广州市男男性行为人群 STD／HIV 相关高危行为特征及就诊延误影响因素调查分析

摘要

Objective:To explore the characteristics of STD/HIV-related high-risk behaviors and the influencing factors of health-seeking delay among MSM in Guangzhou , and to provide evi-dence for developing targeted prevention and control measures .Methods:A face-to-face question-naire and HIV and syphilis antibody tests were conducted among MSM attenders in the VCT and STD clinics in Guangzhou from October 2014 to September 2015 .Enrollment criteria were those who showed suspicious STD/HIV related symptoms and had sex with men in the last two years . Results:Among 313 participants surveyed ,38.02% had sex with a female partner in the past 2 years.40.89%maintained a fixed male partner .The proportion who used condom for each anal sex was 47.04%.80.51%delayed to seek a health-care clinic , with the average of first treatment interval being 30 days.The influencing factors of health-seeking delay included occupation ,atti-tude toward homosexuality , heterosexual sex in the past two years , infection of STDs except syphi-lis, frequency of clinic visit , and have no sex .The infection rate of HIV and active syphilis were 20.77%and 6.39%respectively and the co-infection rate was 4.79%.Those with health-seeking delay had a higher rate of HIV and active syphilis infection and the statistic difference was signifi -cant.Conclusion:The HIV infection rate remains high among MSM in Guangzhou .High-risk be-haviors are common.Target intervention program to increase the access to quality medical services should be implemented .%目的：了解广州市男男性行为（ MSM ）人群 STD／HIV 相关高危行为特征和就诊延误影响因素，为制定有针对性的防控措施提供依据。方法：2014年10月至2015年9月期间，对参加STD／HIV自愿咨询检测且已经出现疑似STD／HIV感染相关症状、近2年内发生过同性性行为的MSM进行面对面问卷调查，采集静脉血检测HIV和梅毒。结果：共调查313名MSM，38.02％近2年内与异性发生过性行为，40.89％拥有固定的同性性伴，肛交性行为中每次都使用安全套的比例为47.04％。本次病程中80.51％发生就诊延误，首次就诊间隔时间平均为30天，影响就诊延误的因素主要包括职业、对同性恋的态度、近2年是否发生异性性行为、是否曾患其它非梅毒性病、就诊频次、是否暂停性生活。血清学监测结果HIV感染率为20.77％，现症梅毒感染率为6.39％，同时感染HIV和梅毒的比例为4.79％，就诊延误发生者的HIV感染率和梅毒感染率均高于未发生就诊延误者，差异有统计学意义（ P值均＜0.05）。结论：广州市MSM人群HIV感染率高，高危行为普遍存在，就诊延误发生率高，防控形势严峻，应加大宣传教育、提高医疗服务可及性和服务质量以减少就诊延误的发生。