Article(id=1241102742274503125, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102730337505325, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202312151, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1702137600000, receivedDateStr=2023-12-10, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773831552331, onlineDateStr=2026-03-18, pubDate=1721836800000, pubDateStr=2024-07-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773831552331, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773831552331, creator=13701087609, updateTime=1773831552331, updator=13701087609, issue=Issue{id=1241102730337505325, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='14', pageStart='2497', pageEnd='2688', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773831549486, creator=13701087609, updateTime=1773831697291, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241103350322745680, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102730337505325, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241103350322745681, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102730337505325, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=2642, endPage=2648, ext={EN=ArticleExt(id=1241102744560398867, articleId=1241102742274503125, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Prevalence,trends, and correlations of newly reported HIV and syphilis infections among men who have sex with men, Naning, 2019-2023, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the trends and factors associated with newly reported HIV and syphilis infections among men who have sex with men (MSM) in Nanning city, and provide a reference for developing targeted prevention strategies for the MSM population.

Methods

A questionnaire survey was conducted among MSM people in Nanning, Guangxi from 2019 to 2023, and venous blood samples were collected to detect HIV, HCV and syphilis. The trend chi-square test was used to analyze the trends of newly reported HIV,syphilis, and self-reported sexually transmitted infections prevalence. Logistic regression was employed to identify factors associated with newly reported HIV and syphilis infection.

Results

A total of 1,954 MSM participated in the survey. The prevalence of newly reported HIV and syphilis were 3.8% and 4.6%. Respectively, there was a significant decline in newly reported HIV prevalence, from 6.8% in 2019 to 2.5% in 2023 (,trend P<0.05), while newly reported syphilis prevalence increased from 1.8% to 11.1% during the same period (, trend P<0.05). The study identified several factors associated with newly reported HIV infection, including lower education levels (aOR=1.70,95%CI:1.04-2.77) and inconsistent condoms use during anal intercourse (aOR=10.11, 95%CI: 5.94-16.89). Lower education levels (aOR=2.74, 95%CI: 1.71-4.38), a history of drug use (aOR=6.96, 95%CI: 1.42-34.19), and a history of self-reported sexually transmitted diseases (aOR=10.37, 95%CI:5.79-19.89) were found to be associated with newly reported syphilis infection. aged ≥30 (aOR=0.50, 95%CI:0.31-0.81)was identified as a protective factor against syphilis infection.

Conclusion

The prevalence of newly reported HIV was a downward trend, but the trend of newly reported syphilis prevalence showed an upward trend among MSM in Nanning, 2019-2023. The study suggests that relevant health departments need to take targeted intervention measures for the MSM population in conjunction with the internet, improve the usage rate of condoms, and strengthen the regulation of drugs and pharmaceuticals.

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目的

了解2019—2023年南宁市男男性行为者(men who have sex with men, MSM) HIV和梅毒新发感染趋势及其影响因素,为制定针对MSM人群的防控策略提供参考依据。

方法

2019—2023年对广西南宁市的MSM人群进行问卷调查并采集静脉血检测HIV、HCV和梅毒。采用趋势卡方(χ2) 检验分析HIV、梅毒新发感染率和自报告性传播疾病患病率的时间趋势;采用多因素logistic回归分析HIV和梅毒新发感染的影响因素。

结果

共有1 954名MSM参与调查,HIV和梅毒总体新发感染率分别为3.8%,4.6%,其中HIV新发感染率从2019年的6.8%下降至2023年的2.5%(,趋势P<0.05),梅毒新发感染率从2019年的1.8%上升至2023年的11.1%(,趋势P<0.05)。多因素logistic回归分析显示,文化程度为大专以下(aOR=1.70,95%CI:1.04~2.77)和最近六个月肛交时不坚持使用安全套(aOR=10.11, 95%CI: 5.94~16.89)是该人群感染HIV的危险因素。文化程度为大专以下(aOR=2.74, 95%CI:1.71~4.38),有吸毒史(aOR=6.96, 95%CI:1.42~34.19),自报告性有传播疾病史(aOR=10.37, 95%CI: 5.79~19.89)是该人群感染梅毒的危险因素;年龄≥30岁(aOR=0.50, 95%CI: 0.31~0.81)是该人群感染梅毒的保护因素。

结论

2019—2023年南宁市MSM人群HIV新发感染率总体呈下降趋势,梅毒新发感染率总体呈上升趋势。相关卫生部门需结合互联网对MSM人群采取有针对性的干预措施,提高安全套的使用率,加强毒品和药品的监管力度。

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梁冰玉,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=+gYvbHaetITCgbPslvxsTg==, magXml=xxh3NetsfHMbFnhtOIVDrw==, pdfUrl=null, pdf=z66LDqBrOyGo7hlGwOTPHg==, pdfFileSize=741989, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=Bsq3c7+SGeYNRTwkl5s+FA==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=GmB43aERh2+XrTFieZVZog==, mapNumber=null, authorCompany=null, fund=null, authors=

刘君辉(1982—),男,本科,副主任医师,研究方向:性病艾滋病防控

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刘君辉(1982—),男,本科,副主任医师,研究方向:性病艾滋病防控

