目的 了解儿童家长对水痘知识认知情况和疫苗接种意愿,为制定健康促进和疫苗接种策略提供依据.方法 利用多阶段随机抽样方法,通过"问卷星"网络平台,对2 963名新入学一年级学生家长开展问卷调查.结果 一年级学生家长水痘知识知晓率为49.63％(95％CI:47.10％～52.26％),8个问题的知晓率在34.52％～97.63％,对水痘的典型临床特征(34.52％)和感染后能持久免疫(42.69％)知晓率最低.多因素分析显示,受教育程度高者(OR=2.09,95％CI:1.87～2.33)、受访者为母亲(OR=1.45,95％CI:1.21～1.73)、年人均收入高者(OR=1.19,95％CI:1.09～1.29)知晓率更高;水痘疫苗接种意愿为94.17％(95％CI:90.67％～97.78％).结论 南京一年级学生家长水痘疫苗接种意愿较高,有利于开展水痘疫苗扩大免疫工作;但水痘知识知晓率较低,应加强水痘防治知识宣传.

Objective:To understand the reported incidence level, change of the trend, epidemic characteristics and spatial clustering of scrub typhus in Nanjing, to explore key seasons, populations and areas for prevention and control, and to guide formulation of scientific and precise prevention and control strategies and measures.Methods:The reported data of scrub typhus in Nanjing from January 1, 2011 to December 31, 2020 were collected in the "Infectious Disease Surveillance System" from Chinese Center for Disease Control and Prevention. The reported incidence level and change of the trend were analyzed, and the seasonal, population and spatial distribution characteristics were described. Global spatial autocorrelation analysis was carried out by ArcGIS 10.3 software, and the spatial clustering scanning was carried out by using FleXScan 3.1.2 software.Results:A total of 192 cases of scrub typhus were reported in Nanjing from 2011 to 2020. Median annual reported incidence was 0.21/100 000 (0.12/100 000 - 0.49/100 000). Totally 87.5% (168/192) of cases were reported from October to November, and the peak occurred in November (57.8%, 111/192). Among these cases, males accounted for 64.1% (123/192); and the median age was 59 years old (6 - 84 years old). The groups ≥60 years old and 45 - 59 years old accounted for 47.9% (92/192) and 31.2% (60/192), respectively, which accounted for 79.2% (152/192) in all groups. Farmers accounted for 43.8% (84/192), household chores and unemployed people accounted for 16.7% (32/192), retired persons accounted for 15.6% (30/192) and workers accounted for 6.8% (13/192), which accounted for 82.8% (159/192) in all occupations. The top four areas in the total number of reported cases were Jiangning District (23.4%, 45/192), Luhe District (22.9%, 44/192), Gulou District (10.4%, 20/192) and Jiangbei New Area (8.9%, 17/192), which accounted for 65.6% (126/192) in all districts. According to global spatial autocorrelation analysis, Moran's I = 0.34 ( Z = 5.90, P < 0.001). FlexScan 3.1.2 software scanned and detected two spatial clusters areas, the first-class of cluster area covered three streets in Jiangning District, one street in Yuhuatai District and two streets in Pukou District [restricted log likelihood ratio ( RLLR) = 26.91, P < 0.001]. The second-class of cluster area included six townships/streets in Luhe District and four streets in Jiangbei New Area ( RLLR = 26.48, P < 0.001). All the cluster areas were agriculture-related. Conclusions:The reported incidence level of scrub typhus in Nanjing is low and stable which belongs to a typical autumn epidemic area. The middle-aged and elderly population is the key population and the agriculture-related area is key area. It is suggested that scrub typhus should be included in the management of statutory or regional key infectious diseases in Nanjing. Additionally, training on diagnosis and treatment technology and information report management of scrub typhus need to be carried out, and comprehensive prevention and control interventions such as health education, personal protection, rodent prevention and control and vector control should be strengthened and implemented in the high incidence season.

