Prevalence and influencing factors of Chlamydia trachomatis, Neisseria gonorrhoeae and Treponema pallidum infection among men who have sex with men in Yunnan province, 2020: a cross-sectional survey
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摘要:
目的 了解云南省男男性行为人群(MSM)沙眼衣原体(CT)、淋球菌(NG)和梅毒感染现状,探索云南省MSM人群CT、NG和梅毒感染的影响因素,为制定性传播感染防治策略提供依据。 方法 2020年1 — 12月,通过滚雪球抽样在云南省14个州(市)招募男男性行为者,共招募1298名MSM。采集尿液、咽拭子和直肠拭子以及血液标本进行CT/NG核酸扩增检测和梅毒检测。使用logistic回归模型分析CT、NG和梅毒感染影响因素。 结果 1298名MSM调查者中,CT、NG、梅毒的感染率分别为9.9 %、3.1 %、3.2 %。直肠拭子CT的阳性率最高(6.0 %,61/1023),咽拭子NG的阳性率最高(1.8 %,22/1190)。多因素分析结果显示,滇中地区(OR = 4.217,95 % CI = 1.611~11.04)和滇西北地区(OR = 3.521,95 % CI = 1.357~9.136)、初中及以下文化程度(OR = 2.333,95 % CI = 1.427~3.813)的MSM感染CT的风险更高,初中及以下文化程度(OR = 2.935,95 % CI =1.265~6.812)、通过互联网/交友软件寻找性伴(OR = 2.64,95 % CI = 1.019~6.836)的MSM感染NG的风险更高,最近1年有性病史(OR = 43.983,95 % CI = 19.31~100.182)的MSM感染梅毒的风险更高。 结论 云南省MSM人群CT、NG和梅毒感染率处于较高水平,应加强对MSM人群的综合干预,建议对存在高危性行为的MSM进行CT、NG和梅毒筛查。 Abstract:Objective To investigate the prevalence and influencing factors of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Treponema pallidum (TP) infection among men who have sex with men (MSM) in Yunnan province for providing evidence to develop strategies on sexually transmitted infection prevention and control. Methods Totally 1 400 MSM aged 15 – 65 years and with insertive oral or anal sex during past one year were recruited with snowball sampling in 14 prefectures/cities of Yunnan province in 2020. Face-to-face questionnaire interview, sampling of b1ood, urine, and pharyngeal/rectal swab specimens for tests of CT, NG and TP infection were carried out among the MSM. Logistic regression model was adopted in analyses on influencing factors of the infections. Results Among the 1 298 MSM with valid information, the detection rates were 9.9% (number of positive cases: 129), 3.1% (40) and 3.2% (42) for CT, NG and TP infection, respectively, with the highest positive rate (6.0%, 61/1 023) of CT infection for rectal swab specimens and that (1.8%, 22/1 190) of NG infection for pharyngeal swab specimens. The results of multivariate logistic regression analysis showed that the MSM living in central region (odds ratio [OR] = 4.217, 95% confidence interval [95% CI]:1.611 – 11.04) or northwestern region (OR = 3.521, 95% CI: 1.357 – 9.136) compared to living in northeastern of the province and the MSM with the education of junior high school and below (versus college and above: OR = 2.333, 95% CI: 1.427 – 3.813) were more likely to have CT infection; the results also revealed that with the education of junior high school and below (versus college and above: OR = 2.935, 95% CI: 1.265 – 6.812) and seeking sexual partners via internet/dating applications (versus through other routes: OR = 2.64, 95% CI: 1.019 – 6.836) were risk factors for NG infection, and suffering from sexually transmitted diseases in past one year was a risk factor (OR = 43.983, 95% CI: 19.31 – 100.182) for TP infection. Conclusion Among MSM in Yunnan province, the prevalence of CT, NG and TP infection were relatively high, suggesting that comprehensive intervention measures, including screening on the infections among high-risk individuals, should be strengthened in the MSM. 1) (张肖为本文并列第一作者) -
表 1 云南省男男性行为者CT、NG和梅毒感染情况(%)
检测项目 检测数 阳性数 感染率(%) χ2 值 P 值 CT 1298 129 9.9 53.964 < 0.001 咽拭子 1190 7 0.6 尿液 1288 70 5.4 直肠拭子 1023 61 6.0 NG 1298 40 3.1 8.151 0.017 尿液 1288 8 0.6 直肠拭子 1023 17 1.7 咽拭子 1190 22 1.8 梅毒 1298 42 3.2 CT、NG合并感染 1298 10 0.8 CT、梅毒合并感染 1298 3 0.2 表 2 云南省男男性行为者CT、NG和梅毒感染的多因素logistic回归分析
因素 合计 阳性数 感染率(%) P 值 OR 值 95 % CI CT 地区a 0.007 滇东北 150 5 3.3 1.000 滇东南 200 15 7.5 0.250 1.848 0.649~5.267 滇西南 251 21 8.4 0.103 2.303 0.844~6.281 滇西北 391 49 12.5 0.010 3.521 1.357~9.136 滇中 306 39 12.7 0.003 4.217 1.611~11.04 文化程度 0.003 大专及以上 451 30 6.7 1.000 高中或中专 417 39 9.4 0.091 1.554 0.931~2.594 初中及以下 430 60 14.0 0.001 2.333 1.427~3.813 最近6个月,是否与同性发生过肛交性行为 0.756 是 1180 110 9.3 1.000 否 118 19 16.1 1.095 0.618~1.941 最近6个月,是否与异性发生性行为 0.193 否 1159 108 9.3 1.000 是 139 21 15.1 1.424 0.836~2.426 NG 文化程度 0.042 大专及以上 451 8 1.8 1.000 高中或中专 417 13 3.1 0.136 1.978 0.807~4.845 初中及以下 430 19 4.4 0.012 2.935 1.265~6.812 寻找性伴的主要方式 其他场所 316 5 1.6 1.000 互联网/交友软件 982 35 3.6 0.046 2.640 1.019~6.836 梅毒 地区 a 0.046 滇东北 150 1 0.7 1.000 滇西南 251 6 2.4 0.668 1.622 0.178~14.809 滇西北 391 12 3.1 0.402 2.444 0.302~19.783 滇中 306 10 3.3 0.411 2.43 0.293~20.169 滇东南 200 13 6.5 0.073 6.786 0.833~55.241 民族 0.333 汉族 937 24 2.6 1.000 少数民族 361 18 5.0 1.429 0.694~2.943 最近1年是否被诊断患过性病 < 0.001 否 1263 26 2.1 1.000 是 35 16 45.7 43.983 19.31~100.182 注:a 滇东北:昭通市、曲靖市;滇西北:大理州、丽江市、保山市、德宏州;滇东南:红河州、文山州;滇中:昆明市、玉溪市、楚雄州;滇西南:临沧市、普洱市、西双版纳州。 -
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