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Chinese Journal of Health Education, 2022, 38(4): 339-343, 363., articleTitle=Related characteristics of fixed sexual partners of men who have sex with men and influencing factors of unprotected anal intercourse, refAbstract=null)], funds=[Fund(id=1241102758007337969, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, awardId=2022AC23005, language=CN, fundingSource=广西科技基地人才专项(2022AC23005), fundOrder=null, country=null), Fund(id=1241102758087029748, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, awardId=2022JJA141110, language=CN, fundingSource=广西自然科学基金(2022JJA141110), fundOrder=null, country=null), Fund(id=1241102758170915829, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, awardId=桂卫科教发[2022]4号, language=CN, fundingSource=广西医疗卫生重点学科艾滋病防制学科(桂卫科教发[2022]4号), fundOrder=null, country=null), Fund(id=1241102758279967734, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, awardId=南卫医[2021]4号, language=CN, fundingSource=南宁市第四周期医学重点学科传染病防制学科(南卫医[2021]4号), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241102749190910715, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, xref=1., ext=[AuthorCompanyExt(id=1241102749195105019, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, companyId=1241102749190910715, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Nanning Center for Disease Control and Prevention, Nanning, Guangxi 530023, China), AuthorCompanyExt(id=1241102749203493628, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, companyId=1241102749190910715, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.南宁市疾病预防控制中心, 广西 南宁 530023)]), AuthorCompany(id=1241102749299962628, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, xref=2., ext=[AuthorCompanyExt(id=1241102749308351236, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, companyId=1241102749299962628, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.广西医科大学公共卫生学院&广西艾滋病防治研究重点实验室)])], figs=[ArticleFig(id=1241102755444618195, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, language=EN, label=Fig.1, caption=Trend of newly reported HIV, syphilis and HCV infections, and self-reported sexually transmitted infections prevalence in MSM, 2019-2023, figureFileSmall=5tcUHRJTp/uiuTbAp3JXoQ==, figureFileBig=Bsq3c7+SGeYNRTwkl5s+FA==, tableContent=null), ArticleFig(id=1241102755511727062, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, language=CN, label=图1, caption=2019—2023年MSM人群HIV、梅毒、HCV新发感染率以及自报告性传播疾病发生率的时间趋势, figureFileSmall=5tcUHRJTp/uiuTbAp3JXoQ==, figureFileBig=Bsq3c7+SGeYNRTwkl5s+FA==, tableContent=null), ArticleFig(id=1241102755700470746, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, language=EN, label=Table 1, caption=

Demographic characteristics among MSM in Nanning, 2019-2023 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总数20192020202120222023 P趋势
N1 954(100.0)398(20.4)384(19.7)388(19.9)388(19.9)396(20.3)
年龄(岁)2.0650.151
<301 058(54.1)234(58.7)206(53.6)197(50.7)213(54.8)208(52.5)
≥30896(45.9)164(41.3)178(46.4)191(49.3)175(45.2)188(47.5)
与女性的婚姻状况2.3840.123
已婚或同居280(14.3)67(16.9)63(16.5)40(10.4)57(14.6)53(13.3)
其它1 674(85.7)331(83.1)321(83.5)348(89.6)331(85.4)343(96.7)
户籍5.9800.014
广西1 778(91.0)349(87.6)344(89.5)359(92.5)366(94.6)360(90.9)
非广西176(9.0)49(12.4)40(10.5)291(7.5)22(5.6)36(9.1)
民族1.3440.246
汉族1 127(57.7)243(61.0)231(60.1)207(53.3)211(54.3)235(59.3)
其他827(42.3)155(39.0)153(39.9)181(46.7)177(45.7)161(40.7)
文化水平1.4130.234
大专以下519(26.6)109(27.3)116(30.2)101(26.0)85(21.9)108(27.2)
大专及以上1 435(73.4)289(72.7)268(69.8)287(74.0)303(78.1)288(72.8)
是否为同性恋14.508<0.001
1 853(94.8)361(90.7)362(94.2)378(97.4)367(94.5)385(97.2)
101(5.2)37(9.3)22(5.8)10(0.6)21(5.5)11(2.8)
知晓艾滋病知识0.1330.715
1 939(99.2)391(98.2)384(100.0)388(100.0)384(99.0)392(98.9)
15(0.8)7(1.8)0(0.0)0(0.0)4(1.0)4(1.1)
吸毒2.2160.137
11(0.6)1(0.3)1(0.3)4(1.0)0(0.0)5(1.2)
1 943(99.4)397(99.7)383(99.7)384(99.0)388(100.0)391(98.8)
性伴是通过互联网查找3.7270.054
1 910(97.7)383(96.2)371(96.6)387(99.8)383(98.8)386(97.5)
44(2.3)15(3.8)13(3.4)1(0.2)5(1.2)10(2.5)
), ArticleFig(id=1241102757239780317, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, language=CN, label=表1, caption=

2019—2023年南宁市男男性行为人群的人口学特征 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总数20192020202120222023 P趋势
N1 954(100.0)398(20.4)384(19.7)388(19.9)388(19.9)396(20.3)
年龄(岁)2.0650.151
<301 058(54.1)234(58.7)206(53.6)197(50.7)213(54.8)208(52.5)
≥30896(45.9)164(41.3)178(46.4)191(49.3)175(45.2)188(47.5)
与女性的婚姻状况2.3840.123
已婚或同居280(14.3)67(16.9)63(16.5)40(10.4)57(14.6)53(13.3)
其它1 674(85.7)331(83.1)321(83.5)348(89.6)331(85.4)343(96.7)
户籍5.9800.014
广西1 778(91.0)349(87.6)344(89.5)359(92.5)366(94.6)360(90.9)
非广西176(9.0)49(12.4)40(10.5)291(7.5)22(5.6)36(9.1)
民族1.3440.246
汉族1 127(57.7)243(61.0)231(60.1)207(53.3)211(54.3)235(59.3)
其他827(42.3)155(39.0)153(39.9)181(46.7)177(45.7)161(40.7)
文化水平1.4130.234
大专以下519(26.6)109(27.3)116(30.2)101(26.0)85(21.9)108(27.2)
大专及以上1 435(73.4)289(72.7)268(69.8)287(74.0)303(78.1)288(72.8)
是否为同性恋14.508<0.001
1 853(94.8)361(90.7)362(94.2)378(97.4)367(94.5)385(97.2)
101(5.2)37(9.3)22(5.8)10(0.6)21(5.5)11(2.8)
知晓艾滋病知识0.1330.715
1 939(99.2)391(98.2)384(100.0)388(100.0)384(99.0)392(98.9)
15(0.8)7(1.8)0(0.0)0(0.0)4(1.0)4(1.1)
吸毒2.2160.137
11(0.6)1(0.3)1(0.3)4(1.0)0(0.0)5(1.2)
1 943(99.4)397(99.7)383(99.7)384(99.0)388(100.0)391(98.8)
性伴是通过互联网查找3.7270.054
1 910(97.7)383(96.2)371(96.6)387(99.8)383(98.8)386(97.5)
44(2.3)15(3.8)13(3.4)1(0.2)5(1.2)10(2.5)
), ArticleFig(id=1241102757369803744, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, language=EN, label=Table 2, caption=