目的 了解南京市猩红热的流行特征,探寻防控重点地区,指导科学制定防控策略和措施.方法 采用描述流行病学方法,分析2014-2019年南京市报告的猩红热病例流行病学特征,利用简单季节指数法、回顾性时空重排扫描,探索病例季节和时空分布特征.结果2014-2019年南京市共报告猩红热病例1 578例,中位数为214例(120～596例),报告发病率中位数为2.55/10万(1.47/10万～7.06/10万),2014年以来报告发病水平呈上升趋势.季节分布呈双峰特征,分别为11月至次年1月(季节指数为1.5、2.0、1.0)和4至6月(季节指数1.0、1.9、1.4).病例年龄中位数为6岁(0～43岁),6～10岁占61.4％,3～5岁占32.1％,0～2岁占4.0％;学生占51.2％,幼托儿童占39.9％,散居儿童占7.1％.江北新区和六合区报告发病水平远高于南京市其他地区,2019年报告发病率分别为37.78/10万(265例)和27.98/10万(212例),江北新区江北人民医院和六合区中医院分别诊断报告了南京市58.8％和12.2％的病例.2014-2018年时空聚集地区为江北新区(RR=19.4,P＜0.001),2019年时空聚集地区为江北新区、六合区和栖霞区(RR=9..5,P＜0.001).结论 建议加强对猩红热的防控,医疗机构开展猩红热诊治的培训并提高相应的实验室检测能力;开展专题研究,调查医疗机构猩红热诊断质量.

目的 调查水痘暴发事件,了解水痘疫苗保护效果,为制定科学防控策略和措施提供依据.方法 搜索2018年9月1日至2019年1月23日,该幼儿园儿童和教职员工中出现典型的水痘样皮疹(丘疹或疱疹或结痂)者.采集8例患者的咽拭子标本开展病原学检测;利用"问卷星"和"江苏省预防接种综合服务管理信息系统"平台,收集6个班级的所有儿童的水痘疫苗接种等信息,调查疫苗的保护效果.结果 共搜索到水痘患者106例,儿童罹患率为14.5％(104/717),教职工罹患率为2.8％(2/72);首例患者为小6班儿童,2018年9月6日发病,疫情持续4个月,流行曲线显示为增殖模式,患者可分为8代.暴发波及8个班级,班级罹患率17.5％ ～58.5％;接种水痘疫苗者中的水痘罹患率为12.9％(8/62),未接种水痘疫苗者中水痘罹患率为54.4％(81/149),水痘疫苗保护率为76％(95％CI=54％ ～88％);37.5％(3/8)患者咽拭子标本水痘-带状疱疹病毒核酸阳性.结论 在低免疫水平人群中暴发水痘的防控难度大,水痘疫苗保护效果较好,建议进一步加强水痘疫苗接种宣传,将儿童水痘疫苗接种纳入扩大免疫规划.

目的 明确2019年南京市登革热的输入和本地传播风险,科学制定防控策略和措施,指导应急准备,提早部署防控工作.方法 采用定量与定性相结合的方法对境外输入的病例数进行估计,对境内输入风险进行定性分析,对影响登革热本地传播的各种因素分别进行赋值并确定权重,采用量化指标对本地传播风险进行分析和评价.结果 2019年南京市境外输入病例数估计为7例(2 ～12例),存在境内输入风险但较低.2019年7-10月南京市有7个地区本地传播风险为“可能”,5-6月除秦淮区本地传播风险为“可能”外,其他地区本地传播的风险均为“不太可能”,1-3月和11-12月无本地传播风险.结论 南京市2019年仍会有登革热病例输入,7-10月需重点关注登革热本地传播,建议采取病例发现、规范处置、持续监测、健康宣教等综合措施,科学防控登革热疫情.

目的 分析2009-2018年南京市主要虫媒传染病流行病学特征,为制定防控策略提供参考.方法 收集2009-2018年南京市主要虫媒传染病监测数据,进行描述流行病学分析.结果 2009-2018年南京市主要报告6种虫媒传染病,累计报告病例767例,年均发病率0.98/10万(0.65/10万～1.27/10万),除2011年外,发病率总体呈上升趋势(x2 =27.07,P＜0.001),报告发病率从高到低依次是肾综合征出血热、恙虫病、疟疾、发热伴血小板减少综合征、登革热和流行性乙型脑炎.发病时间集中在4-7月和10月、11月,占40.29％(309/767)和27.25％(209/767).发病率居前3位的为高淳区(3.52/10万)、溧水区(2.50/10万)和江宁区(1.22/10万).发病年龄主要集中在25 ～69岁,占82.92％(636/767);男性发病率高于女性;职业以农民为主,占44.20％(339/767).结论 南京市近十年主要虫媒传染病发病总体呈上升趋势,发病具有明显的季节性、地域性和人群特征.应根据不同疾病的特点,对高发地区和高发人群制定相应的防控措施.

