400例MSM行为特征及HIV、HAV、HCV、HEV、梅毒感染状况的横断面调查
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摘要
目的了解云南省玉溪市MSM人群的行为特征及HIV、HAV、HCV、HEV、梅毒感染状况,为开展有针对性的健康教育和行为干预提供依据。方法 2018年4-7月在玉溪市采用横断面调查,滚雪球抽样方法,共纳入400例MSM,开展行为学问卷调查,采集血液样本进行HIV、HAV、HCV、HEV和梅毒抗体检测。结果 400例MSM中98.25%对艾滋病基本知识知晓。318例最近6个月与男性发生过肛交性行为,88.68%都坚持每次使用安全套,最近1次肛交时96.86%使用了安全套。84例最近6个月与异性发生性行为,94.05%都坚持每次使用安全套,最近1次与异性发生性行为时98.81%使用了安全套。HIV、HAV、HCV、HEV、梅毒感染率分别为3.00%(95%CI:1.33～4.67)、1.25%(95%CI:0.16～2.34)、0.25%(95%CI:0.00～0.74)、1.00%(95%CI:0.03～1.98)、4.75%(95%CI:2.67～6.83)。结论 MSM人群不仅是HIV、HCV、梅毒的高危人群,HAV、HEV也高发,需针对该人群推广接种HAV、HEV疫苗。
Objective The aim of this study was to understand the behavioral characteristics and the infection status of HIV,HAV, HCV, HEV, syphilis among men who had sex with men(MSM) in Yuxi prefecture of Yunnan province, and to provide the strategies of sexual health education and behavioral intervention. Methods A total of 400 MSM cases were included using cross-sectional survey and snowball-rolling method from April to July 2018. The behavioral questionnaire survey was conducted,and blood samples were collected for HIV, HAV, HCV, HEV, syphilis antibody testing. Results The knowledge rate of AIDS was 98.25% among 400 MSM. 318 cases had anal sex with men in the last six months, with 88.68% using condoms consistently, and 96.86% of them used condoms in the last anal sex episode. 84 cases had sex with female in the last six months, with 94.05% using condoms consistently, and 98.81% of them used condoms in the last sex with female. The HIV,HAV, HCV, HEV and syphilis infection rates were 3.00%(95% confidence interval [95% CI]: 1.33-4.67), 1.25%(95% CI:0.16-2.34), 0.25%(95% CI: 0.00-0.74), 1.00%(95% CI: 0.03-1.98) and 4.75%(95% CI: 2.67-6.83), respectively. Conclusion The MSM was demonstrated to be high-risk population of HIV, HCV, syphilis, and of HAV and HEV in Yuxi prefecture,supporting the importance for HAV and HEV vaccines in MSM.
Objective The aim of this study was to understand the behavioral characteristics and the infection status of HIV,HAV, HCV, HEV, syphilis among men who had sex with men(MSM) in Yuxi prefecture of Yunnan province, and to provide the strategies of sexual health education and behavioral intervention. Methods A total of 400 MSM cases were included using cross-sectional survey and snowball-rolling method from April to July 2018. The behavioral questionnaire survey was conducted,and blood samples were collected for HIV, HAV, HCV, HEV, syphilis antibody testing. Results The knowledge rate of AIDS was 98.25% among 400 MSM. 318 cases had anal sex with men in the last six months, with 88.68% using condoms consistently, and 96.86% of them used condoms in the last anal sex episode. 84 cases had sex with female in the last six months, with 94.05% using condoms consistently, and 98.81% of them used condoms in the last sex with female. The HIV,HAV, HCV, HEV and syphilis infection rates were 3.00%(95% confidence interval [95% CI]: 1.33-4.67), 1.25%(95% CI:0.16-2.34), 0.25%(95% CI: 0.00-0.74), 1.00%(95% CI: 0.03-1.98) and 4.75%(95% CI: 2.67-6.83), respectively. Conclusion The MSM was demonstrated to be high-risk population of HIV, HCV, syphilis, and of HAV and HEV in Yuxi prefecture,supporting the importance for HAV and HEV vaccines in MSM.
引文
[1] Jacobsen KH, Koopman JS. Declining hepatitis A seroprevalence:a global review and analysis[J]. Epidemiology and Infection, 2004, 132(6):1005-1022.
[2] Kamar N, Bendall R, Legrand-Abravanel F, et al. Hepatitis E[J].Lancet, 2012, 379(9835):2477-2488.
[3] Greco L, Renteria SC, Guarneri DA, et al. HEV and HAV seroprevalence in men that have sex with men(MSM):An update from Milan,Italy[J]. Journal of Medical Virology, 2018, 90(8):1323-1327.
[4] Payne BA, Medhi M, Ijaz S, et al. Hepatitis E virus seroprevalence among men who have sex with men, United Kingdom[J]. Emerging Infectious Diseases, 2013, 19(2):333-335.
