Missed Opportunities for Human Immunodeficiency Virus and Syphilis Testing Among Men Who Have Sex With Men in China: A Cross-Sectional Study.
Missed Opportunities for Human Immunodeficiency Virus and Syphilis Testing Among Men Who Have Sex With Men in China: A Cross-Sectional Study.
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DOI：
10.1097/olq.0000000000000773
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发表时间：
2018-06
影响因子：
3.1
通讯作者：
Tucker JD
中科院分区：
文献类型：
--
作者：
Ong JJ;Fu H;Pan S;Smith MK;Wu D;Wei C;Cao B;Ma W;Yang L;Tang W;Tucker JD
男男性行为者（MSM）感染艾滋病毒/梅毒的风险很高。为了为双重检测策略提供信息，我们描述了中国HIV/梅毒检测的模式，并研究了与从未检测过HIV/梅毒相关的因素。来自8个城市的男男性行为者完成了一项在线调查（2016年）：生理上出生为男性，年龄≥16岁，一生中至少与另一名男性发生过一次性行为。收集了人口统计、性行为和艾滋病毒/梅毒检测数据。多变量多项逻辑回归确定了从未检测过艾滋病毒/梅毒的男性与检测过两种感染的男性的相关特征。总共有2105名男性参与。其中，35.1%（738/2105）从未进行过HIV/梅毒检测，而在进行过HIV/梅毒检测的人中，只有一半（54.0%,709/1312）进行过梅毒检测。与曾经接受过这两种感染检测的男性相比，从未进行艾滋病毒/梅毒检测的可能性增加的人群包括：非同性恋性身份（患病率优势比（POR） 1.86, 95%CI[1.45-2.37]），未披露与除常规伴侣以外的男性的性行为/性史（POR 2.22,[1.75-2.78]）或与卫生专业人员（POR 11.11,[7.69-14.29]），在过去三个月内未与偶然性伴侣发生无安全套性行为（POR 1.89, [1.37-2.56]），无社区性健康参与（POR 15.16,[9.40-24.45]），主要在线下遇到伴侣（POR 1.49,[1.16-1.92]）。中国男男性行为者在HIV/梅毒终生检测方面存在显著差距。迫切需要针对从未检测过的人并将梅毒检测纳入艾滋病毒检测服务的战略。未来的机会包括医疗点双重检测试剂盒，以及在中国不断扩大的初级卫生保健系统中进行检测。
Men who have sex with men(MSM) are at high risk of HIV/syphilis. To inform strategies for dual testing, we describe patterns of HIV/syphilis testing, and examine factors associated with never testing for HIV/syphilis in China. An online survey(2016) was completed by MSM from eight cities: men born biologically male, age ≥16 years, and had sex with another man at least once during their lifetime. Demographic, sexual behavioural and HIV/syphilis testing data were collected. Multivariable multinomial logistic regression identified characteristics associated with men who never tested for HIV/syphilis, compared to men who ever tested for both infections. Overall, 2,105 men participated. Among them, 35.1%(738/2105) never tested for HIV/syphilis, and in those ever tested for HIV, only half (54.0%,709/1312) had tested for syphilis. Relative to men who had ever tested for both infections, those with increased probability of never testing for HIV/syphilis include non-gay sexual identity (prevalence odds ratio(POR) 1.86, 95%CI[1.45–2.37]), not disclosed their sexuality/sexual history with men other than their regular partner (POR 2.22, [1.75–2.78]) or with health professionals (POR 11.11, [7.69–14.29]), no condomless sex with casual partners in the last three months (POR 1.89, [1.37–2.56]), no community engagement in sexual health (POR 15.16, [9.40–24.45]), and mainly met partners offline (POR 1.49, [1.16–1.92]). There are significant gaps in lifetime testing for HIV/syphilis amongst Chinese MSM. Strategies to target never testers and integrate syphilis testing within HIV testing services are urgently needed. Future opportunities include point-of-care dual test kits, and testing in China’s expanding primary healthcare system.