目的 了解南京市2008-2017年手足口病的发病趋势和流行特征,为进一步制定手足口病预防策略和措施提供依据.方法 采用描述性流行病学方法分析手足口病病例和病原的分布特征.结果 2008-2017年南京市共报告手足口病157 698例,年均报告发病率为206.61/10万(94.06/10万～305.02/10万),累计报告死亡病例2例.2008-2013年报告发病率呈现升高趋势(t=3.481,P=0.025),2014年开始,发病率呈现隔年高发的周期性.2008-2017年累计报告重症病例2 307例,重症率为1.46％.手足口病发病呈现双峰模式,全年发病有2个高峰:4-7月(春夏高峰)和11-12月(秋冬高峰),男性发病率为258.78/10万,女性发病率为187.44/10万.实验室检测病例共计8 373例,病原学分型结果显示,普通病例病原构成中其他肠道病毒占比37.17％,CoxA16占比33.04％,EV71％占比29.78％.重症病例则以EV71病原为主,其次是其他肠道病毒,占比19.46％,CoxA16占比3.97％.结论 南京地区手足口病的流行具有明显的季节、地区、人群分布和病原构成特点,针对重点人群做好疾病防控将有利于手足口病的整体控制.

Objective To analyze the incidence rate of varicella outbreak in a kindergarten in Nanjing city, to find out the risk factors of varicella outbreak and to evaluate the protection effect of varicella vaccine. Methods A retrospective case analysis was conducted on 54 patients with varicella who appeared in a kindergarten in Nanjing between March 19, 2018 and June 27, 2018. Among them, there were 33 boys and 21 girls, aged from 3 to 25 years, with infants aged from 3 to 6 years, and the average age of infants was (5.30±0.88) years. The incidence and vaccination of varicella among the kindergarten students and teachers were collected through active search and questionnaire survey. Descriptive study and cohort study were used for analysis. Results A total of 54 cases were reported, with an incidence rate of 7.74%. The outbreak involved 10 classes and 2 teachers, with the highest incidence rate of 34.3%. The first case occurred on March 26, 2018, and the epidemic lasted for 68 days. In this outbreak, the protection rate of varicella vaccine was 58% (RR=0.42, 95CI% : 0.22~0.80). Conclusions The incidence of varicella outbreaks is relatively high in kindergartens and other collective units. Relevant institutions should strengthen the monitoring and management of infectious diseases in schools, kindergartens and other collective units, and strengthen the training of knowledge related to infectious diseases. Key words: Varicella; Outbreak; Investigation

目的 查明此次水痘暴发的原因,制定有效地防控措施,预防类似事件的再次发生.方法 通过查看健康监测记录,访谈各班级管理人员等方式,搜索2018年4月10日至7月31日,某集体单位儿童、工作人员中出现典型的水痘样皮疹者,利用病例一览表收集病例信息,采集部分病例的咽拭子标本开展病原学检测.结果 共搜索到水痘病例68例,某生活老师是首例病例,也是本次暴发的传染来源;儿童罹患率为33.5％ (67/200).疫情持续68天,流行曲线显示为增殖模式,病例可分为五代.发病儿童参加公共课导致疫情跨班级传播,共波及6个班,A班(90.0％)和C班(76.5％)罹患率最高,A班和C班的罹患率(82.8％)高于采取有效病例隔离措施的其他班级(13.2％,x2=80.97,P＜0.001).5份病例咽拭子标本都为水痘-带状疱疹病毒核酸阳性.结论 这是一起发生在免疫空白人群的水痘暴发,未采取有效地病例隔离措施导致疫情的扩散,建议进一步加强对集体单位工作人员的健康筛查和监测,强化相关人员传染病业务培训.

目的 了解2017年南京市腹泻病门诊医务人员对霍乱防治知识掌握情况,对开设腹泻门诊的态度,为制定腹泻病门诊设置和肠道传染病防控提供参考依据.方法 2017年4月17日-5月5日,从南京市辖区内设有腹泻病门诊的160家医疗机构中,问卷调查当天在岗的腹泻病门诊医生、护士、检验和管理人员,收集调查对象基本信息、霍乱防治相关知识及腹泻病门诊认知情况等信息,并对数据进行分析.结果 霍乱防治知识知晓率为47.5％(366/770),95％CI为43％～53％,8个问题的正确率为26.0％～97.4％.女性、不在编人员及年收入高者知晓率较高,三级和一级医疗机构的调查对象知晓率高于二级医疗机构.调查对象中91.0％持赞成开设腹泻病门诊,并对腹泻病门诊的建设提出了建议.结论 应继续加强腹泻病门诊相关医务人员霍乱防治知识培训,医务人员对本级医院开设腹泻病门诊多持支持态度,建议结合目前霍乱流行态势,及时进行资源优化,降低腹泻病门诊设置要求.

