【摘要】 目的 了解不同确诊时长的大学生MSM人群中HIV感染者行为特征差异，为大学生MSM人群中HIV感染者的随访干预工作提供参考依据。方法 2019年1月—2021年3月，采用方便抽样方法抽取陕西省、重庆市和广东省疾病预防控制中心随访管理的大学生MSM人群中HIV感染学生为调查对象。确诊时长定义为调查日期与确诊日期的差值，按照确诊时长将感染者分为确诊0～3个月、4～12个月、13～24个月、25个月及以上4组。通过问卷调查收集人口学信息、艾滋病相关知识、态度和行为等资料。通过单因素分析比较各组间特征，使用Logistic回归分析不同确诊时长对行为的影响。结果 共计纳入171名大学生MSM感染者。不同确诊时长的大学生MSM在近6个月发生男男性行为(χ~2=11.06)、近6个月未坚持使用安全套(χ~2=14.58)、艾滋病抗病毒治疗(χ~2=31.62)、漏服药情况(χ~2=17.33)等方面的差异具有统计学意义(P均<0.05)。多因素分析显示，近6个月是否发生男男性行为、近6个月未坚持使用安全套的最终模型中均包含确诊时长；相比于确诊时长0～3个月的人群，确诊4～12个月(OR=0.35,95%CI:0.14～0.88)、13～24个月(OR=0.30,95%CI:0.12～0.77)的近6个月发生男男性行为的比例降低；确诊时长4～12个月(OR=0.24,95%CI:0.09～0.65)、13～24个月(OR=0.17,95%CI:0.05～0.55)和25个月及以上(OR=0.32,95%CI:0.11～0.92)的近6个月未坚持使用安全套的比例降低。结论 不同确诊时长的大学生MSM人群HIV感染者在性行为、抗病毒治疗等方面的行为特征有显著差异，建议加强关注并重点干预确诊时长较长(超过2年)的人群，同时应持续强化抗病毒治疗服药依从性教育。更多还原

【Abstract】 Objective To understand the differences in the behavioral characteristics of HIV-infected MSM at different duration of diagnosis among college students, and to provide a reference for follow-up intervention for HIV-infected MSM among college students.Methods From January 2019 to March 2021,a convenience sampling method was used to select HIV-infected MSM among college students under the follow-up management by CDCs in Shaanxi Province, Chongqing City and Guangdong Province as survey objects.The duration of diagnosis was defined as the time length between the date of investigation and the date of diagnosis.The duration of diagnosis was divided into four groups: 0-3 months, 4-12 months, 13-24 months, 25 months and above.Data such as demographic information, AIDS-related knowledge, attitudes and behaviors were collected through questionnaires.Univariate analysis was used to compare the differences in characteristics among the groups, and logistic regression was used to analyze the impact of different duration of diagnosis on sexual behavior.Results A total of 171 HIV positive MSM among college students were included.There were significantly different in each group among behaviors such as having MSM in the past 6 months(χ~2=11.06),without consistent condom use in the past 6 months(χ~2=14.58),taking HIV antiretroviral treatment or not(χ~2=31.62),and missed medication(χ~2=17.33)(P<0.05).Multivariate analysis results showed that the final analysis model included the duration of diagnosis for MSM and consistent condom use in the past 6 months.Compared with the group diagnosed 0-3 months, the proportion of MSM in the past 6 months was lower in group 4-12 months(OR=0.35,95%CI:0.14-0.88)and 13-24 months(OR=0.30,95%CI:0.12-0.77).The proportion of non-consistent use of condoms in the past 6 months decreased in group 4-12 months(OR=0.24,95%CI:0.09-0.65),13-24 months(OR=0.17,95%CI:0.05-0.55)and 25 months and above(OR=0.32,95%CI:0.11-0.92).Conclusion There are significant differences in sexual behaviors and antiviral treatment of HIV-infected MSM among college students with different duration of diagnosis.It is recommended to pay more attention on the intervention among the group with a long diagnosis duration(more than 2 years),and to strengthen antiviral treatment drug compliance education.更多还原