某市男男性行为人群猴痘病毒感染影响因素

徐菁佩; 李君钒; 代珍; 施雅莹; 何勤英; 王亮

doi:10.16462/j.cnki.zhjbkz.2025.03.006

某市男男性行为人群猴痘病毒感染影响因素

doi: 10.16462/j.cnki.zhjbkz.2025.03.006

1.
成都市疾病预防控制中心性病艾滋病防制科，成都 610041
2.
成都市疾病预防控制中心传染病防制科，成都 610041

基金项目:

2024年成都市医学科研课题 2024138

详细信息

通讯作者:
王亮，E-mail: 363686849@qq.com

中图分类号: R183.7;R181
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- 被引次数: 0
出版历程
- 收稿日期: 2024-10-30
- 修回日期: 2025-01-07
- 网络出版日期: 2025-04-11
- 刊出日期: 2025-03-10

Analysis of factors influencing monkeypox infection among men who have sex with men in a city

1.
Department of Sexually Transmitted Diseases and HIV Prevention and Control, Chengdu Center for Disease Control and Prevention, Chengdu 610041, China
2.
Department of Infectious Disease Control and Prevention, Chengdu Center for Disease Control and Prevention, Chengdu 610041, China

Funds:

Medical Research Project of Chengdu in 2024 2024138

More Information

Corresponding author: WANG Liang, E-mail: 363686849@qq.com

摘要

摘要: 目的了解某市男男性行为者(men who have sex with men, MSM)猴痘病毒感染的流行病学及临床特征，分析MSM感染猴痘病毒的影响因素。方法由某市MSM社会组织通过滚雪球抽样法于2024年5―6月招募符合条件的MSM开展回顾性横断面研究，对参与调查的MSM基本信息、2023年5月以来猴痘诊疗史、猴痘相关症状、流行病学史、猴痘疫苗接种史以及性病、人类免疫缺陷病毒感染情况进行统计分析。采用多因素非条件二元logistic回归分析模型分析猴痘病毒感染的影响因素。结果有效调查MSM 3 039人，平均年龄为(33.00±7.81)岁，常住地为本地的占97.47%(2 962/3 039)，非本地的占2.53%(77/3 039)。共调查49例猴痘病例，其中21例为确诊病例，猴痘样病例17例，疑似病例11例。所有猴痘病例中，有33例曾出现过疑似猴痘样病例相关症状，症状中皮疹占比为100.00%(33/33)，发热、淋巴结肿大、头痛、咽喉痛均占比为30.30%(10/33)，其中54.55%(18/33)病例有过并发症，20.41%(10/49)的猴痘病例在发病前21 d有过同性性行为接触和偶遇性行为。多因素logistic回归分析模型结果显示，职业为商业服务(OR=4.560, 95% CI: 1.942~10.707, P＜0.001)的MSM感染猴痘病毒风险高于学生MSM，接种过猴痘疫苗(OR=0.067, 95% CI: 0.018~0.255, P＜0.001)和知晓周围有未就诊猴痘疑似病例(OR=0.128, 95% CI: 0.054~0.304, P＜0.001)的MSM感染猴痘病毒风险相对更低。结论 MSM是猴痘疫情防控的重点人群，应加强对该人群的监测，根据群体特点制定相应的防控策略。
- 男男性行为者 /
- 猴痘 /
- 预防
Abstract: Objective To understand the epidemiological and clinical characteristics of monkeypox infection in the population of men who have sex with men (MSM) in a city, and to analyze the factors influencing monkeypox infection in the MSM population. Methods A cross-sectional survey was conducted by a MSM social organization in a city through snowball sampling method to recruit eligible MSM in May-June 2024. The basic information of the participating MSM, history of monkeypox diagnosis and treatment since May 2023, monkeypox-related symptoms, epidemiological history, history of vaccination, and HIV infection were statistically analyzed. A multivariate unconditional binary logistic regression model was used to analyze the influencing factors of monkeypox virus infection. Results A total of 3 039 MSM were effectively investigated, with a mean age of (33.00±7.81) years. Of them, 97.47% (2 962/3 039) were local and 2.53% (77/3 039) were non-local in their usual place of residence. A total of 49 monkeypox cases were investigated, of which 21 were confirmed cases, 17 monkeypox-like cases and 11 suspected cases. Of all the monkeypox cases, 33 had experienced symptoms related to suspected monkeypox-like, with 100.00% (33/33) of the symptoms being skin rash, and 30.30% (10/33) of the symptoms being fever, swollen lymph nodes, headache, and sore throat. There were also complications in 54.55% (18/33) of the cases. There were 20.41% (10/49) cases of monkeypox who had a history of homosexual sexual contact and incidental sexual intercourse 21 days before the onset of the disease. Multifactorial logistic regression analysis showed that MSM whose occupation was business services (OR=4.560, 95% CI: 1.942-10.707, P < 0.001) had a significantly higher risk of contracting monkeypox than MSM who were students. While those who having been vaccinated against monkeypox (OR=0.067, 95% CI: 0.018-0.255, P < 0.001) and being aware of the presence of undiagnosed suspected monkeypox infections in the neighborhood (OR= 0.128, 95% CI: 0.054-0.304, P < 0.001) had a relatively lower risk of monkeypox infection among MSM. Conclusions The MSM population is a key population for the prevention and control of monkeypox epidemics, and the surveillance of this population should be strengthened. Also, appropriate prevention and control strategies should be developed according to the characteristics of the group.
- Men who have sex with men /
- Monkeypox /
- Prevention

