HIV testing and preventive services accessibility among men who have sex with men at high risk of HIV infection in Beijing, China.
HIV testing and preventive services accessibility among men who have sex with men at high risk of HIV infection in Beijing, China.
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中国北京艾滋病毒感染高危男男性行为者的艾滋病毒检测和预防服务可及性
DOI：
10.1097/md.0000000000000534
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发表时间：
2015-02
期刊：
影响因子：
1.6
通讯作者：
Ruan Y
中科院分区：
文献类型：
--
作者：
Zhao Y;Zhang L;Zhang H;Xia D;Pan SW;Yue H;Lu H;Xing H;He X;Shao Y;Ruan Y
近年来，我国大部分地区男男性行为者（MSM）中的艾滋病流行呈惊人的增长趋势。尽管中国不断扩大艾滋病综合检测和干预服务的规模，但许多中国男男性行为者仍然缺乏足够的艾滋病预防服务。为了解北京市男男性行为人群对艾滋病检测和预防服务的利用情况，以及影响男男性行为人群接受艾滋病检测和预防服务的相关因素，本研究于2009年9月至2010年1月、2010年9月至2011年1月对北京市男男性行为人群进行了连续三次横断面调查，2011年9月至2012年1月。收集并分析人口统计学和行为学数据。血液样本进行了艾滋病毒和梅毒检测。结果1312人中HIV感染率为7.9%，梅毒感染率为15.4%。69%的人曾经接受过艾滋病毒检测，在过去12个月（P12 M）内分别有56.2%、78.7%和46.1%的人接受过艾滋病毒检测、免费避孕套/润滑剂和性传播感染服务。男男性接触者中，社交网络较大者和认识HIV感染者更有可能接受HIV检测和预防服务;对HIV/AIDS的污名化和歧视态度较低者与接受HIV检测呈正相关，而过去6个月内无保护肛交（P6 M）者参与预防服务较少。据报告，艾滋病毒检测的最大障碍是害怕检测艾滋病毒呈阳性（79.3%）和认为没有艾滋病毒风险（75.4%）。几乎所有与会者都认为，确保保密性将鼓励更多的男男性行为者进行艾滋病毒检测。北京市男男性行为人群中HIV、梅毒和高危行为的患病率较高，HIV检测率相对较低，需要进一步解决HIV检测的障碍，提高预防服务的可及性。
AbstractThe HIV epidemic among men who have sex with men (MSM) has been increasing at an alarming rate in most areas of China in recent years. Many Chinese MSM still lack sufficient access to HIV prevention services, despite ongoing scale-up of comprehensive HIV testing and intervention services. The purpose of this study was to investigate utilization of HIV testing and prevention services, and related factors that influence the MSM people to access HIV test or other services to prevent HIV among MSM in Beijing, China.Three successive cross-sectional surveys of MSM were conducted in Beijing from September 2009 to January 2010, September 2010 to January 2011, and September 2011 to January 2012. Demographic and behavioral data were collected and analyzed. Blood samples were tested for HIV and syphilis. Three models were established to analyze factors associated with HIV testing and preventive services.Of the 1312 participants, prevalence of HIV and syphilis was 7.9% and 15.4%, respectively. Sixty-nine percent ever had an HIV test, 56.2%, 78.7%, and 46.1% received HIV test, free condom/lubricants, and sexually transmitted infection services in the past 12 months (P12M), respectively. MSM with larger social networks and who knew someone infected with HIV were more likely to receive HIV testing and preventive services; lower degrees of stigma and discriminatory attitudes toward HIV/AIDS were positively associated with having an HIV test, whereas unprotected anal intercourse in the past 6 months (P6M) was associated with less preventive services participation. The most reported barriers to HIV testing were fear of testing HIV positive (79.3%) and perceiving no risk for HIV (75.4%). Almost all participants felt that ensuring confidentiality would encourage more MSM to have an HIV test. The two main reasons for not seeking HIV test was not knowing where to go for a test (63.2%) and perceiving low risk of HIV infection (55.1%).Given a high prevalence of HIV, syphilis, and risky behaviors and a relatively low HIV testing rate among MSM in Beijing, more efforts are urgently needed to address barriers to HIV testing and improve accessibility of prevention services.