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Study On Epidemic Trends Of HIV Incidence And Its Risk Factors Among Men Who Have Sex With Men In Chongqing

Posted on:2012-08-02Degree:MasterType:Thesis
Country:ChinaCandidate:R R LuFull Text:PDF
GTID:2404330488995292Subject:Health statistics
Abstract/Summary:PDF Full Text Request
Men who have sex with men(MSM)belongs to the highest risk group in the course of HIV infection by sex activities,which is related to the behavior and the extent of sex.The proportion of being infected by HIV through the way of homosexual activity is increased each year.Despite the researches about the behavior and infection condition have been reported,the work for evaluation of the incidence of HIV and the effect of prevention and treatment of AIDS in Chongqing is still absent.We will discuss the above questions in the following.Objectives:To understand the population characteristics and investigate the infection condition of HIV or Syphilis among MSM in Chongqing.To evaluate the incidence of HIV infection and analyse the relevant factors in next few years and provide evidences for laying down strategies about preventing and controlling the increase of HIV infection among MSM in Chongqing.Methods:Between the year of 2006 and 2009,four cross-sectional surveys were executed among MSM in major districts of Chongqing city.The individuals were recruited by the Internet or the introduction of key informants and their partners or through the way of snowball sampling.The blood samples were taken for detection of HIV or Syphilis serum test,after informed consent,from each subjects.The individuals were chosen and inquired through one by one survey.The research was based upon the standard incidence of MSM people and the result of vertical comparison in 2006.We will estimate the incidence on the base of the incidence for age of less than 2o years,which is recommended by Osmond.The estimated incidence=The number of positive HIV/[?(age-the first age of sex with male)].Frequency analysis,Chi-square analysis,linear trend analysis,single factor/multiple factors regression analysis were conducted for the population characteristic\infection of HIV or syphilis,the impact of high risk behavior on the incidence and the trend of developing.The impact factors were first analyzed by Logistic regression,which was followed by the multiple factors analysis of related variables.The independent impact factor was analyzed by the step-back technique(?in=0.05,?out=0.10)Results:1.3391 subjects were recruited through four cross-sectional surveys.Among them,3314 were in line with the demanding of survey.The average ages for MSM was decreased(?2=98.50,P<0.00)and the active places have been changed from the pub to Internet cafes(?2=1387.56,P<0.00).The proportion of unmarried has been elevated gradually(?2=90.85,P<0.00),The ratio of being investigated has been increased for the floating MSM group from 2006 to 2009(74.5%vs60.4%,?2=158.10,P<0.00).Most participants belong to Han zu,however,there were statistics differences for education,profession,sexual orientation(?2=35.65,P<0.00,?2=246.30,P<0.00,?2=19.01,P<0.00),respectively.There were no statistics differences for the knowledge of HIV during four surveys.2.The sex activities were active among MSM group.The proportion of having morethan 2 sexual partners in the last 6 months was 50%.The ratio of having anal sex activities with male in past 6 months was gone up from 79.3%to 99%during three-year period from 2006 to 2009(?2=120.90,P<0.00).The usage of condom in the last sexual activity has been kept in a lower level,fluctuated slightly from 31%to 36%.The ratio of commercial sexual activities and drug of abuse among MSM in Chongqing is lower,however,the quarter of them have heterosexual activity.Despite the proportion of accepting intervention services have been increased every year,the growth extent is limited.3.The number of HIV infection among MSM have gone up from 10.9%in 2006 to 19.1%(?2=25.12,P<0.00).After linear trend test,the rank correlation coefficient between HIV infection and the year of investigation was 0.09(P<0.01).The standard infection rate of HIV has been increased from 10.9%to 20.2%.And the result is higher than the actual infection rate.Based upon the result of the least age group(less than 20 years),the incidence of HIV infection among MSM have been increased from 2.5%in 2006 to 5.2%in 2008.However,the incidence was declined in 2009 for the first time.The incidence of syphilis was elevated slightly each year,which would be more obvious after being standard.It is assumed that the incidence of syphilis infection would be fluctuated from 2.9%to 3.8%.To those person who have different sexual orientation,the incidence of HIV infection would be increased each year.Compared with heterosexual or bisexual activities,the incidence is lower among homosexual ones(3.6%versus 9.5%in 2008).And the incidence among married MSM is double than unmarried ones,which has a great statistics significance in every year.As for incidence,there is a difference between the group who involved in the detection of HIV and the one who not involved(1.2%-8.8%versus 3.0%-6.0%),but the difference is fluctuating over the time.The incidence of the former was increased firstly and then dropped over time,but for the latter the incidence have been elevated,which shows the detection of HIV playing a positive role in the prevention for the spread of AIDS.In 2006s,,the rate of being infected among the MSM who have a good grasp knowledge of AIDS is lower than the one who have not(??2=12.67,P<0.00),but there were no statistics differences in the next 3 years.The estimated incidence for both almost been the same since 2006.However,the latter have a rapid increasing evaluated incidence from 2006 to 2009(2.0%vs11.5%).Until 2009,the estimated incidence for the latter was a triple than the former.During the period of 2006 to 2009,the rate of being infected by HIV in the group who have been infected by syphilis as well was higher than the one who have not been infected.There was a great statistics significance for both(in 2006:?2=6.77,P<0.01;in 2007:??2=30.39,P<0.01;in 2008:?2=54.42,P<0.01;in 2009:x2=30.47,P<0.01).In 2007,the elevated incidence for MSM who have a positive syphilis serum test was double than the negative one.And the disparity would being widened over time.(in 2009,the incidence for the one who have a positive syphilis serum test and those who have a negative was 22.2%and 3.2%,respectively).4.Through the investigation of impact factors by the Logistic analysis,over the past 4 years,the relative stable risk factor is the infection of syphilis,which are followed by the lower level of education,the older age and the one comes from bathroom and internet cafes.The registered permanent residence,knowledge of HIV,the age who have the first sex activity,the gender of the first sex partner,the age of 1st homosexual activity,the numbers of sex partner in the past 6 months,the condition of condom usage in the course of anal sex activity in the past 6 months,the related STD symptoms in the last year are all becoming the major risks for HIV in the only one year survey.The reason for that may be caused by sampling error.Therefore,some researches should be carried out.Conclusions:1.The incidence of HIV infection among MSM in Chongqing city has been increased rapidly over time,the highest of which is 5.2%.The effect of preventing the prevalence of HIV is not satisfactory.Therefore,strong interventions should be carried out for the high risk group for MSM people.AS a result of the elevated incidence,the number of being infected by HIV among MSM people would be increased accordingly.The key should be put on the free anti-virus treatment in the next years.2.The survey was taken by Snowball sampling.The change of related impact factors for HIV infection may be caused by the different samples.The infection of syphilis among MSM has become the most major high risk factors for HIV,which are followed by the lower level of education,the older age and the one comes from the bathroom and internet cafes.It is emergent for Chongqing government took more effective intervention measures for those persons.3.The more understand of knowledge of prevention and treatment for HIV,the less estimated incidence among MSM group,which reminds us that education still be the key point for intervention measures.Compared with the one who have not been tested for HIV,theestimated incidence is lower for tested one.This phenomenon reminds us that the detection of HIV is an effective measure and should be executed more deeply in the next work.4.The sex activities are active among MSM group.However,The low frequency of usage of condom and multiple sex partners are common.The seperation of known and action reminds us that the extent of education and intervention should be executed more deeply.
Keywords/Search Tags:Men who have sex with men, Acquired Immune Deficiency Syndrome, Incidence, Trend, Risk factor
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