[5] Freidl GS, Sonder GJ, Bovee LP, et al. Hepatitis a outbreak among men who have sex with men(MSM)predominantly linked with the EuroPride, the Netherlands, July 2016 to February 2017[J]. Eurosurveillance, 2017, 22(8):2-6.
[6] Lee YL, Lin KY, Cheng CY, et al. Evolution of hepatitis A virus seroprevalence among HIV-positive adults in Taiwan[J]. PLOS One, 2017, 12(10):e0186338-e0186352.
[7]姚建忠,王跃力,王娟,等.志贺菌感染-新型的性传播感染[J].中国艾滋病性病,2018,24(5):516-517.
[8] Beyrer C, Sullivan P, Sanchez J, et al. The increase in global HIV epidemics in MSM[J]. AIDS(London, England), 2013, 27(17):2665-2678.
[9] Zhang XJ, Jia MH, Chen M, et al. Prevalence and the associated risk factors of HIV, STIs and HBV among men who have sex with men in Kunming, China[J]. International journal of STD&AIDS, 2017, 28(11):1115-1123.
[10]罗红兵,梅静远,宋丽军,等.云南省2010年13州(市)男男性行为者艾滋病综合监测[J].中华流行病学杂志,2012,33(7):706-709.
[11]黄勤,李巧巧,李苑,等.2010-2013年中国男男性行为人群艾滋病/梅毒感染状况、性行为特征及艾滋病知识知晓情况的Meta分析[J].中华流行病学杂志,2015,36(11):1297-1304.
[12] Duan ZH, Fan SF, Lu R, et al. Consistently high HIV prevalence among men who have sex with men in Chengdu city from 2009 to2014[J]. International Journal of STD&AIDS, 2016, 27(12):1057-1062.
[13] Zhou Y, Li D, Lu D, et al. Prevalence of HIV and syphilis infection among men who have sex with men in China:a meta-analysis[J].Bio Med Research International, 2014, 2014:620431.
[14]付金翠,李世福,刘小春,等.2010-2013年玉溪市男男性接触者HIV感染及相关危险行为探讨[J].现代预防医学,2014,41(23):4370-4374.
[15] Das M, Chu PL, Santos GM, et al. Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco[J]. PLOS One, 2010, 5(6):e11068-e11076.
[16] Wu Z, Xu J, Liu E, et al. HIV and syphilis prevalence among men who have sex with men:a cross-sectional survey of 61 cities in China[J]. Clinical infectious diseases:an official publication of the Infectious Diseases Society of America, 2013, 57(2):298-309.
[17] Chow EP, Wilson DP, Zhang L. HIV and syphilis co-infection increasing among men who have sex with men in China:a systematic review and meta-analysis[J]. PLOS One, 2011, 6(8):e22768.
[18]王岚,李东民,葛琳,等.2009-2012年中国艾滋病哨点监测人群丙型肝炎病毒感染状况分析[J].中华流行病学杂志,2013,34(6):543-547.
[19]葛琳,李东民,李培龙,等.2010-2015年中国艾滋病哨点监测人群HIV、梅毒和HCV感染状况分析[J].疾病监测,2017,32(2):111-117.
[20] Hong-Van T, Laeyendecker O, Nandi V, et al.Prevalence and mapping of hepatitis C infections among men who have sex with men in New York City[J]. PLOS One, 2018, 13(7):e0200269-e0200284.
[21] Wu T, Li SW, Zhang J, et al. Hepatitis E vaccine development:a 14year odyssey[J]. Human Vaccines&Immunotherapeutics, 2012, 8(6):823-827.
[22]张锋,姜立民,朱赟.中国大陆地区2004-2012年甲型肝炎的流行特征分析[J].国际流行病学传染病学杂志,2014,41(5):305-307.
[23]包叶江,高孟,姜立民,等.中国2004-2013年戊型肝炎的流行病学特征分析[J].国际流行病学传染病学杂志,2016,43(1):35-38.
[24]孙薇,陆敏,潘德观,等.白云机场口岸从业人员甲型和戊型肝炎Ig M分析[J].中国公共卫生,2015,31(7):933-935.
[25]徐菀璐,罗华,王宇,等.2014-2016年景洪市食品、公共场所从业人员甲、戊肝调查分析[J].食品安全质量检测学报,2018,9(4):951-954.
[26]许静茹,凌华,李志峰,等.2013-2015年重庆市从业人员甲肝、戊肝病毒感染情况分析[J].预防医学情报杂志,2017,33(6):555-559.
[2] Kamar N, Bendall R, Legrand-Abravanel F, et al. Hepatitis E[J].Lancet, 2012, 379(9835):2477-2488.
[3] Greco L, Renteria SC, Guarneri DA, et al. HEV and HAV seroprevalence in men that have sex with men(MSM):An update from Milan,Italy[J]. Journal of Medical Virology, 2018, 90(8):1323-1327.
