| Objectives1.To understand the demographic characteristics of male patients in STD clinics in Shandong Province,the awareness of AIDS knowledge,characteristics of high-risk sexual behaviors and related services such as AIDS.2.To analyze of HIV and syphilis infection and related factors of infection in male patients in STD clinics in Shandong Province;3.To explore the trends of high-risk sexual behavior and HIV syphilis infection among male patients in STD clinics in Shandong Province,and provide reference for AIDS and syphilis prevention and control.MethodsAccording to the syphilis and HIV epidemic intensity and epidemic situation in different areas of Shandong Province,a medical institution STD clinic was selected as a survey point in 17 cities across the province.During the survey period(July-November every year),men who came to STD clinics for the first time(whether or not they were diagnosed with sexually transmitted diseases)and were aged 15 years and older were included in the survey with consecutive sampling methods.Questionnaires and serological tests were performed on male patients who were included in the survey.The HIV test used a serum enzyme-linked immunosorbent assay for primary screening,and those who are positive for screening continued to perform immunoblotting tests to confirm that those who are positive for both tests are judged to be HIV-infected.In the syphilis test,the serum enzyme-linked immunosorbent assay was used for the primary screening,and the positive screening test was continued with the to luidine red unheated serum test for retesting.If both tests were positive,the syphilis infection was determined.The data analysis mainly adopted four methods:descriptive analysis,χ2 test,multi-factor logistic regression analysis and χ2 trend test.The descriptive analysis was mainly to describe the composition ratio(%)of the general demographic characteristics,high-risk sexual behavior characteristics,and HIV-related services of male patients in STD clinics.The variables included in the multivariate analysis were the variables with statistically significant differences in the results of the single factor analysis.The method used was a two-class logistic regression,and the method of inclusion was forward stepwise,and the test level was a=0.05.Results1.In 2015,a total of 6070 male patients were surveyed for STD clinics.The samples were mainly from general hospitals,accounting for 58.4%(3542/6070).The average age was 36.7±12.5 years old,mainly in the 21-30 age group,accounting for 36.1%(2194/6070);Marriage was predominantly married,accounting for 75.0%(4553/6070);The locality of the household registration was mainly in Shandong Province,accounting for 97.1%(5890/6067);The ethnic group was dominated by the Han nationality,accounting for 99.0%(6009/6070);The awareness of AIDS knowledge was mostly known,accounting for 82.1%(4986/6070).HIV antibody positive rate was 0.5%(33/6070);The positive rate of syphilis antibody was 6.1%(371/6070);The positive rate of hepatitis C antibody was 0.2%(12/6070).2.In the past three months,38.4%(2314/6030)of male patients had commercial sex,of which 96.2%(2162/2247)male patients had sexual intercourse with ≤ 2 females(dark sputum);29.7%(1789/6031)of male patients had sex with temporary partners,95.7%(1679/1754)of male patients had sexual intercourse with<2 temporary partners;2.5%(151/6044)of male patients had anal sex with the same sex.In the recent year,21.0%(1269/6056)of male patients have been diagnosed with STDs;0.5%(30/6062)of male patients have been injected with drugs;31.2%(1896/6069)of male patients have received condom promotion and distribution/AIDS counseling and testingservices;0.9%(53/6068)of male patients have received community drug maintenance/cleaning needle supply/exchange services;5.8%(354/6067)of male patients have received peer education services;12.5%(760/6070)of male patients have received HIV testing services(except this time).3.Single factor analysis showed that factors associated with HIV infection included unmarried(χ2= 15.460,P<0.001),and anal sex behavior with the same sex in the last six months(χ2=327.280,P<0.001),accepted in the recent year HIV testing service(except this time)(χ2=21.877,P<0.001).Factors associated with syphilis infection included unmarried(χ2=15.959,P<0.001),AIDS knowledge(χ2=18.500,P<0.001),and temporary sexual behavior in the last three months(χ2=16.508,P<0.001),anal sex has occurred with the same sex in the past six months(χ2=26.041,P<0.001),and diagnosed with sexually transmitted diseases the latest year(χ2=175.422,P<0.001).4.Multivariate analysis showed that HIV-infected male patients were more likely to be unmarried(OR=0.447,95%CI:0.216-0.923)and had same-sex anal sex behavior(OR=38.115,95%CI:18.457-78.708)compared with males who were not infected with HIV..Compared with male patients who were not infected with syphilis,male patients infected with syphilis were more likely to be unmarried(OR=0.662,95%CI:0.525-0.834)and foreign household registration(OR=2.032,95%CI:1.248-3.310),unknown of AIDS knowledge(OR=0.552,95%Cl:0.431-0.708),diagnosed with STD(OR=3.942,95%CI:3.172-4.898),and infected with HIV(OR=3.985,95%CI:1.714-9.262).5.2011-2015,the resource subjects from the outpatient clinic of STD(X2 trend＝32.755,P<0.001),≥ 41 years old(X2 trend = 63.679,P<0.001),married(X2 trend = 36.618,P<0.001)The proportion of male patients in the province(X2 trend = 62.223,P<0.001)and Han nationality(X2 trend = 34.730,P<0.001)in the calendar year was on the rise;The awareness rate of AIDS knowledge(X2 trend=106.589,P<0.001),HIV infection rate(X2 trend=38.930,P<0.001)showed an upward trend,and the HCV infection rate showed a downward trend(X2 trend=7.444,P=0.006).);The infection rates of syphilis in 2011-2015 were 5.5%(367/6619),6.3%(415/6610),4.9%(324/6634),6.8%(421/6163),and 6.1%(371/6070),respectively.The difference was not considered statistically significant(X2 trend = 3.144,P = 0.076).6.In 2011-2015,the incidence of sexual behavior in male patients with>2 ladies(dark sputum)decreased in three months(X2 trend = 163.152,P<0.001);The incidence of sexual behavior with temporary partners was decreased in three months(X2 trend = 50.931,P<0.001);The proportion of male patients who had been injected with drugs showed a downward trend(X2trend=7.536,P=0.006);The incidence of same-sex anal sex behavior decreased within six months(X2trend= 18.956,P<0.001);The proportion of male patients diagnosed with STD within one year was on the rise(χ2 trend = 19.796,P<0.001);The proportion of male patients who received condom promotion and HIV/AIDS counseling and testing services during the year was on the rise(χ2 trend = 32.866,P<0.001);The proportion of male patients who received community drug maintenance treatment/clean needle supply/exchange services within one year showed a downward trend(χ2 trend=13.991,P<0.001);The proportion of male patients who had received HIV testing services within one year showed an upward trend(χ2trend = 9.733,P = 0.002).Conclusions1.Male sexually transmitted outpatients in Shandong Province are mainly young and married;high-risk sexual behaviors are mainly commercial sexual behaviors and temporary sexual behaviors.2.The HIV and syphilis infection rates of male patients in STD clinics in Shandong Province are all at low levels.Unmarried,same-sex anal sex are risk factors for HIV infection.Unmarried,foreign resident registration,AIDS knowledge,diagnosis of sexually transmitted diseases,and HIV infection are risk factors for syphilis infection.3.The HIV infection rate of male patients in STD clinics in Shandong Province has been increasing over the years,and the trend of syphilis infection rate is not obvious. |
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