Anal sexual behaviour among men who have sex with men in Nanning, 2019-2023 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总数20192020202120222023 P趋势
N1 894(100.0)375(19.8)364(19.2)384(20.3)384(20.3)387(20.4)
最近一周是否肛交315.171<0.001
1 289(68.1)162(43.2)153(42.1)308(81.3)315(82.1)351(91.7)
605(31.9)213(56.8)211(57.9)76(19.7)69(17.9)36(9.3)
最近六个月肛交时都使用安全套166.327<0.001
1 575(83.2)180(48.0)332(91.3)374(97.4)352(91.7)337(87.1)
319(16.8)195(52.0)32(8.7)10(2.6)32(8.3)50(12.9)
最近六个月有过同性商业性行为0.2270.634
1 856(98.0)366(97.6)361(99.2)375(97.7)376(98.0)378(97.7)
38(2.0)9(2.4)3(0.8)9(2.3)8(2.0)9(2.3)
), ArticleFig(id=1241102757449495524, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, language=CN, label=表2, caption=

2019—2023年南宁市男男性行为人群同性肛交性行为特征 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总数20192020202120222023 P趋势
N1 894(100.0)375(19.8)364(19.2)384(20.3)384(20.3)387(20.4)
最近一周是否肛交315.171<0.001
1 289(68.1)162(43.2)153(42.1)308(81.3)315(82.1)351(91.7)
605(31.9)213(56.8)211(57.9)76(19.7)69(17.9)36(9.3)
最近六个月肛交时都使用安全套166.327<0.001
1 575(83.2)180(48.0)332(91.3)374(97.4)352(91.7)337(87.1)
319(16.8)195(52.0)32(8.7)10(2.6)32(8.3)50(12.9)
最近六个月有过同性商业性行为0.2270.634
1 856(98.0)366(97.6)361(99.2)375(97.7)376(98.0)378(97.7)
38(2.0)9(2.4)3(0.8)9(2.3)8(2.0)9(2.3)
), ArticleFig(id=1241102757579518951, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, language=EN, label=Table 3, caption=

Trend of newly reported HIV, syphilis and HCV infection and self-reported sexually transmitted infections among MSM, 2019-2023 (n=1 954)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总数
(n=1 954)
2019
(n=398)
2020
(n=384)
2021
(n=388)
2022
(n=388)
2023
(n=396)
P趋势
HIV阳性75(3.8)27(6.8)20(5.2)14(3.6)4(1.0)10(2.5)17.148<0.001
梅毒阳性89(4.6)7(1.8)17(4.4)11(2.8)10(2.6)44(11.1)26.141<0.001
自报告性传播疾病60(3.1)10(2.5)11(2.9)7(1.8)5(1.3)27(6.8)6.6690.010
HCV阳性1(0.1)0(0.0)0(0.0)0(0.0)0(0.0)1(0.3)1.9800.159
HIV、梅毒合并感染11(0.6)4(1.0)3(0.8)1(0.3)0(0.0)3(0.8)1.1310.288
), ArticleFig(id=1241102757684376555, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, language=CN, label=表3, caption=

2019—2023年男男性行为人群中HIV、梅毒和HCV新发感染率(%)及自报告性传播疾病发生率(%)的流行趋势(n=1 954)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总数
(n=1 954)
2019
(n=398)
2020
(n=384)
2021
(n=388)
2022
(n=388)
2023
(n=396)
P趋势
HIV阳性75(3.8)27(6.8)20(5.2)14(3.6)4(1.0)10(2.5)17.148<0.001
梅毒阳性89(4.6)7(1.8)17(4.4)11(2.8)10(2.6)44(11.1)26.141<0.001
自报告性传播疾病60(3.1)10(2.5)11(2.9)7(1.8)5(1.3)27(6.8)6.6690.010
HCV阳性1(0.1)0(0.0)0(0.0)0(0.0)0(0.0)1(0.3)1.9800.159
HIV、梅毒合并感染11(0.6)4(1.0)3(0.8)1(0.3)0(0.0)3(0.8)1.1310.288
), ArticleFig(id=1241102757755679724, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, language=EN, label=Table 4, caption=