[4] Payne BA, Medhi M, Ijaz S, et al. Hepatitis E virus seroprevalence among men who have sex with men, United Kingdom[J]. Emerging Infectious Diseases, 2013, 19(2):333-335.
[5] Freidl GS, Sonder GJ, Bovee LP, et al. Hepatitis a outbreak among men who have sex with men(MSM)predominantly linked with the EuroPride, the Netherlands, July 2016 to February 2017[J]. Eurosurveillance, 2017, 22(8):2-6.
[6] Lee YL, Lin KY, Cheng CY, et al. Evolution of hepatitis A virus seroprevalence among HIV-positive adults in Taiwan[J]. PLOS One, 2017, 12(10):e0186338-e0186352.
[7]姚建忠,王跃力,王娟,等.志贺菌感染-新型的性传播感染[J].中国艾滋病性病,2018,24(5):516-517.
[8] Beyrer C, Sullivan P, Sanchez J, et al. The increase in global HIV epidemics in MSM[J]. AIDS(London, England), 2013, 27(17):2665-2678.
[9] Zhang XJ, Jia MH, Chen M, et al. Prevalence and the associated risk factors of HIV, STIs and HBV among men who have sex with men in Kunming, China[J]. International journal of STD&AIDS, 2017, 28(11):1115-1123.
[10]罗红兵,梅静远,宋丽军,等.云南省2010年13州(市)男男性行为者艾滋病综合监测[J].中华流行病学杂志,2012,33(7):706-709.
[11]黄勤,李巧巧,李苑,等.2010-2013年中国男男性行为人群艾滋病/梅毒感染状况、性行为特征及艾滋病知识知晓情况的Meta分析[J].中华流行病学杂志,2015,36(11):1297-1304.
[12] Duan ZH, Fan SF, Lu R, et al. Consistently high HIV prevalence among men who have sex with men in Chengdu city from 2009 to2014[J]. International Journal of STD&AIDS, 2016, 27(12):1057-1062.
[13] Zhou Y, Li D, Lu D, et al. Prevalence of HIV and syphilis infection among men who have sex with men in China:a meta-analysis[J].Bio Med Research International, 2014, 2014:620431.
[14]付金翠,李世福,刘小春,等.2010-2013年玉溪市男男性接触者HIV感染及相关危险行为探讨[J].现代预防医学,2014,41(23):4370-4374.
[15] Das M, Chu PL, Santos GM, et al. Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco[J]. PLOS One, 2010, 5(6):e11068-e11076.
[16] Wu Z, Xu J, Liu E, et al. HIV and syphilis prevalence among men who have sex with men:a cross-sectional survey of 61 cities in China[J]. Clinical infectious diseases:an official publication of the Infectious Diseases Society of America, 2013, 57(2):298-309.
[17] Chow EP, Wilson DP, Zhang L. HIV and syphilis co-infection increasing among men who have sex with men in China:a systematic review and meta-analysis[J]. PLOS One, 2011, 6(8):e22768.
[18]王岚,李东民,葛琳,等.2009-2012年中国艾滋病哨点监测人群丙型肝炎病毒感染状况分析[J].中华流行病学杂志,2013,34(6):543-547.
[19]葛琳,李东民,李培龙,等.2010-2015年中国艾滋病哨点监测人群HIV、梅毒和HCV感染状况分析[J].疾病监测,2017,32(2):111-117.
[20] Hong-Van T, Laeyendecker O, Nandi V, et al.Prevalence and mapping of hepatitis C infections among men who have sex with men in New York City[J]. PLOS One, 2018, 13(7):e0200269-e0200284.
[21] Wu T, Li SW, Zhang J, et al. Hepatitis E vaccine development:a 14year odyssey[J]. Human Vaccines&Immunotherapeutics, 2012, 8(6):823-827.
[22]张锋,姜立民,朱赟.中国大陆地区2004-2012年甲型肝炎的流行特征分析[J].国际流行病学传染病学杂志,2014,41(5):305-307.
[23]包叶江,高孟,姜立民,等.中国2004-2013年戊型肝炎的流行病学特征分析[J].国际流行病学传染病学杂志,2016,43(1):35-38.
[24]孙薇,陆敏,潘德观,等.白云机场口岸从业人员甲型和戊型肝炎Ig M分析[J].中国公共卫生,2015,31(7):933-935.
[25]徐菀璐,罗华,王宇,等.2014-2016年景洪市食品、公共场所从业人员甲、戊肝调查分析[J].食品安全质量检测学报,2018,9(4):951-954.
[26]许静茹,凌华,李志峰,等.2013-2015年重庆市从业人员甲肝、戊肝病毒感染情况分析[J].预防医学情报杂志,2017,33(6):555-559.