目的分析2012—2019年深圳队列调查研究的男男性行为者(men who have sex with men,MSM)梅毒感染情况,为降低本地区该人群梅毒感染率开展有效的干预措施提供数据参考。方法以2012—2019年深圳MSM不同队列调查研究如时空场所抽样(time-location sampling,TLS)、同伴推动抽样(respondent driven sampling,RDS)、自愿咨询检测门诊抽样(voluntary counseling and testing,VCT)、跨境人群调查、阴性人群随访等研究对象,采集静脉血进行梅毒抗体筛查检测。使用χ2检验和二分类logistic回归对MSM的梅毒感染率进行单因素和多因素统计学分析。结果2012—2019年共检测MSM 20358例,平均年龄(28.99±7.94)岁,梅毒抗体总检出阳性率为13.4%。2012年MSM梅毒的感染率最高为19.3%,其后逐年呈先下降后上升趋势,各年份之间的梅毒感染率差异有统计学意义(χ2趋势=119.05,P<0.001)。≥50岁的MSM人群梅毒感染率为最高(33.6%),<20岁的为最低(7.8%),而30~岁、40~岁、≥50岁各年龄段和<20岁的梅毒感染率有显著性差异(P值均<0.001)。跨境人群调查MSM的梅毒感染率为最高(21.4%);阴性人群随访、RDS和VCT的感染率较高,分别为15.4%、14.2%和14.1%;TLS的感染率为最低(11.6%)。VCT的感染率是TLS的1.240倍(P值<0.001),RDS、阴性人群随访和跨境人群调查感染率分别是TLS的1.158,1.209,2.023倍(P值均<0.05)。在TLS人群中,有商业性行为的感染率(5.0%)低于无商业性行为的(18.3%)(χ2=347.73,P<0.001)。结论2012—2019年深圳市MSM人群梅毒感染率呈逐年下降趋势,TLS调查的梅毒感染率较低,>40岁组阳性病例占比上升明显,应重点关注>40岁MSM人群的梅毒防控。
Objectives: To monitor the prevalence and riskfactors of HIV in high-risk populations, to provide ascientific basis for policy-makers to evaluate theeffectiveness of HIV prevention, and to formulate stra-tegic measures for prevention and treatment.Methods: From 1997 to 2002, 3 110 incarceratedcommercial sex workers (CSWs) and 4 748 outpatientsof a sexually-transmitted disease (STD) departmentunderwent HIV antibody testing in Shenzhen. HIVantibody screening of samples was made by enzymelinked immunosorbent assay (ELISA).Results: Among the outpatients, the proportiondiagnosed with an STD were 71.5%, 70%, 87.5%,87.3%, 85.2%, 82.2%, respectively, in the years from1997 to 2002. The predominant STDs presented weresyphilis, non-gonococcal urethritis (NGU) and condy-loma acuminata (CA). One out-patient was found to beHIV-positive in 2001 and another in 2002, with a preva-lence of 0.25 % (1/400). During the same period, theproportion of CSW who reported always using a con-dom were 45.9%, 49.8%, 40.8%, 57.9%, 44.9%,and 58.2%. 13.4% of CSW were drug users, amongwhom 9.3% used injection drugs and 3.2% reportedsharing syringes with others. One CSW was found tobe HIV-positive in the first survey in 1998 with a preva-lence of 0.4 % (1/250). In 2002, two CSW tested posi-tive in the first semiannual study with a prevalence of0.65% (2/307), and one case in the second study, witha prevalence of 0.48% (1/210).Conclusion: The result of this surveillance indicatethat HIV is prevalent among these high-risk popula-tions of commercial sex workers and STD outpatients.