Correlates of HIV and syphilis infection among MSM with newly reported HIV, 2019-2023 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总数
[n(%)]
HIV阳性
[n(%)]
cOR(95%CI)aOR(95%CI)P
N1 954(100.0)75(3.8)
年龄(岁)
<30a1 058(54.1)39(3.7)
≥30896(45.9)36(4.0)1.09(0.69~1.73)
与女性的婚姻状况
已婚/同居280(14.3)8(2.9)
其它1 674(85.7)67(4.0)1.42(0.67~2.98)
户籍
广西1 778(91.0)66(3.7)
外省176(9.0)9(5.1)1.40(0.68~2.86)
民族
汉族1 127(57.7)41(3.6)
其它827(42.3)34(4.1)1.14(0.71~1.81)
文化程度
大专以下519(26.6)31(6.0)2.01(1.25~3.22)1.70(1.04~2.77)0.035
大专及以上1 435(73.4)44(3.1)
是否为同性恋
1 853(94.8)71(3.8)
101(5.2)4(4.0)1.04(0.37~2.89)
性伴是否通过互联网方式来进行查找
1 910(97.7)74(3.9)
44(2.3)1(2.3)0.577(0.78~4.25)
是否知晓艾滋病知识
1 939(99.2)74(3.8)
15(0.8)1(6.7)1.80(0.23~13.87)
最近六个月是否与同性有过肛交
1 894(96.9)69(3.6)
60(3.1)6(10.0)2.94(1.22~7.06)7.03(2.74~18.02)<0.001
最近六个月肛交时坚持使用安全套
1 575(83.2)24(1.5)
319(16.8)45(14.1)10.61(6.36~17.72)10.10(5.94~16.89)<0.001
无肛交性行为60(3.1)6(10.0)7.18(2.82~18.29)7.03(2.74~18.02)<0.001
最近六个月是否与异性发生过性行为
107(5.5)5(4.7)1.24(0.49~3.15)
1 847(94.5)70(3.8)
最近六个月与异性发生性行为坚持使用安全套
46(2.4)1(2.2)
61(3.1)4(6.6)3.16(0.34~29.25)
无异性性行为1847(94.5)70(3.8)1.81(0.25~13.33)
是否有吸毒史
11(0.6)1(9.1)0.40(0.05~3.13)
1 943(99.4)74(3.8)
最近一年是否接受过安全套宣传/艾滋病咨询
1 884(96.4)68(3.6)0.34(0.15~0.76)0.92(0.25~3.46)0.904
70(3.6)7(10.0)
最近一年是否接受过同伴教育
1 869(95.6)67(3.6)0.36(0.17~0.78)1.27(0.36~4.40)0.711
85(4.4)8(9.4)
自报告性传播疾病
60(3.1)4(6.7)1.83(0.65~5.20)
1 894(96.9)71(3.7)
变量梅毒阳性[n(%)]cOR(95%CI)aOR(95%CI)P
N89(4.6)
年龄(岁)
<3059(5.6)
≥3030(3.3)0.59(0.37~0.92)0.50(0.31~0.81)0.005
与女性的婚姻状况
已婚/同居12(4.3)
其它77(4.6)1.08(0.58~2.01)
户籍
广西82(4.6)
外省7(4.0)0.86(0.39~1.88)
民族
汉族47(4.2)
其它42(5.1)1.23(0.80~1.88)
文化程度
大专以下39(7.5)2.25(1.46~3.47)2.74(1.71~4.38)<0.001
大专及以上50(3.5)
是否为同性恋
87(4.7)
2(2.0)0.41(0.10~1.69)
性伴是否通过互联网方式来进行查找
86(4.5)
3(6.8)1.55(0.47~5.11)
是否知晓艾滋病知识
88(4.5)
1(6.7)1.50(0.20~11.56)
最近六个月是否与同性有过肛交
89(4.7)
0(0.0)
最近六个月肛交时坚持使用安全套
70(4.4)
19(6.0)1.36(0.81~2.30)
无肛交性行为0(0.0)
最近六个月是否与异性发生过性行为
1(0.9)0.19(0.03~1.37)
88(4.8)
最近六个月与异性发生性行为坚持使用安全套
1(2.2)
0(0.0)
无异性性行为88(4.8)2.30(0.31~16.88)
是否有吸毒史
2(18.2)4.74(1.01~22.27)6.96(1.42~34.19)0.017
87(4.5)
最近一年是否接受过安全套宣传/艾滋病咨询
88(4.7)3.38(0.46~24.63)
1(1.4)
最近一年是否接受过同伴教育
87(4.7)2.03(0.49~8.37)
2(2.4)
自报告性传播疾病
19(31.7)12.08(6.67~21.87)10.73(5.79~19.89)<0.001
70(3.7)
), ArticleFig(id=1241102757877314543, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102742274503125, language=CN, label=表4, caption=

