用同伴推动抽样法对南京市男男性接触人群进行抽样调查

发布时间：2018-03-10 19:41

本文选题：男男性接触者(MSM)　切入点：人类免疫缺陷病毒感染者/艾滋病病人　出处：《南京医科大学》2010年硕士论文　论文类型：学位论文

【摘要】：目的:本研究旨在通过对同伴推动抽样法(respondent-driven sampling, RDS)的采用,了解江苏省南京市男男性接触者(MSM)人群HIV/AIDS及梅毒的感染状况,了解该人群HIV的流行状况、人口统计学特征、性行为特征,从而比较全面地掌握该人群疾病感染的情况,为今后的预防干预措施的指定与落实提供比较可靠的理论依据。另外,本研究对RDS方法的招募效果、招募的平衡性等进行了合理的评价,以检验RDS方法是否比较准确的招募到了具有代表性的样本。方法:采用RDS,对南京市430名MSM进行问卷调查和血清学检测。在调查结束后,用EpiData 3.0软件建立数据库,数据的录入采用双轨录入。数据库录入后使用Excel工作表进行清洗(逻辑性检测、缺漏项回访等),重新赋值和生成新的变量后进行统计分析;用RDSAT5.6软件分别计算相关指标的粗构成比和调整构成比,并分析相关指标的趋同性、导出相关变量的权重;用NetDraw软件绘制招募图;导出的权重系数和原数据库合并后导入SPSS16.0软件进行Logistic回归分析、t检验。结果:(1) 2008年5月-8月,本研究共招募了430名MSM,其中MSM人群HIV感染率为4.7%(粗率),校正后为6.6% (95%CI:3.0,10.4);梅毒感染率为11.9%,校正后梅毒感染率为12.6%(95%CI:8.1,18.3),HIV和梅毒合并感染校正率为2.9%(95%CI:0.3,5.3);通过乘数法及社区访谈,最终估计南京市MSM人群总数为25,000人,范围在20,000-32,000人;(2)双性恋人群相关性行为比同性恋人群更危险;梅毒、无保护性肛交、首次发生男男性行为的年龄是感染HIV的危险因素(P0.05);感染HIV、具有排尿痛或烧灼感、尿道分泌物异常、生殖器或肛门出现皮肤破损或增生物的人感染梅毒的风险更高,职业为公司职员的人罹患梅毒的风险比其他人群更高,预防干预措施是感染梅毒的一个保护因素;(3)离异或丧偶、在过去6个月和固定性伴以外的同性发生性行为、性角色为“0”、最近一次发生性行为之前曾经饮酒、在过去6个月有多个性伴是发生无保护性肛交的危险因素;(4)波次平衡和周次平衡均可用于衡量RDS招募的平衡性;RDS招募的有效性分析显示RDS是招募MSM人群的有效方法。结论:(1)南京市MSM人群HIV、梅毒感染率较高,情况不容乐观,我们需要加强对MSM人群的宣传和干预,加强对MSM人群的检测,促进阳性感染者的发现,控制传染源,减缓HIV蔓延的趋势;(2)通过对RDS招募的样本进行分析,我们可以发现,RDS是招募MSM等隐蔽性人群,获得相对具有代表性的样本的有效方法。
[Abstract]:Objective: through the study of respondent driven sampling (respondent-driven sampling, RDS) by the understanding of Jiangsu city of Nanjing province MSM (MSM) infection in the population of HIV/AIDS and syphilis, understand the epidemic situation of HIV in this population, demographic characteristics, behavior characteristics, to fully grasp the situation of infectious diseases the crowd, for future intervention to provide a reliable theoretical basis and implementation. In addition, the research results of RDS recruitment methods, such as the balance of the recruitment for a reasonable evaluation, to test whether the RDS method is more accurate in recruiting a representative sample.
Methods: using RDS, by questionnaire survey and serological testing of 430 MSM in Nanjing city. At the end of the investigation, the establishment of a database with EpiData 3 software, the input data with dual input. After using Excel database entry work table for cleaning (logic detection, missing item return visit etc.), statistical analysis and re assignment the formation of new variables; the related indices were calculated respectively by RDSAT5.6 software and the adjustment of crude composition ratio, and analysis of the related index of convergence, weights are derived related variables; draw recruitment chart with the NetDraw software; the weight coefficients are derived and the original database merged into SPSS16.0 software for Logistic regression analysis and t test.
Results: (1) -8 months of May 2008, this study recruited a total of 430 MSM, the MSM population HIV infection rate was 4.7% (crude), after correction for 6.6% (95%CI:3.0,10.4); the infection rate of syphilis was 11.9%, after correction of syphilis infection rate was 12.6% (95%CI:8.1,18.3), HIV and syphilis infection rate and correction 2.9% (95%CI:0.3,5.3); through the multiplier method and community interviews, the final estimated population size of MSM in Nanjing was 25000, in the range of 20000-32000 people; (2) bisexual population correlation behavior is more dangerous than gay people; syphilis, unprotected anal intercourse, the first occurrence of MSM age is a risk factor for HIV infection (P0.05); HIV infection, with pain or burning urination, urethral secretion abnormalities, genital or anal skin damage or increase the risk of living people infected with syphilis at higher risk for the company staff occupation of people suffering from syphilis is higher than the rest of the population, prevention The intervention was a protective factor of syphilis infection; (3) divorced or widowed, had sex in the past 6 months and same-sex fixed partners outside the role as "0" before the last sex was drinking in the past 6 months have multiple sexual partners were risk factors unprotected anal intercourse; (4) the waves of balance and balance can be used to measure the RDS week balance recruitment; effective RDS recruitment analysis shows that RDS is an effective method for the recruitment of MSM people.
Conclusion: (1) HIV MSM group in Nanjing City, syphilis infection rate is higher, the situation is not optimistic, we need to strengthen the propaganda and intervention of the MSM population, strengthen the inspection of the MSM population, promote positive infection, source of infection, slowing the spread of HIV trend; (2) through the recruitment of RDS the sample analysis, we can find that the RDS MSM is recruiting hidden people, effective way to obtain representative samples.

【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R512.91;R181.3

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