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表 1 33例猴痘病例相关症状情况

Table 1. Symptoms of 33 symptomatic monkeypox case

症状 Symptoms	病例数 Number of cases	占比 Proportion/%
皮疹Rash	33	100.00
发热Fever	10	30.30
淋巴结肿大Lymphadenopathy	10	30.30
头痛Headache	10	30.30
咽喉痛Sore throat	10	30.30
疲劳Fatigue	9	27.27
肌肉酸痛Muscle aches	9	27.27
腹泻Diarrhea	7	21.21
发冷Chills	6	18.18
肛门生殖器疼痛和/或出血 Pain and/or bleeding in the anal and genital areas	6	18.18
咳嗽Cough	6	18.18
呕吐Vomiting	6	18.18
结膜炎Conjunctivitis	1	3.03

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表 2 49例猴痘病例症状出现前21 d风险暴露情况分布

Table 2. Distribution of risk exposure in the first 21 days of symptom onset of 49 monkeypox cases

流行病学史Epidemiological history	病例数Number of cases	占比Proportion/%
同性性行为接触史History of same-sex sexual contact	10	20.41
偶遇性行为史History of sexual encounters	10	20.41
病例/疑似病例接触史History of exposure to cases/suspected cases	8	16.33
猴痘流行地旅居史History of travel and residence in monkeypox-endemic sites	7	14.29
多性伴史History of multiple sexual partners	7	14.29
境内外性聚会史History of sexual gatherings at home and abroad	6	12.24
商业性行为史History of commercial sexual activity	4	8.16
猴痘流行地可疑动物接触史History of suspected animal contact in areas where monkeypox is endemic	2	4.08

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表 3 MSM猴痘病毒感染情况影响因素分析

Table 3. Analysis of influencing factors of monkeypox infection in MSM

变量 Variable	猴痘病例 Cases of monkeypox^① (n=49)	非猴痘病例 Non-monkeypox cases^① (n=2 990)	单因素分析 Univariate analysis		多因素分析 Multivariate analysis
变量 Variable	猴痘病例 Cases of monkeypox^① (n=49)	非猴痘病例 Non-monkeypox cases^① (n=2 990)	χ²值value	P值value	OR值value (95% CI)	P值value
年龄/岁Age/years			6.590	0.128^④
18~＜30	34(69.39)	1 642(54.92)
30~＜40	9(18.37)	807(26.99)
40~＜50	2(4.08)	332(11.10)
50~＜60	4(8.16)	147(4.92)
≥60	0(0)	62(2.07)
婚姻状况Marital status			-0.051	1.000^④
离异Divorced	4(8.16)	247(8.26)
丧偶Widowed	0(0)	29(0.97)
未婚Not married	39(79.60)	2 339(78.23)
已婚Married	6(12.24)	375(12.54)
文化程度Cultural level			2.272	0.561^④
初中及以下Junior high school and below	4(8.16)	237(7.93)
大学(含本科和专科) University (including undergraduate and specialized)	31(63.27)	1 804(60.33)
高中(包括职高、中专、技校) High school (including vocational high school, secondary specialized school, technical school)	8(16.33)	703(23.51)
硕士及以上Master′s degree and above	6(12.24)	246(8.23)
职业Occupation			15.724	0.001
学生Student	21(42.85)^②	603(20.17)			1.000
商业服务Business services	8(16.33)^②③	627(20.97)			4.560(1.942~10.707)	＜0.001
待业及自由职业Unemployed and freelance	12(24.49)^③	896(29.96)			1.603(0.586~4.386)	0.358
其他Others	8(16.33)^③	864(28.90)			1.662(0.661~4.179)	0.280
性取向Sexual orientation			6.782	0.027^④
同性恋Homosexual	31(63.27)^③	2 314(77.39)			1.000
双性恋Bisexual	14(28.57)^②	439(14.68)			1.085(0.349~3.367)	0.888
其他Other	4(8.16)	237(7.93)			2.186(0.648~7.378)	0.207
2023年5月以来与同性同居Cohabitation with MSM since May 2023			0.043	0.885
是Yes	27(55.10)	1 692(56.59)
否No	22(44.90)	1 298(43.41)
猴痘疫苗接种史History of monkeypox vaccination			13.813	＜0.001^④
是Yes	4(8.16)	16(0.54)			1.000
否No	45(91.84)	2 974(99.46)			0.067(0.018~0.255)	＜0.001
HIV感染情况HIV-infected status			4.613	0.023^④
是Yes	8(16.33)	213(7.12)			1.000
否No	41(83.67)	2 777(92.88)			0.464(0.194~1.113)	0.085
2023年5月以来患过性病Have had a sexually transmitted disease since May 2023			6.470	0.015
是Yes	13(26.53)	413(13.81)			1.000
否No	36(73.47)	2 577(86.19)			0.614(0.307~1.228)	0.168
知道周围有未就诊猴痘疑似病例 Know that there are people around who are suspected of monkeypox infection who have not been treated			24.985	＜0.001^④
是Yes	9(18.37)	57(1.91)			1.000
否No	40(81.63)	2 933(98.09)			0.128(0.054~0.304)	＜0.001
注：MSM, 男男性行为者; HIV，人类免疫缺陷病毒。 ①以人数(占比/%)表示；②③为χ²分割两两比较结果；④ Fisher精确检验。 Note: MSM, men who have sex with men; HIV, human immunodeficiency virus. ① Number of people (proportion /%); ②③ are the results of χ² segmentation; ④ Fisher′s exact test.

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