2019—2023年男男性行为人群HIV和梅毒新发感染的影响因素 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总数
[n(%)]
HIV阳性
[n(%)]
cOR(95%CI)aOR(95%CI)P
N1 954(100.0)75(3.8)
年龄(岁)
<30a1 058(54.1)39(3.7)
≥30896(45.9)36(4.0)1.09(0.69~1.73)
与女性的婚姻状况
已婚/同居280(14.3)8(2.9)
其它1 674(85.7)67(4.0)1.42(0.67~2.98)
户籍
广西1 778(91.0)66(3.7)
外省176(9.0)9(5.1)1.40(0.68~2.86)
民族
汉族1 127(57.7)41(3.6)
其它827(42.3)34(4.1)1.14(0.71~1.81)
文化程度
大专以下519(26.6)31(6.0)2.01(1.25~3.22)1.70(1.04~2.77)0.035
大专及以上1 435(73.4)44(3.1)
是否为同性恋
1 853(94.8)71(3.8)
101(5.2)4(4.0)1.04(0.37~2.89)
性伴是否通过互联网方式来进行查找
1 910(97.7)74(3.9)
44(2.3)1(2.3)0.577(0.78~4.25)
是否知晓艾滋病知识
1 939(99.2)74(3.8)
15(0.8)1(6.7)1.80(0.23~13.87)
最近六个月是否与同性有过肛交
1 894(96.9)69(3.6)
60(3.1)6(10.0)2.94(1.22~7.06)7.03(2.74~18.02)<0.001
最近六个月肛交时坚持使用安全套
1 575(83.2)24(1.5)
319(16.8)45(14.1)10.61(6.36~17.72)10.10(5.94~16.89)<0.001
无肛交性行为60(3.1)6(10.0)7.18(2.82~18.29)7.03(2.74~18.02)<0.001
最近六个月是否与异性发生过性行为
107(5.5)5(4.7)1.24(0.49~3.15)
1 847(94.5)70(3.8)
最近六个月与异性发生性行为坚持使用安全套
46(2.4)1(2.2)
61(3.1)4(6.6)3.16(0.34~29.25)
无异性性行为1847(94.5)70(3.8)1.81(0.25~13.33)
是否有吸毒史
11(0.6)1(9.1)0.40(0.05~3.13)
1 943(99.4)74(3.8)
最近一年是否接受过安全套宣传/艾滋病咨询
1 884(96.4)68(3.6)0.34(0.15~0.76)0.92(0.25~3.46)0.904
70(3.6)7(10.0)
最近一年是否接受过同伴教育
1 869(95.6)67(3.6)0.36(0.17~0.78)1.27(0.36~4.40)0.711
85(4.4)8(9.4)
自报告性传播疾病
60(3.1)4(6.7)1.83(0.65~5.20)
1 894(96.9)71(3.7)
变量梅毒阳性[n(%)]cOR(95%CI)aOR(95%CI)P
N89(4.6)
年龄(岁)
<3059(5.6)
≥3030(3.3)0.59(0.37~0.92)0.50(0.31~0.81)0.005
与女性的婚姻状况
已婚/同居12(4.3)
其它77(4.6)1.08(0.58~2.01)
户籍
广西82(4.6)
外省7(4.0)0.86(0.39~1.88)
民族
汉族47(4.2)
其它42(5.1)1.23(0.80~1.88)
文化程度
大专以下39(7.5)2.25(1.46~3.47)2.74(1.71~4.38)<0.001
大专及以上50(3.5)
是否为同性恋
87(4.7)
2(2.0)0.41(0.10~1.69)
性伴是否通过互联网方式来进行查找
86(4.5)
3(6.8)1.55(0.47~5.11)
是否知晓艾滋病知识
88(4.5)
1(6.7)1.50(0.20~11.56)
最近六个月是否与同性有过肛交
89(4.7)
0(0.0)
最近六个月肛交时坚持使用安全套
70(4.4)
19(6.0)1.36(0.81~2.30)
无肛交性行为0(0.0)
最近六个月是否与异性发生过性行为
1(0.9)0.19(0.03~1.37)
88(4.8)
最近六个月与异性发生性行为坚持使用安全套
1(2.2)
0(0.0)
无异性性行为88(4.8)2.30(0.31~16.88)
是否有吸毒史
2(18.2)4.74(1.01~22.27)6.96(1.42~34.19)0.017
87(4.5)
最近一年是否接受过安全套宣传/艾滋病咨询
88(4.7)3.38(0.46~24.63)
1(1.4)
最近一年是否接受过同伴教育
87(4.7)2.03(0.49~8.37)
2(2.4)
自报告性传播疾病
19(31.7)12.08(6.67~21.87)10.73(5.79~19.89)<0.001
70(3.7)
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2019—2023年南宁市男男性行为人群HIV和梅毒新发感染趋势及其影响因素
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刘君辉 1 , 覃世玉 2 , 徐斌 1 , 陶春杏 2 , 占钧瑜 1 , 黄婷 2 , 覃熙茂 1 , 苏秋仟 2 , 许秀东 1 , 梁冰玉 2
现代预防医学 | 疾病预防控制 2024,51(14): 2642-2648
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现代预防医学 | 疾病预防控制 2024, 51(14): 2642-2648
2019—2023年南宁市男男性行为人群HIV和梅毒新发感染趋势及其影响因素
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刘君辉1, 覃世玉2, 徐斌1, 陶春杏2, 占钧瑜1, 黄婷2, 覃熙茂1, 苏秋仟2, 许秀东1, 梁冰玉2
作者信息
  • 1.南宁市疾病预防控制中心, 广西 南宁 530023
  • 2.广西医科大学公共卫生学院&广西艾滋病防治研究重点实验室
  • 刘君辉(1982—),男,本科,副主任医师,研究方向:性病艾滋病防控

通讯作者:

梁冰玉,E-mail:
Prevalence,trends, and correlations of newly reported HIV and syphilis infections among men who have sex with men, Naning, 2019-2023
Jun-hui LIU1, Shi-yu QIN2, -Bin XU1, Chun-xing TAO2, Jun-yu ZHAN1, Ting HUANG2, Xi-mao QIN1, Qiu-qian SU2, Xiu-dong XU1, Bing-yu LIANG2
Affiliations
  • Nanning Center for Disease Control and Prevention, Nanning, Guangxi 530023, China
出版时间: 2024-07-25 doi: 10.20043/j.cnki.MPM.202312151
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目的

了解2019—2023年南宁市男男性行为者(men who have sex with men, MSM) HIV和梅毒新发感染趋势及其影响因素,为制定针对MSM人群的防控策略提供参考依据。

