中国男性性传播疾病门诊就诊者的 HIV/性传播疾病模式及其相关危险因素：HIV 干预的重点。
HIV/STD pattern and its associated risk factors among male STD clinic attendees in China: a foci for HIV intervention.
机构信息
National Center for STD Control and Prevention, China Centers for Diseases Control and Prevention, Nanjing 210042, China.
出版信息
BMC Public Health. 2011 Dec 26;11:955. doi: 10.1186/1471-2458-11-955.
BACKGROUND
Previous studies suggested a high prevalence of STDs including HIV among female sex workers and men who have sex with men in China, but little was known about the prevalence in male patients attending public STD clinics. The aim of this study was to investigate STD patterns and HIV prevalence among male STD clinic attendees in different areas in China and the associated risk factors. The feasibility of Provider-initiated HIV testing and counseling (PITC) was evaluated as well.
METHODS
A cross-sectional study was conducted at 46 public STD clinics in 4 provinces in China. Between July 2009 and September 2009, a total of 3243 eligible subjects were invited to participate in an interview with a structured-questionnaire for collecting socio-demographic characteristics and sexual behavioral information. They also were asked to provide venous blood samples for serological determinations of HIV and syphilis infection, and first void urine specimens for detecting Chlamydia trachomatis and Neisseria gonorrhoeae infections,
RESULTS
Out of the 3243 eligible patients, 2951(91%) men agreed to take part in the HIV and syphilis testing. The overall prevalence rate of HIV infection was 0.7% while the rates of syphilis, N. gonorrhoeae, C. trachomatis infections were 10.7%, 4.3% and 6.9%, respectively, with the highest syphilis and N. gonorrhoeae rates in Jiangsu Province. Patients from Guangxi province, homosexual/bisexual practices and intravenous drug use were significantly associated with HIV infection in multivariate logistic regression analyses. Provider-initiated HIV testing and counseling (PITC) was well accepted by attendees, with 91% of eligible attendees agreeing to undergo HIV testing and counseling. All HIV positive patients were properly managed accordingly.
CONCLUSIONS
A modest prevalence of HIV infection and substantial prevalence of other STD infections were found among male patients attending public STD clinics in China. The findings further support the introduction of HIV and syphilis PITC strategy into this important setting.
背景
先前的研究表明，在中国，性工作者和男男性行为者中包括 HIV 在内的性传播疾病（STD）的流行率很高，但对于在公立 STD 诊所就诊的男性患者中的流行率却知之甚少。本研究旨在调查中国不同地区男性 STD 诊所就诊者的 STD 模式和 HIV 流行率，以及相关的危险因素。同时评估了医生主动提供 HIV 检测和咨询（PITC）的可行性。
方法
这是一项在中国 4 个省的 46 家公立 STD 诊所进行的横断面研究。在 2009 年 7 月至 9 月期间，共有 3243 名符合条件的受试者受邀参加了一项包含社会人口学特征和性行为信息的结构化问卷访谈。他们还被要求提供静脉血样进行 HIV 和梅毒感染的血清学检测，以及首次尿样进行沙眼衣原体和淋病奈瑟菌感染的检测。
结果
在 3243 名符合条件的患者中，有 2951 名（91%）男性同意接受 HIV 和梅毒检测。HIV 感染的总流行率为 0.7%，而梅毒、淋病奈瑟菌、沙眼衣原体的感染率分别为 10.7%、4.3%和 6.9%，其中江苏省的梅毒和淋病奈瑟菌感染率最高。多因素 logistic 回归分析显示，广西省患者、同性恋/双性恋行为和静脉吸毒与 HIV 感染显著相关。医生主动提供 HIV 检测和咨询（PITC）受到就诊者的广泛接受，91%的合格就诊者同意接受 HIV 检测和咨询。所有 HIV 阳性患者均得到妥善管理。
结论
在中国公立 STD 诊所就诊的男性患者中，HIV 感染的流行率较低，而其他 STD 感染的流行率较高。这些发现进一步支持在这一重要场所引入 HIV 和梅毒 PITC 策略。
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