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[2004 - 2015年重庆市男男性行为人群HIV感染空间聚集性分析]

[Analysis of Spatial Clustering of HIV infected in men who have sex with men in Chongqing of 2004-2015].

作者信息

Hao Y X, Qin Q Q, Wu G H, Zhang W, Guo W, Cui Y, Liu H, Hu Y Y, Sun J P

机构信息

National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2017 May 6;51(5):432-437. doi: 10.3760/cma.j.issn.0253-9624.2017.05.012.

Abstract

UNLABELLED

To analyze the spatial clustering characteristics of HIV/AIDS among men who have sex with men (MSM) in Chongqing from January 2004 to December 2015 and understand the HIV/AIDS related behaviors among MSM by interview. Data related to MSM who were infected with HIV and whose present address were in Chongqing, were collected from Information System on the HIV/AIDS Prevention and Control. Information included the age when the information was inputted, address, occupation, education level, and marital status. The total number of MSM who were infected with HIV and reported was 6 604 in Chongqing. Those with unknown address were ruled out. The spatial autocorrelation analysis and the local spatial autocorrelation analysis were carried out by using ArcGIS 10.3. In addition, in November 2015 and May 2016, using a convenience sampling, we conducted one-on-one interviews among 23 MSM in the Chongqing Center for Disease Control and prevention.

INCLUSION CRITERIA

Receiving voluntary counseling and testing in the urban area of Chongqing and willing to participate in the interview by oral informed consent; male and self-described as MSM. The content of the interview included basic information, sexual orientation, sexual role, the main place of making friends, the main place of sexual behavior, a long-term experience in other provinces and drug abuse. The HIV/AIDS reported number in Chongqing from 2004 to 2015 showed an uptrend, except in 2010. The age distribution of 6 604 cases of HIV positive patients was mainly concentrated in the 15-34 years old, about 68.5% (4 522 cases). There was a positive spatial autocorrelation in MSM, except 2005 (Moran's I0.046, P0.823), form 2004 to 2015, Global Moran's values were 0.308, 0.254, 0.335, 0.683, 0.673, 0.558, 0.620, 0.673, 0.685, 0.654 and 0.649, respectively; all values were <0.01. The result of local spatial autocorrelation analysis showed that high-high accumulation area development in Chongqing city was divided into two stages in 2004-2015, which were Yuzhong, Jiangbei, and Shapingba district in 2004-2007 and the expanded Jiulongpo, Nan'an, and Yubei district in 2008-2015. Qualitative interviews results revealed that the age of the respondents was 20-44, and the mainly way of making friends were using mobile phone App and internet (17 participants). Most of the participants (11 participants) were making friends in the bar. The majority of respondents would ask the friends or themselves to use condoms when meeting with them the first time (19 participants), and 8 of respondents reported that they would not use condoms when their old friends refused to use condoms. The HIV infected MSM mainly aged between 15-34 years old and the spatial distribution of HIV/AIDS among MSM was clustered in economically developed main area in Chongqing. MSM began to make friends on the Internet, and could not adhere to using condom, which indicated that we should focus on internet intervention to find more efficacious interventions.

摘要

未标注

分析2004年1月至2015年12月重庆市男男性行为者(MSM)中艾滋病病毒/艾滋病(HIV/AIDS)的空间聚集特征,并通过访谈了解MSM中与HIV/AIDS相关的行为。从HIV/AIDS预防控制信息系统收集了现住址在重庆且感染HIV的MSM的数据。信息包括录入信息时的年龄、地址、职业、文化程度和婚姻状况。重庆报告的感染HIV的MSM总数为6604例。排除地址不详者。使用ArcGIS 10.3进行空间自相关分析和局部空间自相关分析。此外,在2015年11月和2016年5月,我们采用便利抽样方法,对重庆市疾病预防控制中心的23名MSM进行了一对一访谈。

纳入标准

在重庆市城区接受自愿咨询检测并通过口头知情同意愿意参加访谈;男性且自我描述为MSM。访谈内容包括基本信息、性取向、性角色、主要交友场所、主要性行为场所、在其他省份的长期经历和药物滥用情况。2004年至2015年重庆报告的HIV/AIDS病例数呈上升趋势,但2010年除外。6604例HIV阳性患者的年龄分布主要集中在15 - 34岁,约占68.5%(4522例)。2004年至2015年,MSM中存在正空间自相关,2005年除外(莫兰指数I为0.046,P为0.823),各年全局莫兰指数值分别为0.308、0.254、0.335、0.683、0.673、0.558、0.620、0.673、0.685、0.654和0.649;所有P值均<0.01。局部空间自相关分析结果显示,2004 - 2015年重庆市高 - 高聚集区发展分为两个阶段,2004 - 2007年为渝中半岛、江北区和沙坪坝区,2008 - 2015年为扩展后的九龙坡区、南岸区和渝北区。定性访谈结果显示,受访者年龄为20 - 44岁,主要交友方式是使用手机应用程序和互联网(17名参与者)。大多数参与者(11名参与者)在酒吧交友。大多数受访者(19名参与者)在初次见面时会要求朋友或自己使用避孕套,8名受访者报告说当老朋友拒绝使用避孕套时他们也不会使用。感染HIV的MSM主要年龄在15 - 34岁,MSM中HIV/AIDS的空间分布聚集在重庆经济发达的主城区。MSM开始通过互联网交友且不能坚持使用避孕套,这表明应重点进行互联网干预以找到更有效的干预措施。

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