目的 了解乌鲁木齐市(乌市)男男性行为兼异性性行为者(MSMW)人口学、行为特征及HIV感染因素.方法 按照《全国艾滋病哨点监测实施方案》,通过哨点监测系统获取乌市某区2010-2014年MSM一般人口学、性行为及血清学等资料,按其是否近6个月内与异性发生过性行为分MSMW、仅为男男性行为者(MSMO)两个亚组人群对比分析.结果 共监测MSM2 073人,其中MSMW216人(10.4%),MSMO 1 857人(89.6%).MSMW年龄集中在>30岁为115人(53.2%),与MSMO相比,MSMW倾向于与同性发生商业性行为(OR=2.09,95%CI:1.35 ~3.21);且最近一次同性性行为安全套使用率较低(OR=0.58,95%CI:0.40 ~ 0.85).MSMW和MSMO人群HIV感染率分别为7.4%和9.0%,差异无统计学意义(x2=0.604,P>0.05).多因素logistic回归分析显示,MSMW感染HIV的影响因素为最近一次同性肛交性行为时使用安全套(OR=0.24,95%CI:0.09~ 0.71)、最近一周同性肛交性行为次数(OR=6.63,95%CI:1.47~29.90);MSMO人群感染HIV的影响因素为非汉族(OR=6.40,95%CI:1.62~ 25.36)、本地居住时间短(OR=7.47,95%CI:1.98~ 28.20)、同性商业性行为从未/有时使用安全套(OR=6.14,95%CI:1.93 ~ 19.52).结论 乌市MSMW亚人群HIV感染状况与其影响因素较MSMO差异较大,应制定针对不同亚群体的预防策略.
Objective To understand the demographic characteristics,sexual behaviors and the factors associated with HIV infection in men who have sex with men and also with women (MSMW) in Urumqi.Methods According to the "National AIDS Sentinel Surveillance Protocol",the data of MSM's demographic characteristics,sex behavior histories and serological detection results were collected through Urumqi AIDS sentinel surveillance system during 2010-2014.In MSM,those also had heterosexual behaviors were considered as MSMW.Results Of 2 073 MSM surveyed,216 (10.4%) were MSMW,and 115 MSMW (53.2%) were aged 30>years.Compared with MSM,MSMW were more prone to have commercial homosexual behaviors (OR=2.09,95%CI:1.35-3.21),and the condom use rate at the latest homosex was low among them (OR=0.58,95%CI:0.40-0.85).The HIV infection rates in MSMW and MSM were 7.4% and 9.0%,respectively,the difference had no significance (x2 =0.604,P>0.05).Multivariate logistic analysis showed that among the MSMW the condom use at the latest homosex (OR=0.24,95%CI:0.09-0.71),and the number of anal sex in the past week (OR=6.63,95% CI:1.47-29.90) were the factors associated with HIV infection,and in MSM,the factors associated with HIV infection were non-Han nationality (OR=6.40,95% CI:1.62-25.36),local residence time (OR=7.47,95% CI:1.98-28.20),using no condoms or using condoms occasionally at commercial sex (OR=6.14,95% CI:1.93-19.52).Conclusion The HIV infection status and associated factors varied between MSMW and MSM in Urumqi.Therefore,it is necessary to take targeted AIDS prevention measures among them.