目的 明确诊断,确定南京市首例人感染猪链球菌病例的感染来源和暴露方式.方法 采集病例血液和脑脊液标本,利用血平板和PCR开展链球菌分离检测,通过访谈病例及其妻子、接诊临床医生,查阅就诊记录和病历资料,开展流行病学调查.结果 病例为36岁男性,2018年8月29日7时以高热起病,病程中出现头痛、呕吐和神志不清、嗜睡等神经系统症状.病例脑脊液中分离的菌株经生化反应和荧光定量PCR鉴定为猪链球菌Ⅱ型.病例于8月25日在湖南省某市某屠宰场购买10个生猪头,在洗切加工过程中手部2处划伤但未及时清洗和消毒.结论 这是1起境内输入性人感染猪链球菌疫情,经过病例手部破损的伤口接触传播.建议当地加强畜间疫情监测、牲畜检疫和屠宰场(点)监管.

目的 了解南京市男男性行为者(MSM)中有异性性行为者(MSMW)和无异性性行为者(MSMO)的行为特征及影响因素,为制定更有针对性的干预措施提供依据.方法 在知情同意的前提下,采用分类滚雪球法招募MSM,开展问卷调查,收集人口学、行为学等信息并进行HIV、梅毒抗体血清学检测.结果 共调查MSM 1895人,MSMW组405人(21.4％),MSMO组1490人(78.6％).MSMW组HIV/梅毒感染率分别为10.12％和8.15％;MSMO组HIV/梅毒感染率分别11.88％和7.52％,2组感染率差异均无统计学意义(P＞0.05).最近6个月内同性多性伴现象普遍存在,2组差异无统计学意义(P＞0.05).MSMW组发生无保护性肛交的比例和商业性行为的比例高于MSMO组,而商业性行为中坚持每次使用安全套的比例低于MSMO组(P＜0.05).多因素Logistic回归分析结果显示,大专及以上文化程度(OR=0.68,95％CI:0.48 ～0.96)和知晓艾滋病防治知识(OR =0.58,95％ CI:0.37～0.91)是MSM发生异性性行为的阻碍因素,在婚/同居(OR =5.24,95％CI:3.24～8.03)、性取向为双性恋/异性恋/不确定、性角色为双向组或插入组、最近6个月有商业性行为(OR =3.77,95％CI:1.89 ～7.49)、酒吧型交友场所(OR=2.50,95％CI:1.61～3.87)是MSM发生异性性行为的促进因素(P＜0.05).结论 南京市MSMW的比例较高,存在高危行为,应从社会及家庭的角度加以防治,以控制HIV从高危人群向一般人群扩散.

目的 了解南京市重症手足口病(hand-foot-mouth disease,HFMD)的流行特征,并分析时空聚集性,为HFMD的重点防控工作提供依据.方法 采用描述流行病学方法,分析2009-2016年南京市报告的重症HFMD流行病学和病原学特征,采用时空重排扫描分析时空聚集性特征.结果 2009-2016年南京市共报告重症病例1 526例,年均报告191例(93～284例);重症病例占HFMD比例为11‰(6‰ ～ 20‰),无趋势变化(Z=1.5,P=0.125),5岁及以下儿童重症病例报告发病率为53/10万(21/10万～ 76/10万).4～7月报告病例占54％;病例中男性占64％,年龄中位数为2岁(0～13岁),5岁及以下占97％,1～3岁占75％;散居儿童占67％,幼托儿童占31％.除2013年外,其他各年均探测到时空聚集区域(均有P＜0.001),聚集地区由中心城区向南部江宁、雨花台和溧水转移,聚集时间多为3～7月.重症病例肠道病毒阳性检出率为39％(17％ ～ 70％),阳性标本中75％(54％ ～89％)为EV71,5％(0～ 17％)为CoXA16.结论 南京市重症HFMD流行特征与普通病例一致,但病原以EV71为主,应加强重点地区和人群监测,宣传接种EV71疫苗.

