| Men who have sex with men (MSM) mainly consist of male homosexual, malebisexual, male transgender, maleheterosexual et al. Along with the social development and the cultural pluralism, MSM are more and more active. The age of the first experience of sex becomes younger, and the manners of sex are more diversified and often accompanied with unsafe sexual behavior. Men who have sex with mem(MSM) is one of the high-risk groups of infection and spread of syphilis and HIV/ADIS. Syphilis has become one of a major health problem of China’s MSM population. Benzathine penicillin treatment of syphilis infection among MSM follow-up compliance is poor, a higher rate of treatment failure and serum fixed incidence, difficult to effectively control the spread of syphilis in this population. Therefore, investigating the impact of factors affect MSM syphilis infection and find more effective treatment for the syphilis meaningful, targeted intervention and effective treatment to reduce the spread of the syphilis.Objectives:In order to understand of high-risk behavior factors among MSM syphilis infection, and syphilis infection status, analysis of the relationship between syphilis infection and high-risk sexual behavior of MSM; and supply different treatment options treatment for syphilis patients of MSM and develop follow-up observation; explore the MSM syphilis infection and syphilis treatment programs to provide targeted behavioral interventions for MSM populations, and to provide more effective treatment options for MSM syphilis patients.Methods:This study takes the Affiliated Hospital of Medcal college Qingdao University sexually transmitted disease clinics (sexual health center, the national sentinel detection units, Shandong Province VCT testing clinic) as study site. Recruit survey by of the way respondent-driven sampling method, relying on the MSM working group, key insider, online recruitment, gay bars to. Using face-to-face questionnaires and serological testing to collect survey of general demographic characteristics, behavioral characteristics, partner characteristics and syphilis infection status. MSM syphilis, using descriptive statistical analysis of general demographic characteristics; chi-square test and multivariate unconditional logistic regression analysis among MSM syphilis infection. And syphilis in patients with different treatment methods, treatment, follow-up observation, the chi-square test was used to compare different treatment program.Results:The survey for the1276MSM, maximum age52years, the minimum age is17years old, average age (27.7±6.4) years of age. Unmarried persons was87.1%(1111/1276), married or cohabiting and11.5%(147/1276), divorced or hurt even by1.4%(18/1276). Han Chinese98.4%(1256/1276), a minority of1.6%(20/1276). Primary and below2.0%(25/1276), secondary or technical secondary school and53.8%(687/1276), college and above,44.2%(564/1276). Nearly three months of sexual partners to get to know the ways:network accounted for61.8%(789/1276), gay venues (public toilets, baths, bars, parks, etc.) accounted for16.7%(213/1276), people who know or was introduced to account for15.2%(194/1276), other means of6.3%(80/1276). Syphilis (TPP positive of RPR titer of1:4or more) of171cases (6cases with HIV infection), the syphilis rate was13.4%(171/1276).Among MSM syphilis infection-related factors and the main role as "0", the last three months have anal sex, nearly three months of sexual intercourse for the full use of condoms, number of sexual partners10, the last six months related to sexually transmitted diseases symptomsfactors related to new drugs such as methamphetamine.MSMs infected with early syphilis were randomly divided into three treatment groups:monotherapy of benzathine penicillin(Group A), monotherapy of ceftriaxone sodium(Group B), combined therapy of benzathine penicillin and ceftriaxone sodium(Group B) for efficacy comparison. The results showed that:Group A, B, and C, primary syphilis all have a subsided syphilis lesions a week after treatment. secondary syphilis skin lesions subsided, group A or group B, ie, a monotherapy group was41.51%, group C was76.00%in the combined treatment group. By the chi-square test(χ2=8.104, P=0.007), Single treatment group and combined treatment group difference was statistically significant(P<0.05), combined therapy group of secondary syphilis skin lesions subsided fast. RPR negative conversion rate after3months’treatment, the monotherapy group16.19%((17/105), the combined treatment group RPR negative rate of33.96%(18/53), by the χ2test(χ2=6.451, P=0.015), the difference between the two groups was statistically significant (P<0.05). RPR negative conversion rate after June, a separate The drug group was41.90%(44/105), the combined treatment group was62.26%(33/53), χ2test (χ2=5.844, P=0.019), the difference between the two groups was statistically significant (P<0.05).Conclusions:The main source of this survey among MSM sex partners for the network and the gay places (parks, baths, bars, etc.); the syphilis infection rate as high as13.4%, HIV infection rate was2.43%, HIV and syphilis combined infection rate of0.78%; The study results show that the main role as "0and1almost" men in the past three months with the number10have an STD-related symptoms in the last couple of years, taking the new drugs, nearly three months to buy sexual activity, nearly three months to sell sex, the last three months have anal sex acts, nearly three months to have sexual relations with men not use condoms, the age of30years of age, academic qualifications for primary school and other factors associated with syphilis infection; The crowd of syphilis treatment with benzathine penicillin alone is superior to the effect of benzathine penicillin combined with ceftriaxone sodium or ceftriaxone alone, early diagnosis and early cure is more conducive to effective prevention and control of the populations and their society as a whole syphilis/HIV/AIDS. Further increase the sample size needed to extend the observation time to determine the short-term and long-term efficacy of the treatment. |
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