2011-2016年北京市年轻男男性行为者HIV和梅毒新发感染情况的队列研究

发布时间：2018-01-22 11:00

本文关键词： 年轻男男性行为者人类免疫缺陷病毒梅毒新发感染率影响因素　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的通过队列研究,了解2011-2016年北京市年轻男男性行为者(Young Men who have Sex with Men,YMSM)HIV和梅毒新发感染情况,收集2011-2016年北京市YMSM人群社会人口学、艾滋病检测知识与态度、性行为学等方面的信息,并分析HIV和梅毒新发感染的相关因素,从而为针对性实施相应的干预措施提供参照依据。方法本研究于2011年7月到2016年4月,分年度在北京市独立进行基线的招募工作,并于6个月后完成其随访调查,共有五个独立队列并招募696名YMSM,6个月后共随访到567人。以调查表和实验室检测的方法收集信息。运用软件工程师开发的应用程序survey建立数据库,使用SPSS18.0统计软件包整理和分析数据。运用Logistic回归分析进行单因素和多因素分析。结果1.2011年基线招募150人,2012年基线招募149人,2013年基线招募149人,2014年基线招募138人,2015-2016年基线招募110人。五个独立队列基线招募在年龄、外省户籍且在本市居住时间、婚姻状况、是否为学生、学历、月收入、性取向、是否通过互联网寻找性伴、近一个月与同性性行为次数、近三个月固定性伴个数、近三个月与固定性伴有肛交、近三个月与临时性伴有肛交、近三个月与临时性伴肛交安全套每次能坚持使用、近一次与临时性伴肛交时使用安全套和未来三个月与临时性伴肛交完全可能使用安全套方面的差异有统计学意义(P0.05)。2.2011年6个月后共随访到115名调查对象,随访率为76.7%;2012年6个月后共随访到120名调查对象,随访率为80.5%;2013年6个月后共随访到125名调查对象,随访率为83.9%;2014年6个月后共随访到117名调查对象,随访率为84.8%;2015-2016年6个月后共随访到90名调查对象,随访率为81.8%;五个独立队列共随访到567名调查对象,随访率为81.5%。近一年未做过HIV检测者(OR=0.458,95%CI=0.310-0.678,P0.001)队列的随访情况较差。3.2011年随访结束后共观察59.13人年,期间HIV抗体阳转5人,HIV新发感染率为8.46/100人年(95%CI=2.73-19.73);2012年随访结束后共观察61.08人年,期间HIV抗体阳转2人,HIV新发感染率为3.27/100人年(95%CI=0.37-11.82);2013年随访结束后共观察70.28人年,期间HIV抗体阳转5人,HIV新发感染率为7.11/100人年(95%CI=2.29-16.60);2014年随访结束后共观察69.82人年,期间HIV抗体阳转2人,HIV新发感染率为2.86/100人年(95%CI=0.32-10.34);2015-2016年随访结束后共观察53.12人年,期间HIV抗体阳转4人,HIV新发感染率为7.53/100人年(95%CI=2.03-19.28);五个独立队列HIV新发感染率总共为5.74/100人年(95%CI=3.40-9.08),且各个之间差异无统计学意义(χ2=2.969,P=0.563)。自我认为感染HIV的可能性大(OR=3.835,95%CI=1.161-12.667,P=0.027)和近一次与同性发生无保护性肛交(OR=4.122,95%CI=1.579-10.757,P=0.004)是HIV新发感染的危险因素。4.2011年随访调查结束后共观察45.12人年,期间梅毒抗体阳转2人,梅毒新发感染率为4.43/100人年(95%CI=0.50-16.00);2012年随访调查结束后共观察52.10人年,期间梅毒抗体阳转6人,梅毒新发感染率为11.52/100人年(95%CI=0.42-2.51);2013年随访调查结束后共观察58.91人年,期间梅毒抗体阳转6人,梅毒新发感染率为10.19/100人年(95%CI=0.37-2.22);2014年随访调查结束后共观察61.27人年,期间梅毒抗体阳转4人,梅毒新发感染率为6.53/100人年(95%CI=1.75-16.71);2015-2016年随访调查结束后共观察47.32人年,期间梅毒抗体阳转4人,梅毒新发感染率为8.45/100人年(95%CI=2.27-21.64);五个独立队列梅毒新发感染率总共为8.31/100人年(95%CI=5.01-12.58),且各个之间差异无统计学意义(χ2=1.867,P=0.760)。月收入3000元及以下(OR=3.257,95%CI=1.269-8.355,P=0.014)和近一次与同性发生无保护性肛交(OR=6.668,95%CI=2.720-16.344,P0.001)是梅毒新发感染的危险因素。结论1.2011-2016年北京市YMSM人群HIV和梅毒新发感染率居高不下。2.近一年未参加过HIV检测者其队列的随访状况较参加过HIV检测者差。3.自我认为感染HIV的可能性大和近一次与同性发生无保护性肛交是YMSM人群HIV新发感染的危险因素。4.月收入低和近一次与同性发生无保护性肛交是YMSM人群梅毒新发感染的危险因素。
[Abstract]:Objective to understand the cohort study of young MSM in Beijing city in 2011-2016 (Young Men who have Sex with Men, YMSM HIV) and syphilis infection situation, collect sociodemographic YMSM population in Beijing city during 2011-2016, detection of knowledge and attitude of AIDS, sexual behavior and other aspects of the information, and analyze the related factors of HIV and syphilis new infections, so as to provide reference basis for the implementation of the corresponding intervention measures. Methods this study from July 2011 to April 2016, the annual independent baseline recruitment in Beijing City, and to complete the follow-up survey in 6 months, a total of five independent cohorts and 696 YMSM recruited 6 months. After a total of up to 567 people. By collecting information questionnaire and laboratory examination. The use of software engineers to develop the application of survey to establish a database, using SPSS18.0 statistical package for data collation and analysis . using Logistic regression analysis of single factor and multi factor analysis. The result of 1.2011 years of baseline recruited 150 people, recruited 149 people in 2013 2012 baseline, baseline recruited 149 people, 2014 baseline to recruit 138 people, 2015-2016 years to recruit 110 people. The baseline of five independent cohorts recruited in the baseline age, household registration and other provinces in time, living in this city marital status, whether for students, education, monthly income, sexual orientation, whether through the Internet looking for partners, nearly a month and sex number, the number of nearly three months of fixed sexual partners, and fixed with nearly three months of anal sex, and temporary nearly three months with anal sex, and temporary the recent three months with anal sex can