| PurposeTo understand the status of HIV,syphilis,and HCV infection and its influencing factors among male patients in STD clinics in Tianjin from 2010 to 2014,and to formulate preventive measures for sexually transmitted diseases such as AIDS,syphilis and hepatitis C in Tianjin for the next step,and to provide effective information and scientific evidence for the development of intervention models.MethodA questionnaire survey was conducted for male aged 15 and over who visited the STD clinic of Tianjin CDC for the first time from April to June 2010-2014.The questionnaire includes the year of birth,marital status,domicile of the family,ethnicity,whether they have had sex with a prostitute or a temporary partner in the last three months,whether they have injected drugs,a homosexual anal sex in the last three months,whether they have had been diagnosed with a sexually transmitted disease,or received intervention and HIV test during the last year.The continuous sampling method is used until the sample size reaches 400 people each year.After the questionnaire,each respondent will be asked to collect 5 ml of venous blood for HIV,syphilis,and HCV antibody testing.χ~2 test was used to compare the differences in the knowledge rate of HIV/AIDS,the incidence of risk behaviors,HIV infection,syphilis infection and HCV infection.Logistic regression model was used to analyze the influencing factors of HIV infection,syphilis infection and HCV infection.ResultFrom 2010 to 2014,a total of 2,000 male STD outpatients were surveyed.The average age was(30.7±9.0)years.The household registration location was mainly in this city.The ethnic group was mainly Han.The marriage status was mainly unmarried,divorced,or widowed.The awareness rate of AIDS-related knowledge was 94.1%,which decreased year by year from 98%in 2010 to 89.5%in 2014.There was no significant difference in the AIDS knowledge awareness rate among subjects of different ages,different household registrations,different nationalities,and different marital status(P>0.05).From 2010 to 2014,the HIV infection rate of male patients in STD clinics was 3.8%,and the overall trend has increased over the past 5years(χ~2=12.501,P=0.014);the syphilis infection rate was 6.2%,and it has fluctuated around 6%for 5 years;HCV infection rate was 1.7%,and there was no significant difference between different years(P>0.05).6.5%of the study subjects have been diagnosed with STDs in the past year,of which the previous infection rate of syphilis is 3.1%;the previous infection rate of gonorrhea is 0.6%;the previous infection rate of condyloma acuminatum is 1.9%.Differences between years show statistical significance(χ~2=11.428,P=0.022)and showing an upward trend.During the study period,27.6%of the subjects had sex with the prostitute in the last three months,34.4%of the subjects had sex with a temporary partner in the last three months,0.9%of the subjects had injected drugs,and 8.5%of the subjects has had homosexual anal sex.The overall incidence of 3 types of dangerous sexual behavior such as prostitute(χ~2=15.491,P=0.004),temporary partner(χ~2=83.447,P<0.001)and homosexual anal sex(χ~2=13.211,P=0.010)is on the rise.The groups that 40-49 years old(χ~2=10.251,P=0.036),married(χ~2=9.562,P=0.023),and have not been diagnosed with STDs in the past year(χ~2=10.309,P=0.010)have a higher proportion of sex with prostitutes.The groups that 16-19 years old(χ~2=32.231,P<0.001),knowledge of AIDS(χ~2=5.312,P=0.021),and those who have received intervention in the last year(χ~2=12.353,P<0.001)have a higher percentage of sexual intercourse with temporary partners in the last 3 months.The groups that16-19 years old(χ~2=19.636,P=0.001),immigrants(χ~2=38.012,P<0.001),unmarried(χ~2=48.657,P<0.001),have been diagnosed with STDs in the past year(χ~2=38.452,P<0.001)and those who have received intervention in the last year(χ~2=4.897,P=0.027)have more prone to homosexual act.During the study period there are 29.7%of male patients attending STD clinics in Tianjin have had HIV test in the past year,18.2%of them has received a condom distribution or AIDS counselling and testing.2.9%of them have received Community Drug Maintenance Treatment/Clean Needle Supply/Exchange,and 5.7%have received a kind of peer education.In the age group of 16-49 years old,the proportion of having sex with a prostitute(χ~2=5.823,P=0.016),having sex with a temporary partner(χ~2=14.725,P<0.001)in the past 3 months,and have been tested for HIV in the past year(χ~2=18.577,P<0.001)was significantly higher than that in the age group of 50 years or older.Anal sex with same sex(OR=7.807,95%CI=4.663～13.071)is a risk factor for HIV infection.Over 50 years old(OR=1.311,95%CI=1.081～1.591),have anal sex with same sex(OR=2.372,95%CI=1.420～3.961),and have been diagnosed with STD in the last year(OR=5.312,95%CI=3.329～8.476)are the risk factor for syphilis infection.Injecting drugs(OR=79.821,95%CI=25.047～254.374)is a risk factor for HCV infection.ConclusionThe status of HIV,syphilis,and HCV infection in male STD outpatients in Tianjin is not optimistic.This population knows little about non-AIDS transmission routes and the clinical manifestations of AIDS,and there is a mismatch of knowledge and behavior.Syphilis and condyloma acuminata are two types of sexually transmitted diseases that require special attention in Tianjin.People over 50 years old with past history of sexually transmitted diseases are key populations for syphilis prevention and control.Those aged 16-19 years,immigrants,unmarried,with a history of sexually transmitted diseases are people who should pay attention to HIV/AIDS and syphilis prevention and control,injecting drug users are key population for hepatitis C prevention and control.The control of syphilis should be integrated into the management mechanism of AIDS prevention and control,and the joint prevention and control of the two should be emphasized.The proportion of AIDS testing among male STD clinic outpatients in Tianjin is low,and the intervention work is not in place.The AIDS intervention testing should be strengthened. |
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