目的 查明致病因子、传播方式、危险因素和感染来源,控制疫情蔓延.方法 搜索2017年2月15日-22日期间,某小学学生及教职员工中出现呕吐(≥2次/24 h)或腹泻(≥3次/24 h同时伴有性状改变)之一者,开展个案调查;采集病例肛拭子标本,通过RT-PCR检测诺如病毒核酸;收集该校环境卫生情况、日常消毒以及供水、供餐等信息;开展病例对照研究分析发病的危险因素.结果 罹患率为7.8％(46/587);病例主要表现为呕吐(87.0％)、腹泻(71.7％)、恶心(65.2％);流行曲线提示为同源暴露后继之以接触传播,六(5)班罹患率(60.9％)远高于其他班级,有显著的班级聚集性(P＜0.05);性别罹患率、学生与教职工罹患率都无统计学差异(P＞0.05);便后不洗手(OR=3.9,95％CI=1.8～8.5)、关系好的同学中有人发病(OR=3.8,95％CI=1.8～ 7.9)会增加发病的风险;100％(10/10)病例肛拭子标本中检出GII.P7-GII.6型诺如病毒核酸.结论 此次暴发是一起由GII.P7-GII.6型诺如病毒引起的急性胃肠炎暴发,以接触传播为主,不排除气溶胶传播的可能.

目的 了解南京市水痘的发病趋势和流行特征,为进一步制定水痘防控策略和措施提供依据.方法 采用描述流行病学方法,分析突发公共卫生事件和水痘病例的分布特征.结果 2006-2017年南京市共报告水痘病例27 367例,年均报告发病率为29/10万(9.1/10万～115/10万),报告发病率呈升高趋势(t=2.79,P＜0.05),2017年报告病例数最多(9 478例);时间分布呈现双峰,分别为10月～次年1月(54％)和3～6月(28％);男性占55％;病例年龄中位数为9岁(0～90岁),35岁以下占99％,15岁以下占68％,有5岁和9岁两个发病高峰;学生(53％)、幼托儿童(21％)和散居儿童(9.3％)共占84％.报告32起水痘引起的突发公共卫生事件,都发生在学校、托幼机构等集体单位.结论 在2017年纳入丙类传染病管理后,南京市报告水痘病例显著增加,监测敏感性得到提高,应加强水痘的持续监测,同时建议将水痘疫苗纳入免疫规划.

目的 了解南京市细菌性痢疾(菌痢)的流行特征,并分析时空聚集性,为菌痢的重点防控工作提供依据.方法 采用描述流行病学方法,分析2013-2016年南京市报告的菌痢病例流行和病原学特征,采用时空重排扫描分析时空聚集性特征.结果 2013-2016年南京市共报告菌痢病例2 064例,年均报告516例(412 ～671例),年均报告发病率为6.3/10万(5.0/10万～8.2/10万),报告2起暴发疫情,共发病167例.4-10月报告病例占78％;男性占54％;病例年龄中位数为21岁(0～95岁),0～3岁组报告发病率最高;散居儿童(34％)、学生(17％)和离退人员(16％)占比最高.各年全局空间自相关Moran's I都为正值,都P＜0.05;各年均探测到1个时空聚集区域,聚集地区为城区(玄武、鼓楼、秦淮等老城区),聚集时间为4-10月,都P＜0.001.分离培养志贺氏菌株139株,福氏志贺氏菌占58％,宋内氏志贺氏菌占37％.结论 南京市菌痢报告发病逐年下降,城区高发,婴幼儿童和老年人群为重点人群,应根据流行和病原学特征,在重点地区和人群开展针对性防控措施.