方法

2019—2023年对广西南宁市的MSM人群进行问卷调查并采集静脉血检测HIV、HCV和梅毒。采用趋势卡方(χ2) 检验分析HIV、梅毒新发感染率和自报告性传播疾病患病率的时间趋势;采用多因素logistic回归分析HIV和梅毒新发感染的影响因素。

结果

共有1 954名MSM参与调查,HIV和梅毒总体新发感染率分别为3.8%,4.6%,其中HIV新发感染率从2019年的6.8%下降至2023年的2.5%(,趋势P<0.05),梅毒新发感染率从2019年的1.8%上升至2023年的11.1%(,趋势P<0.05)。多因素logistic回归分析显示,文化程度为大专以下(aOR=1.70,95%CI:1.04~2.77)和最近六个月肛交时不坚持使用安全套(aOR=10.11, 95%CI: 5.94~16.89)是该人群感染HIV的危险因素。文化程度为大专以下(aOR=2.74, 95%CI:1.71~4.38),有吸毒史(aOR=6.96, 95%CI:1.42~34.19),自报告性有传播疾病史(aOR=10.37, 95%CI: 5.79~19.89)是该人群感染梅毒的危险因素;年龄≥30岁(aOR=0.50, 95%CI: 0.31~0.81)是该人群感染梅毒的保护因素。

结论

2019—2023年南宁市MSM人群HIV新发感染率总体呈下降趋势,梅毒新发感染率总体呈上升趋势。相关卫生部门需结合互联网对MSM人群采取有针对性的干预措施,提高安全套的使用率,加强毒品和药品的监管力度。

HIV  /  梅毒  /  男男性行为者(MSM)  /  趋势  /  影响因素  /  南宁
Objective

To understand the trends and factors associated with newly reported HIV and syphilis infections among men who have sex with men (MSM) in Nanning city, and provide a reference for developing targeted prevention strategies for the MSM population.

Methods

A questionnaire survey was conducted among MSM people in Nanning, Guangxi from 2019 to 2023, and venous blood samples were collected to detect HIV, HCV and syphilis. The trend chi-square test was used to analyze the trends of newly reported HIV,syphilis, and self-reported sexually transmitted infections prevalence. Logistic regression was employed to identify factors associated with newly reported HIV and syphilis infection.

Results

A total of 1,954 MSM participated in the survey. The prevalence of newly reported HIV and syphilis were 3.8% and 4.6%. Respectively, there was a significant decline in newly reported HIV prevalence, from 6.8% in 2019 to 2.5% in 2023 (,trend P<0.05), while newly reported syphilis prevalence increased from 1.8% to 11.1% during the same period (, trend P<0.05). The study identified several factors associated with newly reported HIV infection, including lower education levels (aOR=1.70,95%CI:1.04-2.77) and inconsistent condoms use during anal intercourse (aOR=10.11, 95%CI: 5.94-16.89). Lower education levels (aOR=2.74, 95%CI: 1.71-4.38), a history of drug use (aOR=6.96, 95%CI: 1.42-34.19), and a history of self-reported sexually transmitted diseases (aOR=10.37, 95%CI:5.79-19.89) were found to be associated with newly reported syphilis infection. aged ≥30 (aOR=0.50, 95%CI:0.31-0.81)was identified as a protective factor against syphilis infection.

Conclusion

The prevalence of newly reported HIV was a downward trend, but the trend of newly reported syphilis prevalence showed an upward trend among MSM in Nanning, 2019-2023. The study suggests that relevant health departments need to take targeted intervention measures for the MSM population in conjunction with the internet, improve the usage rate of condoms, and strengthen the regulation of drugs and pharmaceuticals.

