苏州市男男性行为人群HIV感染的配比病例对照研究

目的探讨苏州市男男性行为人群（MSM）艾滋病病毒（HIV）感染的危险因素。方法采用时间序列病例对照的研究方法,病例来源于2008年5月至2009年7月间苏州MSM人群调查中新发现的HIV感染者,对照为按入组时间进行1∶4匹配的HIV抗体阴性者;问卷调查收集人口学、行为学信息等信息。数据分析运用条件Logistic回归模型。结果共获得病例58人,对照232人。单因素结果显示,与HIV感染相关的因素有大专及以上文化程度（OR=0.40,95%CI：0.20,0.78）、外地户籍（OR=2.19,95%CI：1.05,4.55）、最近6月内有5个及以上同性性伴（OR=2.29,95%CI：1.15,4.56）、最近6月内与同性发生被插入性肛交（OR=2.30,95%CI：1.16,4.59）、最近6月内与同性肛交从不/偶尔使用安全套（OR=4.20,95%CI：1.95,9.08）、感染梅毒（OR=2.28,95%CI：1.17,4.41）;多因素分析表明,大专及以上文化程度（OR=0.45,95%CI：0.21,0.98）是MSM人群HIV感染的保护因素,而肛交从不/偶尔使用安全套（OR=3.76,95%CI：1.60,8.84）是MSM人群HIV感染的危险因素。结论文化程度高是MSM HIV感染的保护因素,而肛交不用安全套是MSM HIV感染的危险因素;需要针对MSM人群开展强化安全套使用的干预。

A case-control study of HIV infection among men who have sex with men in Suzhou

Objective To investigate factors associated with HIV infection among men who have sex with men（MSM） and recommend strategies for improved interventions to reduce the risk of HIV among them.Methods A case-control study was conducted among MSM in Suzhou.MSM who were confirmed as HIV-positive in a MSM survey from May,2008 through July,2009 were defined as study（case） group and those who were detected as HIV negative were defined as control group at a ratio of 1 to 4.All subjects completed the same questionnaire covering socio-demography,sexual behavior and AIDS knowledge.Results A total of 58 cases were enrolled in the study group and 232 cases – in the control group.Conditioned logistic regression analysis was performed to investigate which factors were associated with HIV infection.The univariate analysis indicated that college education or above（OR=0.40,95% CI： 0.20,0.78）,the registered permanent residence outside Suzhou（OR=2.19,95% CI： 1.05,4.55）,having five or more homosexual partners in the past 6 months（OR=2.29,95% CI： 1.15,4.56）,having homosexual receptive anal intercourse（AI）（OR=2.30,95% CI： 1.16,4.59）,never or rarely using condoms in homosexual AI（OR=4.20,95% CI： 1.95,9.08） in the past 6 months and syphilis infection（OR=2.28,5%CI：1.17,4.41） were associated with HIV infection.The multivariate analysis showed that college education or above（OR=0.45,95%CI：0.21,0.98） and never or rarely using condoms in homosexual AI（OR=3.76,95% CI：1.60,8.84）were independently associated with HIV infection.Conclusions Higher education reduced HIV risk while never or rarely using condoms in homo sexual AI was a risk factor for HIV infection among MSM.Intensive interventions to promote condom use among MSM are urgently needed.