都市160例,重庆市168例,广州市173例.采用自行设计的调查问卷,通过计算机辅助调查方法收集资料,调查内容包括社会人口学特征、接受相关检测治疗服务和相关知识知晓状况、最近6个月的性行为和感染状况告知等情况.采用非条件二分类logistic回归模型分析是否接受抗病毒治疗的影响因素,计算OR(95％CI)值.结果 501例HIV阳性MSM中,病毒载量检测率为19.4％ (97例),CD4+T淋巴细胞计数检测率为90.8％ (455例).最近1次CD4+T淋巴细胞计数检测≤350个/μl者为33.0％(150/455),其中接受抗病毒者占56.0％(84/150).与本地户籍者相比,外地户籍HIV阳性的MSM未接受抗病毒治疗的OR(95％CI)值为5.21 (2.33～11.66);与最近6个月无偶然性伴或商业性伴者相比,有偶然性伴或商业性伴者未接受抗病毒治疗的OR(95％CI)值为2.16(1.03～4.50);与最近6个月和男性发生无保护肛交行为者相比,无该行为者未接受抗病毒治疗的OR(95％CI)值为2.68(1.10～6.50);与最近1年诊断感染性病者相比,未诊断性病者未接受抗病毒治疗的OR(95％CI)值为2.70(1.12～6.55).结论 HIV阳性MSM接受相关检测随访与治疗服务率均较低;外地户籍者、最近6个月有偶然性伴或商业性伴或未和男性发生无保护肛交行为者、最近1年未曾诊断感染性病者未接受抗病毒治疗风险较高.
목적 분석HIV양성남남성행위인군(MSM)접수애자병상관검측수방화치료복무상황,급영향접수항병독치료적인소.방법 우2013년1-6월,선취성도、중경、엄주시위조사장소,채용"곤설구"적방법초모조사대상.납입표준:18세이상,유남남성행위,이학인HIV양성,거주재성도、중경혹엄주시.본연구공납입조사대상501례,기중,성도시160례,중경시168례,엄주시173례.채용자행설계적조사문권,통과계산궤보조조사방법수집자료,조사내용포괄사회인구학특정、접수상관검측치료복무화상관지식지효상황、최근6개월적성행위화감염상황고지등정황.채용비조건이분류logistic회귀모형분석시부접수항병독치료적영향인소,계산OR(95％CI)치.결과 501례HIV양성MSM중,병독재량검측솔위19.4％ (97례),CD4+T림파세포계수검측솔위90.8％ (455례).최근1차CD4+T림파세포계수검측≤350개/μl자위33.0％(150/455),기중접수항병독자점56.0％(84/150).여본지호적자상비,외지호적HIV양성적MSM미접수항병독치료적OR(95％CI)치위5.21 (2.33～11.66);여최근6개월무우연성반혹상업성반자상비,유우연성반혹상업성반자미접수항병독치료적OR(95％CI)치위2.16(1.03～4.50);여최근6개월화남성발생무보호항교행위자상비,무해행위자미접수항병독치료적OR(95％CI)치위2.68(1.10～6.50);여최근1년진단감염성병자상비,미진단성병자미접수항병독치료적OR(95％CI)치위2.70(1.12～6.55).결론 HIV양성MSM접수상관검측수방여치료복무솔균교저;외지호적자、최근6개월유우연성반혹상업성반혹미화남성발생무보호항교행위자、최근1년미증진단감염성병자미접수항병독치료풍험교고.
Objective To understand the coverage of HIV related intervention and antiviral treatment among HIV-positive men who have sex with men (MSM) and to examine factors of initiating antiretroviral treatment.Methods A total of 501 HIV-positive MSM were recruited by "snowballing" sampling in Chengdu(160), Chongqing(168) and Guangzhou(173) from January to June, 2013.Participants who were older than18 years, had sex with men, HIV-infected, were living in these 3 cities when survey was conducted were eligible for subjects of this survey.The data were collected by computer assisted survey, including social demography, the coverage of HIV related follow-up intervention and ART, related knowledge level, sexual behaviors in the last 6 months, as well as notification to sexual partners and family.We analyzed the influence factors for initiating ART by Multiple Unconditioned Logistic Regression.Results Among 501 HIV-positive MSM, the ratio of CD4 counting and HIV viral load testing were 90.8％ (455) and 19.4％(97), respectively.The percentage of the latest CD4 counting not more than 350 per μl was 33.0％(150/455).The coverage of initiated ART among the participants who met the qualification was 56.0％ (84/150).The multivariable Logistic regression analysis showed that the possibility of not on ART among participants who were migrants increased to 5.21(2.33-11.66) times of the local residents and the possibility among participants who were diagnosed STD in the last year increased to 2.70(1.12-6.55) times of those who were not infected STD, the possibility of not on ART among participants who had sex with male occasional or commercial partner in the last 6 months increased to 2.16(1.03-4.50) times of those who hadn't, and the possibility among participants who had anal sex with condom use in the past 6 months increased to 2.68 (1.10-6.50) times of those who couldn't insist using condom.Conclusion There were low coverage of series of HIV/AIDS related intervention services among HIV-positive MSM in Chengdu, Chongqi and Guangzhou.Migrants, had sex with male occasional or commercial partner, had anal sex with condom use in the past 6 months, not infected STD in the last year may be the independent risk factors for HIV-positive MSM to not initiating ART.