HIV  /  Syphilis  /  MSM  /  Trend  /  Risk factors  /  Nanning
刘君辉, 覃世玉, 徐斌, 陶春杏, 占钧瑜, 黄婷, 覃熙茂, 苏秋仟, 许秀东, 梁冰玉. 2019—2023年南宁市男男性行为人群HIV和梅毒新发感染趋势及其影响因素. 现代预防医学, 2024 , 51 (14) : 2642 -2648 . DOI: 10.20043/j.cnki.MPM.202312151
Jun-hui LIU, Shi-yu QIN, -Bin XU, Chun-xing TAO, Jun-yu ZHAN, Ting HUANG, Xi-mao QIN, Qiu-qian SU, Xiu-dong XU, Bing-yu LIANG. Prevalence,trends, and correlations of newly reported HIV and syphilis infections among men who have sex with men, Naning, 2019-2023[J]. Modern Preventive Medicine, 2024 , 51 (14) : 2642 -2648 . DOI: 10.20043/j.cnki.MPM.202312151
男男性行为者(men who have sex with men, MSM)是感染HIV和梅毒螺旋体的高危人群[1]。近期的研究发现,2013—2015年南宁MSM人群HIV-1新发感染率为5.9%[2]。 2010—2015年广西青年MSM人群的梅毒感染率为6.5% [3]。南宁市是广西的首府,也是该地区经济最发达的城市,同时MSM的迁入率很高[4]。但是,近年来南宁市的MSM人群HIV和梅毒新发感染率趋势的研究报道比较有限。本研究分析2019—2023年南宁MSM哨点监测数据,旨在了解南宁市MSM人群的HIV和梅毒新发感染趋势及其影响因素,为针对MSM人群的艾滋病及性病干预策略和措施提供科学依据。
以在南宁市居住的MSM人群为研究对象。调查对象的纳入标准是:(1)自定义是MSM,且过去一年内与男性发生过肛交;(2)年龄在18至65岁之间;(3)知情并同意参加本项目。排除标准:(1) 既往感染HIV;(2) 常住地点不在南宁。本研究经广西壮族自治区疾病预防控制中心伦理审查委员会(GXCDCIRB)审核批准。
通过社会组织在MSM社群活动中心采用滚雪球方法和现场招募的方法招募研究对象。2019—2023年的每年4—7月招募MSM作为研究对象,每年不少于400名。由经过专业培训的调查者对研究对象进行面对面问卷调查,同时采集研究对象3~5 ml静脉血用于检测HIV、梅毒。
根据《全国艾滋病哨点监测实施方案操作手册(2022版)》的内容,使用统一的调查问卷收集相关信息,包括以下几个方面的内容:(1)艾滋病知晓情况:以8个题目中答对6题及以上为知晓(艾滋病知识知晓率=知晓人数/调查人数×100%);(2)接收预防艾滋病服务干预情况,包括最近1年内曾接受安全套宣传和发放、艾滋病咨询与检测和同伴教育;(3)性行为发生情况和安全套使用现状;(4)HIV、梅毒和性传播性疾病感染的相关信息。
使用血清酶联免疫吸附试验(ELISA)方法对样本进行双重检测。(1)筛选:所有样本均采用ELISA作为HIV、HCV和TP抗体的筛选试验,阴性结果被确定为血清抗体阴性,无需进一步审查。(2)重新检测:所有筛查阳性样本进行复检,HIV采用WB确认实验进行确认,确认实验阳性则判为阳性;HCV抗体采用与初筛不同原理或厂家的酶免试剂;HP抗体使用非特异检测方法—梅毒甲苯胺红不加热血清试验诊断试剂(RPR/TRUST)。检测结果再次呈阳性,则判定监测结果为阳性。
HIV总体新发感染率=2019—2023年期间新报告HIV抗体阳性病例数/(总调查人数-既往报告HIV感染者)×100%;HIV新发感染率=当年新报告HIV抗体阳性病例数/(当年受调查人数-当年既往报告HIV感染者)×100%;梅毒总体新发感染率=2019—2023年期间新报告梅毒抗体阳性病例总数/总调查人数×100%;梅毒新发感染率=当年新报告梅毒抗体阳性病例数/当年受调查人数×100%。
调查数据录入后应用Excel 2015软件整理建立数据库,采用SPSS 26.0软件对数据进行统计分析。不同年份的性传播疾病感染率和行为学发生率的变化趋势采用卡方趋势检验;HIV和梅毒感染的单因素分析采用卡方检验,并将有统计学意义的变量纳入到多因素logistic回归分析中;以文化程度、最近六个月是否与同性有过肛交、最近六个月与同性肛交时坚持使用安全套、最近一年是否接受过安全套宣传和发放/艾滋病咨询与检测和最近一年是否接受过同伴教育为自变量,是否HIV抗体阳性为因变量(0-否,1-是)纳入HIV新发感染的logistics回归分析。以年龄、文化程度、是否吸毒和自报告性传播疾病为自变量,以是否梅毒抗体阳性为因变量(0-否,1-是)纳入梅毒新发感染的logistics回归分析。采用双侧检验评估统计学显著性,检验水准α=0.05。
共有MSM 1 954人参与本调查,其中年龄<30岁占54.1%,已婚或同居者占14.3%,户籍以广西为主(91.1%),汉族占57.7%,大专及以上文化程度占73.4%,94.8%的人自认为性取向为同性恋,知晓艾滋病知识占99.2%,吸毒者占0.6%,97.7%的人通过互联网来寻找性伴,详见表1
在自报告最近6个月有同性性行为的1 894个调查对象中,最近一周有肛交性行为者占68.1%,最近六个月肛交时都使用安全套者占83.2%,最近六个月没有过同性商业性行为者占98.0%,详见表2
HIV、梅毒总体新发感染率分别为3.8%和4.6%。2019—2023年期间,HIV新发感染率分别为6.8%、5.2%、3.6%、1.0%和2.5%,总体呈现逐年下降趋势(P<0.001);梅毒新发感染率分别为1.8%、4.4%、2.8%、2.6%和11.1%,总体呈现逐年上升趋势(P<0.001)。
2019—2023年调查对象自报告性传播疾病患病率分别为为2.5%、2.9%、1.8%、1.3%和6.8%,呈逐年上升趋势(P=0.010),HCV感染率以及HIV合并梅毒感染率历年呈现较低水平,无明显变化趋势。详见表3图1
