[A cohort study of incidence of club drug abuse in men who have sex with men in Qingdao].

Objective: To understand and analyze the incidence of club drug abuse and influencing factors in men who have sex with men (MSM) in Qingdao, and provide reference for the AIDS prevention and intervention in this population. Methods: From March 2017 to July 31, 2022, MSM who did not abuse club drug were recruited by snowball sampling of MSM social organizations in Qingdao, a prospective cohort was established, and a follow-up survey was conducted every 6 months. The survey collected the information about the MSM's demographic characteristics, sexual characteristics, club drug abuse and others. The incidence of club drug abuse was the outcome dependent variable and the interval between the recruitment into the cohort and the incidence of club drug abuse was the time dependent variable. Cox regression analysis was conducted to identify the influencing factors for club drug abuse. Results: A total of 509 MSM were recruited at baseline survey, and 369 eligible MSM were enrolled in this cohort. A total of 62 MSM began to abuse club drug during the study period, and the cumulative follow-up time was 911.54 person-years, the incidence of club drug abuse was 6.80/100 person-years. All the club drug abusers shared drugs with others in the first club drug abuse, and 16.13% (10/62) had mix-use of club drugs. The multivariate Cox proportional risk regression analysis showed that being students (aHR=2.17, 95%CI: 1.15-4.10), receiving no HIV testing or receiving 1 HIV testing during past 6 months (aHR=4.57, 95%CI:1.80-11.60; aHR=5.15, 95%CI: 2.83-9.36), having sex only with regular sexual partners during past 6 months (aHR=4.75,95%CI:2.32-9.75), having more than 4 homosexual partners (aHR=1.70, 95%CI:1.01-2.87) and abuse of club drug of sexual partners during past 6 months (aHR=12.78, 95%CI:3.06-53.35) were significantly associated with club drug abuse in the MSM. Conclusions: The incidence of club drug abuse was at a high level in the MSM cohort in Qingdao, indicating a high risk for HIV infection. Being student, receiving less HIV testing, having sex only with regular sexual partners, having more homosexual partners and abuse of club drug of sexual partners during past 6 months were risk factors for the incidence of club drug abuse in the MSM. Targeted surveillance and intervention measures should be strengthened to reduce the risk of club drug abuse in MSM.目的： 了解与分析青岛市MSM新型毒品滥用发生率及影响因素，为制定MSM艾滋病预防干预措施提供参考。 方法： 采用开放式队列研究方法，从2017年3月开始，依靠MSM社会组织采用滚雪球抽样方法招募未发生新型毒品滥用的MSM，建立开放队列，并每6个月进行一次随访调查，观察终点日期为2022年7月31日。调查内容包括社会人口学特征、性行为学特征和发生新型毒品滥用情况等信息。以随访过程中研究对象发生新型毒品滥用为结局因变量，以研究对象进入队列至发生新型毒品滥用的时间作为时间因变量，采用Cox比例风险回归模型分析MSM发生新型毒品滥用的影响因素。 结果： 共招募MSM 509人，纳入随访队列369人，发生新型毒品滥用62人，队列随访累积观察时间911.54人年，新型毒品滥用发生率为6.80/100人年。62人首次发生新型毒品滥用均为与他人共同滥用，16.13%（10/62）存在新型毒品混合滥用现象。多因素Cox比例风险回归分析显示，学生（aHR=2.17，95%CI：1.15~4.10）、最近6个月HIV检测次数0次和1次（aHR=4.57，95%CI：1.80~11.60；aHR=5.15，95%CI：2.83~9.36）、仅有固定性伴（aHR=4.75，95%CI：2.32~9.75）、同性性伴数>4个（aHR=1.70，95%CI：1.01~2.87）和性伴滥用新型毒品（aHR=12.78，95%CI：3.06~53.35）的MSM更有可能发生新型毒品滥用。 结论： 青岛市MSM新型毒品滥用发生率较高，存在较高HIV感染风险；发生新型毒品滥用的影响因素包括学生、HIV检测次数较少、仅有固定性伴、多性伴和性伴滥用新型毒品，应针对此部分人群加强干预力度，开展降低新型毒品危害的干预工作。.