摘要目的 了解天津市男男性接触人群(MSM)的梅毒感染状况及相关因素.方法 于2016年4-8月,对天津市16岁及以上且最近6个月与男性发生过插入性口交或肛交性行为的MSM人群进行横断面问卷调查和血清学检测;收集MSM人群人口学及性行为特征,开展HIV、梅毒检测,最终收集有效问卷853份.通过多因素二分类非条件logistic回归模型分析梅毒感染的相关因素.结果 调查对象年龄为31.7±9.4岁,以35岁以下者居多,占70.1％(598/853);最近6个月与同性发生肛交性行为时,每次都使用安全套的比例为65.4％(558/853);调查对象HIV检出率为3.4％、梅毒为9.5％.多因素分析显示,知晓性病艾滋病相关知识(OR=0.46,95％CI:0.23～0.92)、最近1年接受过有关性病艾滋病相关干预(OR=0.40,95％CI:0.23～0.71)者梅毒感染的可能性更低;而最近6个月有同性商业性行为(OR=2.75,95％CI:1.31～5.77)、最近1年患过性病(OR=11.07,95％CI:5.57～26.83)者梅毒感染可能性更高;随着最近一周肛交次数增加,梅毒感染可能性更高(OR=1.45,95％CI:1.03～2.03).结论 男男性行为者梅毒感染率较高,性病艾滋病知识知晓情况、最近一周刚交次数、最近六个月同性商业性行为情况、最近一年患性病情况以及最近一年接受过性病艾滋病相关干预服务情况与调查对象感染梅毒有关.

abstractsObjective To understand the prevalence of syphilis and the associated factors among men who have sex with men (MSM) in Tianjin.Methods From April to August 2016,a cross-sectional survey was conducted among MSM who was over 16 years old and had oral or anal sex with men in the last 6 months in Tianjin,with a face-to-face interview and blood samples were collected.The demographic and sexual characteristics of the MSM was collected,meanwhile HIV and syphilis were tested.A total of 853 valid questionnaires were finally enrolled.Binary logistic regression analysis was used to analyze the relationship between the infection of syphilis and the behaviors.Results The average age of the respondents was 31.7±9.4 years old and the majority of them were under 35 years old,accounted for 70.1％ (598/853),while 65.4％ (558/853) of the respondents used condom consistently when they had anal sex in the last six months.The HIV positive rate was 3.4％ and the rate of syphilis was 9.5％ among MSM.Binary logistic regression analysis showed that the possibility of syphilis infection is lower among MSM who had knowledge of HIV and STD (OR=0.46,95％CI:0.23-0.92),and among those who received intervention of HIV/STD in the last year (OR=0.40,95％CI:0.23-0.71).The possibility of syphilis infection was higher in case of commercially homosexual behaviors in the last six months (OR=2.75,95％CI:1.31-5.77),and STD infections in the last year (OR=1 1.07,95％CI:5.57-26.83).The possibility of syphilis infection increased along with the increment of anal intercourse in the last week,(OR=1.45,95％CI:1.03-2.03).Conclusions The infection rate of syphilis among MSM was relatively high,and the associated factors included the knowledge awareness of HIV and STD,the frequency of anal intercourse in the last week,having commercial homosexual sex in the last six months,infected STD in the last year and having received intervention about HIV/STD in the last year.