HIV阳性男男性行为人群多性伴高危性行为状况及其影响因素分析

张月; 陈芳; 丁凡; 林小杰; 王晓冬; 刘乃鹏; 刘晓宇; 王威; 张洪波

文章摘要

张月,陈芳,丁凡,林小杰,王晓冬,刘乃鹏,刘晓宇,王威,张洪波.HIV阳性男男性行为人群多性伴高危性行为状况及其影响因素分析[J].中华流行病学杂志,2016,37(4):517-521

HIV阳性男男性行为人群多性伴高危性行为状况及其影响因素分析

Unprotected sexual behaviors and related factors of HIV-positive MSM with multiple sexual partners

收稿日期:2015-10-16 出版日期:2016-04-13

DOI：10.3760/cma.j.issn.0254-6450.2016.04.015

中文关键词: HIV阳性男男性行为人群多性伴高危性行为影响因素

英文关键词: HIV-positive men who have sex with men/MSM Multiple partners Unprotected sexual behavior Influencing factors

基金项目:中国全球基金艾滋病项目(CBO-SR-2012-研7)

作者	单位	E-mail
张月	230032 合肥, 安徽医科大学公共卫生学院流行病与卫生统计学系
陈芳	230032 合肥, 安徽医科大学公共卫生学院流行病与卫生统计学系
丁凡	610021 成都同乐健康咨询服务中心
林小杰	610021 成都同乐健康咨询服务中心
王晓冬	610021 成都同乐健康咨询服务中心
刘乃鹏	230032 合肥, 安徽医科大学公共卫生学院流行病与卫生统计学系
刘晓宇	230032 合肥, 安徽医科大学公共卫生学院流行病与卫生统计学系
王威	230032 合肥, 安徽医科大学公共卫生学院流行病与卫生统计学系
张洪波	230032 合肥, 安徽医科大学公共卫生学院流行病与卫生统计学系	zhanghongbo@ahmu.edu.cn

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中文摘要:

目的调查HIV阳性MSM多性伴高危性行为状况,分析其影响因素。方法通过"滚雪球"方法,在成都、重庆和广州市招募年龄≥18岁、经男男性行为感染HIV者为研究对象,取得知情同意后进行电子问卷调查,调查内容包括社会人口学特征、最近6个月的性伴和性行为状况、焦虑和抑郁症状评定等。采用χ²检验、t检验和非条件logistic回归的方法分别进行单因素和多因素分析。结果 501名HIV阳性MSM平均年龄(30.24±7.70)岁,最近6个月多性伴高危性行为报告率为17.4%(87/501)。多因素分析结果显示,最近6个月多性伴高危性行为的危险因素:婚姻状况为在婚(OR=1.93,95%CI:0.77~4.84)、离异或丧偶(OR=3.94,95%CI:1.66~9.36),有焦虑症状(OR=2.22,95%CI:1.16~4.27),有男性固定性伴(OR=5.04,95%CI:1.08~23.54)、男性偶然/商业性伴(OR=2.54,95%CI:1.34~4.80),高危性行为时饮酒(OR=3.00,95%CI:1.37~6.62)、性行为时使用Rush主要成分为(烷基亚硝酸盐)(OR=3.53,95%CI:1.72~7.23),将自己的HIV感染状况对男性固定性伴部分告知(OR=1.84,95%CI:0.78~4.33)、均未告知(OR=2.68,95%CI:1.25~5.73)和性感觉评分高者(OR=1.09,95%CI:1.03~1.15)。结论 HIV阳性MSM的多性伴高危性行为加速HIV的流行,因此,在发展针对该人群心理行为特征的高危性行为干预方法的同时,亟需建立有效遏制HIV经性传播的医学或生物学措施。

英文摘要:

Objective This study aimed to investigate the status of multiple sexual partners and unprotected sexual behaviors and related influencing factors among HIV-positive men who have sex with men(MSM). Methods HIV-positive men having sex with men aged 18 years or older, living in Chengdu, Chongqing or Guangzhou were recruited by using the "snowballing" sampling method. Participants completed the questionnaire on computers, after filling in the Informed Consent Form. Content of the study would include social demographic characteristics, number of sexual partners, sexual behaviors, and the symptoms assessment on depression and anxiety. χ²-test, t-test and non-conditional Multiple logistic Regression methods were used to examine the risky sexual behaviors with multiple sexual partners among the participants engaged in this project. Results Mean age of the 501 participants was(30.24±7.70) years old. In the past 6 months, 17.4%(87/501) of them had engaged in unprotected sexual behavior with two or more sexual partners. Factors at risk would include:being married(OR=1.93, 95%CI:0.77-4.84), divorced or widowed(OR=3.94, 95%CI:1.66-9.36), having primary male sexual partners(OR=5.04, 95%CI:1.08-23.54) and casual or commercial male sexual partners(OR=2.54, 95%CI:1.34-4.80) in the past 6 months, drinking alcohol(OR=3.00, 95%CI:1.37-6.62) or Rush(alkyl nitrite)(OR=3.53, 95%CI:1.72-7.23) during sexual acts, sharing their HIV-infection status to their partly primary male sexual partners(OR=1.84, 95%CI:0.78-4.33) or not(OR=2.68, 95%CI:1.25-5.73), and having high sexual sensation seeking scores(OR=1.09, 95%CI:1.03-1.15). Conclusions Unprotected sexual behaviors with multiple sexual partners among HIV-positive MSM played an important role in expediting the HIV transmission. Development of intervention programs to minimize the risk sexual behaviors and setting up efficient medical and biological measures in controlling the HIV transmission were in urgent need.

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