多因素logistic回归分析发现,文化程度为大专及以下(aOR=1.70,95%CI:1.04~2.77)、最近六个月未发生肛交性行为(aOR=7.03,95%CI:2.74~18.02)、最近六个月肛交时不坚持使用安全套(aOR=10.10,95%CI:5.94~16.89)是HIV感染的危险因素。文化程度为大专及以下(aOR=2.74,95%CI:1.71~4.38)、吸毒(aOR=6.96,95%CI:1.42~34.19)、自报告性传播疾病(aOR=10.73,95%CI:5.79~19.89)是梅毒阳性的危险因素,年龄≥30岁(aOR=0.50,95%CI:0.31~0.81)是梅毒阳性的保护因素。详见表4
本研究首次连续五年评估了南宁市MSM哨点人群HIV、梅毒新发感染以及自报告性传播疾病的流行趋势。结果显示,2019—2023年MSM人群中HIV新发感染率呈逐年下降趋势,而梅毒新发感染率和性传播疾病的报告率呈逐年上升趋势。广西是西南地区艾滋病病毒感染最严重的地区之一[5],这项研究发现对于了解性传播疾病疫情、制定控制和预防性传播疾病的策略具有重要意义。此外,本研究还证明了文化程度、近六个月有肛交性行为时安全套的使用等因素与HIV感染相关,人口学因素(年龄、文化程度)以及吸毒行为与梅毒感染相关,这一发现为制定针对性的干预策略提供了科学依据。
本研究发现,2019—2023年MSM人群HIV总体新发感染率为3.8%, 低于辽宁省的4.44%[6]、江苏省的4.5%[7]和中国MSM人群的5.7%[8]。广西属于经济相对落后的省份,教育水平普遍较低,然而HIV新发感染率处于较低的水平,这可能与近年来当地卫生相关部门积极开展的艾滋病干预服务、HIV检测和加大HIV相关知识的宣传力度有关[9]。2019—2023年广西南宁市HIV新发感染率总体呈下降趋势,这一发现与辽宁省[6]、成都[10]和天津[11]等地区一致,而与山东[12]和陕西[13]等地区的结果不一致。这些地区HIV新发感染率趋势的差异可能是以下几种因素所致,第一,各省份和地区针对MSM人群干预强度的不同;第二,部分地区对MSM的监测时间与COVIO-19型病毒肺炎流行时间存在一定的重合[6],由于当时政府采取强有力的政策限制人群的聚集活动,MSM人群线下交往的机会减少,HIV的感染率也相应下降;第三,本次调查对象的艾滋病知识知晓率超过98%,这可能是HIV感染趋势降低的原因之一。
2019—2023年广西南宁市MSM人群梅毒新发感染率总体呈上升趋势,该地区梅毒感染的形势依然严峻,可通过提高梅毒检测的意愿和检测率,并普及性传播疾病知识和加强梅毒卫生服务力度等方法来降低MSM人群的梅毒感染率。有学者证实了HIV感染与梅毒感染存在关联性[14],然而本研究发现HIV新发感染率总体呈下降趋势,而梅毒新发感染率总体呈上升趋势,这两种疾病时间趋势的不一致与沈月兰等人的发现类似[15]。随着HIV抗逆转录治疗的普及和暴露前预防药物的应用,MSM人群中HIV感染者的病毒载量显著降低,这能够有效减少了艾滋病在该人群的传播。但暴露前药物预防的措施会导致风险补偿(对艾滋病毒感染风险的感知降低而减少安全套的使用),从而增加感染其他性传播疾病的机会[16]
多因素分析发现,过去六个月发生肛交不坚持使用安全套是HIV感染的危险因素,这与以往的研究结果一致[17-18]。先前的研究证实坚持使用安全套可以减少70%~80% HIV传播的可能性[19],所以卫生相关部门应积极对MSM人群进行教育,提高安全套使用率。发生肛交性行为的MSM人群更不容易感染HIV,这与以往的研究结果不一致[20]。原因可能是,第一,本研究仅限于调查最近六个月的肛交行为史,部分自报告最近六个月无肛交行为的HIV阳性者可能在接受调查时已经感染HIV。第二,本研究中66.7%自报告无肛交行为的HIV阳性病例在新冠疫情期间被发现。可能由于疫情管控,MSM人群减少了的社交和肛交行为。有吸毒史是梅毒感染的危险因素,Chen等人也有类似发现[21]。吸食毒品可影响人的判断力和意识行动而更容易发生无保护性行为[22],从而增加感染性病的风险。因此,执法部门应加强对吸毒非法行为的打击以及非法毒品和药品的管制。此外,较低文化程度的MSM人群更容易感染HIV和梅毒,与以往的研究一致[23-24],文化较低的人群缺乏性传播疾病相关知识[25],更容易发生无保护性行为而感染性病[26]。这提示应当在义务教育或更早的学龄阶段普及和推广性传播疾病的相关知识,以覆盖更多的人群,从而整体提高人群的性传播疾病知识的水平。
本研究存在一些不足,第一,安全套的使用、吸毒史和病史的采集属于自报告的信息,可能存在回忆偏倚和报告偏倚。第二,由于MSM哨点监测仅限与南宁市,研究结论可能无法推广到其它地区;第三,本研究采用方便抽样,样本在一定程度上缺乏代表性。
广西南宁HIV新发感染率呈逐年下降趋势,而梅毒新发感染率呈逐年上升趋势。不坚持使用安全套和较低文化程度是感染HIV的危险因素,有吸毒史和较低文化程度为感染梅毒的危险因素。因此,相关卫生部门今后针对该人群的干预措施和策略应加强以下几个方面的干预措施,如提高肛交行为的安全套使用率,提高艾滋病及性病的检测意愿和检检测频率,加强非法毒品和药品的管制,对义务教育阶段或更早学龄阶段的人群普及性病知识。
  • 广西科技基地人才专项(2022AC23005)
  • 广西自然科学基金(2022JJA141110)
  • 广西医疗卫生重点学科艾滋病防制学科(桂卫科教发[2022]4号)
  • 南宁市第四周期医学重点学科传染病防制学科(南卫医[2021]4号)
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2024年第51卷第14期
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doi: 10.20043/j.cnki.MPM.202312151
  • 接收时间:2023-12-10
  • 首发时间:2026-03-18
  • 出版时间:2024-07-25
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  • 收稿日期:2023-12-10
基金
广西科技基地人才专项(2022AC23005)
广西自然科学基金(2022JJA141110)
广西医疗卫生重点学科艾滋病防制学科(桂卫科教发[2022]4号)
南宁市第四周期医学重点学科传染病防制学科(南卫医[2021]4号)
作者信息
    1.南宁市疾病预防控制中心, 广西 南宁 530023
    2.广西医科大学公共卫生学院&广西艾滋病防治研究重点实验室

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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