女女性行为人群规模估计、性传播疾病及危险因素研究

In China, there were very limited studies targeting women who have sex with women (WSW), especially in medical scientific research field. Sociological studies reported that a large number of WSW existed in China. Some foreign and limited domestic epidemiological studies targeting WSW demonstrated that the population had high risk of infecting sexually transmitted diseases (STD), and risk behaviors such as multi-sexual partners, invasive sexual behavior, and drug use. No study about population size estimation and risk factors for STD infection targeting WSW has been reported. This study will use capture-recapture method to conduct population size estimation targeting WSW in Beijing, with information collected from two mobile Apps which had largest number of registered lesbians in China. After conducting stratified random sampling by age among WSW on the two mobile Apps, the study will recruit 1,600 WSW who meet the inclusion criteria to complete an online questionnaire. The questionnaire includes information such as socio-demographic and behavioral characteristics. A total of 320 WSW, selected from the WSW who complete the online questionnaire on Apps through stratified random sampling by age, will be recruited in a prospective cohort study. The cohort study includes the first time STD tests, and an online questionnaire interview and the second time STD tests one year later. Both of the STD tests include HIV, syphilis, Herpes simplex virus type-2, gonorrhoeae, Chlamydia, and trichomonas tests. STD incidence and risk factors will be assessed through the cohort study.

中国关于女女性行为人群（WSW, women who have sex with women）的研究非常少。社会学调查显示中国WSW人群数量庞大。国外和稀有的国内流行病学研究显示WSW感染性传播疾病（STD, sexually transmitted diseases）风险较高，存在多性伴和药物滥用等高危行为。目前国内外均未见WSW的人群规模估计和STD感染危险因素研究。本研究将借助两个用户量最大的女性同性恋手机交友软件（APP），采用捕获-再捕获方法对北京市WSW进行人群规模估计。在两个APP上随机抽样并招募1600名WSW进行APP线上问卷调查，了解社会人口学和行为学等信息。从参加APP问卷调查的WSW中随机抽样并招募320名到医院进行队列研究，包括首次STD（HIV、梅毒、生殖器疱疹、淋病、沙眼衣原体和滴虫）检测，和一年后问卷调查和二次STD检测，评估WSW的STD发病率和危险因素。

英美国家有关女女性行为人群（WSW）的性健康研究众多。中国对WSW的相关研究极少，本研究申请者2011年开展了一项针对北京市WSW的性健康横断面调查。为了进一步了解WSW的性传播感染（STIs）状况及危险因素，开展针对北京WSW的二阶段研究。第一阶段通过两个APP开展线上横断面调查，覆盖了1631名北京地区WSW；该人群自我报告过去一年STIs感染率约6%，感染相关因素包括双性性行为、性玩具与生殖器接触等；该人群出现生殖器溃疡等STIs感染相关症状时未引起重视，过去一年约1/3的WSW未检测STIs。第二阶段包括基线和随访两次现场调查和STIs检测；基线调查和检测从第一阶段WSW中招募到219名；结果显示该人群STIs感染率7.0%，主要是衣原体和HSV-2感染；感染相关因素主要是异性性行为和多性伴；随访到129名WSW，检测结果显示HSV-2发病率3.7/100人年；随访和失访的WSW人口学特征无统计学差异。本研究填补了中国相关领域研究的空白，并报告了该人群高准确度的STIs感染率数据和首个HSV-2发病率数据。