江苏省常州市男男性行为者婚姻状况及其
对艾滋病高危行为和感染率的影响

郭燕丽; 周建波; 郝超; 还锡萍; 史太平; 王金塔; 甄森; 尹跃平

Abstract

郭燕丽,周建波,郝超,还锡萍,史太平,王金塔,甄森,尹跃平.江苏省常州市男男性行为者婚姻状况及其对艾滋病高危行为和感染率的影响[J].Chinese journal of Epidemiology,2013,34(1):19-23

江苏省常州市男男性行为者婚姻状况及其对艾滋病高危行为和感染率的影响

Comparative analysis on both high risk behaviours, infection of HIV and syphilis between married and unmarried men who have sex with men

Received:July 06, 2012

DOI：10.3760/cma.j.issn.0254-6450.2013.01.005

KeyWord: 男男性行为者艾滋病婚姻高危行为

English Key Word: Men who have sex with men AIDS Marriage status High risk behaviors

FundProject:国家科技重大专项(2008ZX10001-005);常州市卫生局重大项目(ZD200905)

Author Name	Affiliation	E-mail
Guo Yan-li	Changzhou Center for Disease Control and Prevention, Changzhou 213022, China	illianguo@sohu.com
Zhou Jian-bo	Changzhou Center for Disease Control and Prevention, Changzhou 213022, China	zjbdhm1234@163.com
Hao Chao	Changzhou Center for Disease Control and Prevention, Changzhou 213022, China
Huan Xi-ping	Jiangsu Provincial Center for Disease Control and Prevention
Shi Tai-ping	Changzhou Center for Disease Control and Prevention, Changzhou 213022, China
Wang Jin-ta	Changzhou Center for Disease Control and Prevention, Changzhou 213022, China
Zhen Sen	Changzhou Center for Disease Control and Prevention, Changzhou 213022, China
Yin Yue-ping	Institute of Dermatosis Research, Chinese Academy of Medical Sciences

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Abstract:

目的了解常州市男男性行为者(MSM)婚姻分布状况，分析婚姻对该人群艾滋病高危行为及HIV感染率的影响。方法采用定向抽样(“滚雪球，’)法进行横断面调查，通过问卷调查收集社会人口学、HIV感染高危行为等信息，并采集血液和尿液样本进行HIV、梅毒、淋球菌和生殖道沙眼衣原体检测。结果有效调查的655名MSM中，在婚比例为37.4%。在婚组(245人)通常在浴池、桑拿等场所寻找性伴(61.6% )，非在婚组(410人)主要通过酒吧/茶吧(33.6%)和互联网(31.1%)寻找性伴。最近6个月发生同性肛交性行为者，在婚组(50.8%)低于非在婚组(73.3% )(P<0.001);最近6个月与异性发生性关系者，在婚组(68.9%)明显高于和非在婚组(33.2% ) (P<0.001), OR=4.454(95%CI: 3.168 - 6.261)。最近一次同性肛交性行为安全套使用率，在婚组和非在婚组分别为71.0%和”.6% ( P=0.152 );最近一次与异性性行为安全套使用率，在婚组(44.0% )明显低于非在婚组(70.4% ) (P<0.001), OR=0.331(95%CI: 0.205~0.535 )。性交易中，在婚组主要是“买”性(66.7% )，而非在婚组主要是“卖”性(63.2%) (P<0.05), OR=3.429(95%CI;1.2559.366 )。最近一年吸食过毒品的比例，非在婚组(3.3%)高于在婚组(0.8%)(P<0.05)。在婚组和非在婚组HN感染率均为8.6%，梅毒感染率分别为17.1%,12.3%，淋球菌阳性率分别为1.6%,2.4%，生殖道沙眼衣原体阳性率分别为3.3%、9.0%(P值均>0.05 )。结论婚姻对MSM高危行为的制约作用有限，应根据MSM婚姻状况的特点，制定多种形式的干预措施。

English Abstract:

Objective To understand the distribution of marriage status among men who have sex with men (MSM) in the city of Changzhou, and to explore the impact of marriage on AIDSrelated high risk behaviors and HIV infection in this population. Methods Target sampling (snowball sampling) was adopted to carry out a cross-sectional study, and structured questionnaire-based interviews were conducted to collect information on social demography, HIV related high riskbehaviors. Blood and urine samples were collated to detect HIV, syphilis, gonorrhea and Chlamydia trachomatis infections. Results Of the 655 participants, 37.4% were married. Married MSM mostly sought their sexual partners at the public bathing house ( 61.6% ), while unmarried MSM were mainly through bars ( 33.6% ) or intemet ( 31.1 % ). The proportion of having anal sex with men during the last6 months was lower in the married group (50.8%)than in the unmarried group ( 73.3 %)(P<0.001).The percentage of having sex with women in the last 6 months was significantly higher in the married group ( 68.9%)than that in the unmarried group (33.2%)( P< 0.001)，(OR=4.454, 95% CI:3.168-6.261).The rates of condom use in the last anal sex with men in married and unmarried groupswere 71.0% and 77.6%，respectively (P=0.152). The rate of condom use in the last intercourse with women was significantly lower in the married group (44.0%)than that in the unmarried group(70.4%)(P<0.001)，( OR=0.331，95%CI:0.205-0.535). In the sex trade,most of the married MSMwould "buy" sex ( 66.7% ), while unmarried MSM would "sell" sex ( 63.2% ) ( P< 0.05 )，(OR=3.429,95%CI: 1.255-9.366). The percentage of having drugs in the previous year was higher in married group ( 3.3%)than that in the unmarried group (0.8%)(P<0.05). In married and unmarried groups,the infection rates of HIV, syphilis, gonorrhea and Chlamydia trachomatis appeared to be ( 8.6%，8.6%)，(17.1%，12.3%)，(1.6%，2.4%)，and (3.3%，9.0%)，respectively (P>0.05). ConclusionMarriage seemed to have had limited effects on reducing the high risk behaviors of MSM. Differentand multiform interventions should be developed according to the different characteristics of marriedor unmarried MSM population.

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