[男男性行为青年人群队列中的梅毒发病率及其危险因素]
[Syphilis incidence and its risk factors in a cohort of young men who have sex with men].
作者信息
Dong Zhenxin, Xu Jie, Zhang Hongbo, Dou Zhi, Mi Guodong, Wu Zunyou, Ruan Yuhua, Shen Limei, Min Xiangdong, Lan Guanghua, Li Fan, Li Tian, Ning Zhen, Wu Guohui, She Min
机构信息
School of Public Health, Anhui Medical University, Hefei 230032, China.
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出版信息
Zhonghua Yu Fang Yi Xue Za Zhi. 2014 Mar;48(3):186-91.
OBJECTIVES
To investigate the incidence of syphilis infection and to determine the risk factors related to syphilis infection among young men who had sex with men (YMSM), which were documented for developing effective intervention to prevent sexually transmitted diseases among YMSM.
METHODS
A cohort study was conducted in 8 cities (Beijing, Shanghai, Kunming,Guiyang, Chongqing, Chengdu, Urumqi and Nanning) from May to December, 2009. A total of 1 037 syphilis-negative YMSM aged 18-25 were enrolled in the cohort and the two follow-up surveys were carried out every six months. The contents of study included sociodemographic characteristics, HIV-related knowledge, sexual behavior and condom use in the 6 months prior to survey. All participants were tested for syphilis with whole blood specimens. Chi-square test was used to compare demographic characteristics of participants in baseline with those of two follow-up, and Cox regression analysis was used to identify risk factors associated with syphilis infection.
RESULTS
The rates of participants in 6, 12 months follow-up surveys was 79.85% (828/1 037) and 82.16% (852/1 037) respectively.39 syphilis seroconversions were found in the 12 months follow-up survey. Cumulative observed person-years during follow-up time was 1 106.67. The syphilis incidence rate was 3.5%. The Multivariate Cox regression analysis showed that the education of senior high school (senior high school vs some college or higher, RR = 2.19, 95% CI:1.21-3.98), bisexual orientation (bisexual orientation vs homosexual orientation, RR = 2.19, 95% CI:1.21-3.97), score of HIV/AIDS knowledge <8 (score of HIV/AIDS knowledge <8 vs knowledge = 8, RR = 2.39, 95%CI:1.35-4.21), had two and more sexual partners and inconsistent condom use in the past 6 months (inconsistent condom use vs consistent condom use, RR = 3.10, 95% CI:1.39-6.91) were significantly associated with syphilis seroconversion in the 12-month period.
CONCLUSIONS
The syphilis incidence was high and risk behaviors were common among YMSM of China.
目的
调查男男性行为者（YMSM）中梅毒感染的发生率，并确定与梅毒感染相关的危险因素，为制定有效的干预措施以预防YMSM中的性传播疾病提供依据。
方法
2009年5月至12月在8个城市（北京、上海、昆明、贵阳、重庆、成都、乌鲁木齐和南宁）进行了一项队列研究。共有1037名年龄在18 - 25岁的梅毒阴性YMSM纳入队列，并每6个月进行两次随访调查。研究内容包括社会人口学特征、艾滋病相关知识、性行为以及调查前6个月内的避孕套使用情况。所有参与者均采集全血标本检测梅毒。采用卡方检验比较基线时参与者与两次随访时的人口学特征，采用Cox回归分析确定与梅毒感染相关的危险因素。
结果
6个月和12个月随访调查的参与者比例分别为79.85%（828/1037）和82.16%（852/1037）。在12个月的随访调查中发现39例梅毒血清学转换。随访期间累计观察人年数为1106.67。梅毒发病率为3.5%。多因素Cox回归分析显示，高中文化程度（高中文化程度vs大专及以上文化程度，RR = 2.19，95%CI：1.21 - 3.98）、双性恋取向（双性恋取向vs同性恋取向，RR = 2.19，95%CI：1.21 - 3.97）、艾滋病知识得分<8分（艾滋病知识得分<8分vs知识得分=8分，RR = 2.39，95%CI：1.35 - 4.21）、在过去6个月内有两个及以上性伴侣且避孕套使用不一致（避孕套使用不一致vs避孕套使用一致，RR = 3.10，95%CI：1.39 - 6.91）与12个月内梅毒血清学转换显著相关。
结论
中国YMSM中梅毒发病率较高且高危行为普遍。
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