Objective To analyze the epidemic characteristics of hemorrhagic fever with renal syndrome (HFRS) in Nanjing City from January 2012 to July 2017, and to provide a basis for formulating better strategies for disease prevention and control. Methods Demographic data of populations and surveillance data of HFRS cases in Nanjing were collected from January 1, 2012 to July 31, 2017. Descriptive epidemiological method, combined with ArcGIS 10.2, was used to explore epidemic characteristics of HFRS, including time, area and population distribution characteristics. The difference of epidemiological characteristics of HFRS were explored between the first 7 months of 2017 and the past 5 years (from 2012 to 2016). Epidemic situation was analyzed in high incidence areas of Nanjing in 2017. Forewarning analysis was performed to detect the probability of the aggregation epidemic. Results A total of 220 HFRS cases were reported in Nanjing City, from January 1, 2012 to July 31, 2017, and the average annual incidence was 0.45 cases per 100, 000 persons. The incidence peaked twice annually and the value (57.3%) in spring (March to June) was higher than that (19.1%) in winter (December to January of next year). The cases from Gaochun District accounted for 44.1% of the reported cases, which was far more than other districts of Nanjing, and most cases located in the eastern and northern areas of Gaochun District and some towns of Lishui District adjacent to Gaochun District. The median age and interquartile range was 48.0 (39.0, 60.0) years old. Among these cases, males accounted for 68.2%, and farmers accounted for 59.5%. At the same time, the age of HFRS cases reported in the first 7 months of 2017 was older than that in the past five years (from 2012 to 2016) (t=-2.62, P<0.05), and the number of HFRS cases from Lishui District increased in the first 7 months of 2017 (11 cases vs 13 cases, χ2= 6.83, P<0.05). Poisson distribution was used to probe the abnormal signals of epidemic situation in the first 7 months of 2017, and 3 abnormal signals (P<0.05) were found in three months (March, May, and July) without aggregation epidemic appeared by further epidemiological investigation. Conclusion The incidence of HFRS in Nanjing was stable in recent years. The majority of HFRS cases located in Gaochun district and Lishui district, young men and farmers were at high risk of the disease exposure. It was necessary to strengthen monitoring of the high-risk area and population. Key words: Hemorrhagic fever with renal syndrome; Hantavirus; Epidemiological characteristic

艾滋病病毒(HIV)、丙型肝炎病毒(HCV)、乙型肝炎病毒(HBV)及梅毒传播途径相同,其中一种疾病的感染也会增加其他病原体的感染机会,而合并感染增加了疾病的复杂程度和治疗的难度.为了解本市HIV感染者合并感染情况,对2015-2016年南京市1 593例HIV感染者抗-HCV、乙肝表面抗原(HBsAg)、梅毒特异性抗体检测结果报告如下.

Objective: To investigate the situation of recreational drug nitrous acid ester inhaler-rush poppers use in men who have sex with men (MSM). Methods: From April to June in 2014, October to December in 2014, April to June in 2015, three round cross-sectional surveys were conducted in MSM recruited in Nanjing by means of serum test and questionnaire survey. Results: Of the 1 721 MSM surveyed in three round, 19.3% (332/1 721) had ever used rush poppers, the proportions of MSM who used rush poppers in three round surveys showed an increasing trend (liner by liner χ(2)= 14.879, P=0.000), which was 12.6% (86/681), 27.6% (121/439) and 20.8% (125/601) respectively. Rush poppers use was associated with HIV infection significantly (OR=1.676, 95%CI: 1.201-2.339, P=0.002). Compared with MSM without rush poppers use, the MSM with rush poppers use were mainly aged <30 years, unmarried, received college and higher education, had lived in Nanjing for less than 2 years, seek sex partners through internet and identified themselves as homosexual orientation. Multivariate logistic analysis showed that less than 30 years old, living in Nanjing for less than 2 years, with college and higher education level, more than 2 sex partners in the past 6 months, being diagnosed with STDs in the previous one year and using traditional drugs were the risk factors associated with rush poppers use. Conclusion: Rush poppers use was related with HIV infection in MSM in Nanjing.

Objective To understand the prevalence of rush poppers use among MSM in Nanjing and assess its association with HIV,syphilis in the context of multiple sexual partnerships and unprotected anal intercourse (UAI).Methods Two rounds of cross-sectional surveys among MSM were conducted from November 2014 to February 2015,and April to July 2015.MSM were interviewed anonymously and tested for HIV and syphilis.The survey in cluded social-demographic characteristics,sexual roles,sexual behaviors and rush poppers use in the past 6 months.Multiple logistic regression models were used to assess the associations of rush poppers use and HIV,syphilis,controlling number of sexual partners and UAI.Results Of 1040 participants,23.7％ ever used rush poppers in the past 6 months;48.8％ of MSM had ≥2 sexual partners and 42.9％ had UAI in the past 6 months.Prevalence of HIV and syphilis were 11.9％ and 6.1％,respectively.Rush poppers use was associated with HIV infection (aOR =2.127,95％CI:1.402-3.225).Men with rush poppers use were more likely to have ≥2 sexual partners (aOR=3.818,95％CI:2.754-5.294) andUAI(aOR=1.765,95％CI:1.310-2.376) in the past 6 months.Rush poppers use was associated with HIV infection (aOR=1.995,95％CI:1.283-2.981) persistently after adjusting for UAI.Conclusion The mediation models suggests a strong role of rush poppers use and UAI to predict the risks for HIV infection,with less influence from multiple partnerships.We should focus on rush poppers use while carrying out health education among MSM.