persist in using condom every time, last anal sex with casual partners use condoms and the future of the temporary three months with possible anal sex difference was statistically significant in terms of condom use (P0.05).2.2011 years 6 months After 115 subjects were followed up, the follow-up rate was 76.7%; in 2012, 6 months after the 120 subjects were followed up, the follow-up rate was 80.5%; in 2013, 6 months after the 125 subjects were followed up, the follow-up rate was 83.9%; in 2014, 6 months after the 117 subjects were followed up, follow-up the rate is 84.8%; 2015-2016 years after 6 months were followed up in 90 subjects, the follow-up rate was 81.8%; five independent cohorts were followed up to 567 of the participants, the follow-up rate was 81.5%. for nearly a year without doing HIV testing (OR=0.458,95%CI=0.310-0.678, P0.001) a total of 59.13 person years of follow-up was the end of queue.3.2011 years of follow-up, 5 people during the HIV seroconversion, HIV infection rate was 8.46/100 person years (95%CI=2.73-19.73); a total of 61.08 people in 2012 after the end of the follow-up period, HIV seroconversion 2, HIV infection rate was 3.27/100 years (95%CI= 0.37-11.82); in 2013 the end of the follow-up After a total of 70.28 person years of observation, during HIV seroconversion 5, HIV infection rate was 7.11/100 person years (95%CI=2.29-16.60); a total of 69.82 people in 2014 after the end of the follow-up period, HIV seroconversion 2, HIV infection rate was 2.86/100 person years (95%CI=0.32-10.34); a total of 53.12 person years of observation over 2015-2016 years of follow-up, 4 people during the HIV seroconversion, HIV infection rate was 7.53/100 person years (95%CI=2.03-19.28); five independent cohort HIV new infection rate for a total of 5.74/100 person years (95%CI=3.40-9.08), and there was no significant difference between each (x 2=2.969, P=0.563). The self that the possibility of HIV infection the (OR=3.835,95%CI=1.161-12.667, P=0.027) and the last occurrence and homosexual unprotected anal intercourse (OR=4.122,95%CI=1.579-10.757, P=0.004) is the end of HIV infection risk factors were observed after.4.2011 years follow-up survey 45.12 years, during the period of syphilis antibody Positive 2 people, the new syphilis infection rate was 4.43/100 person years (95%CI=0.50-16.00); there were 52.10 person years of follow-up survey after the end of 2012, during the period of syphilis antibody positive 6, new syphilis infection rate was 11.52/100 person years (95%CI=0.42-2.51); a total of 58.91 person years of observation during the follow-up survey after the end of 2013, syphilis seroconversion 6, new syphilis infection rate was 10.19/100 person years (95%CI=0.37-2.22); there were 61.27 person years of follow-up survey after the end of 2014, during the period of syphilis antibody positive 4, new syphilis infection rate was 6.53/100 person years (95%CI=1.75-16.71); a total of 47.32 person years of follow-up 2015-2016 years after the end of the investigation period. Syphilis antibody positive 4, syphilis infection rate was 8.45/100 person years (95%CI=2.27-21.64); five independent cohorts of syphilis infection rate for a total of 8.31/100 person years (95%CI=5.01-12.58), and there was no significant difference between each (x 2=1.867, P=0.7 60). Monthly income below 3000 yuan (OR=3.257,95%CI=1.269-8.355, P=0.014) and the last occurrence and homosexual unprotected anal intercourse (OR=6.668,95%CI=2.720-16.344, P0.001) were risk factors of syphilis infection. HIV and syphilis among YMSM in Beijing 1.2011-2016 conclusion new infection rate of.2. is high in nearly a year did not participate in the follow-up of HIV the queue is in the detection of HIV testing on.3. self that the possibility of HIV infection and the last occurrence of same-sex unprotected anal intercourse is among YMSM HIV infection risk factors.4. month low income and nearly a same-sex sexual anal sex is a risk factor for new onset YMSM syphilis infection.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R512.91;R759.1

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