男男性行为大学生HIV感染风险自我认识及影响因素

Self-perception of HIV risk and its potential predictors among college student men who have sex with men in Beijing and Tianjin

目的了解在校大学生男男性行为人群（MSM）HIV感染风险自我认识及其影响因素,为控制大学生群体的HIV感染风险提供参考。方法 2011年11月至2012年1月间,利用工作组网站、QQ群、大学生志愿者、同伴介绍等方式,在北京和天津市37所高校采取滚雪球的方法招募调查对象,对其进行HIV抗体自愿咨询检测和问卷调查。利用单因素和多因素Logistic回归模型分析大学生MSM人群自认HIV感染风险的潜在影响因素。结果 200名大学生MSM参与调查,其中77.5%性取向为同性恋,20.0%认为自己是双性恋,2.5%不确定自己的性取向。入大学后与男性性伴同居者占16%;艾滋病知识100%知晓率为80%,性传播感染知识100%知晓率为7.5%。1.0%的调查对象自认感染HIV风险很高,38.0%认为一般,52.5%自觉危险较小,8.5%认为完全没有风险。在多因素Logistic回归模型中,与自认感染HIV风险较小或无风险有统计学意义的因素包括性取向（OR=2.99,95%CI=1.43~6.14）、曾有酒后性行为（OR=0.16,95%CI=0.05~0.48）、通过互联网认识性伴（OR=2.96,95%CI=1.45~6.14）、近1年饮酒（OR=3.25,95%CI=1.41~7.52）、喜欢与年长的同性发生性行为（OR=3.09,95%CI=1.43~6.66）、近6个月与同性临时性伴发生口交（OR=0.25,95%CI=0.08~0.78）和曾被确诊感染性病（OR=0.21,95%CI=0.07~0.58）。结论大学生MSM人群性病艾滋病知识知晓率偏低,对HIV感染风险的认识存在一些误区。应加强该人群性病艾滋病的健康教育,提高风险意识和自我防护能力。

Objective To evaluate self-perception of HIV risk and its potential predictors among college student men who have sex with men（ MSM） in Beijing and Tianjin, China. Methods A cross-sectional study was conducted to recruit eligible participants into HIV voluntary counseling and testing using snowball sampling in 37 Beijing and Tianjin universities and colleges from November 2011 to January 2012. Program information was released via gay websites, qq groups, college student volunteers, and peer referrals. Questionnaire interview was conducted by trained college student volunteers. Logistic regression was used to explore the potential predictors associated with self-perception of HIV risk. Results A Total of 200 eligible college students MSM completed interview and HIV test, mean age of participants was 21.1± 1.8 years, 16% lived with male sex partners. Those who admitted homosexual, bisexual or not sure about sex orientation accounted for 77. 5, 20. 0 and 2. 5 per cent respectively. Awareness rate of HIV-related information and sexually transmitted infections information were 80% and 7.5% respectively. Only 1.0% reported selfperceived high risk of HIV infection, 38.0% reported medium risk, 52.2% reported low risk, and 8.5% perceived no risk. In multivariate logistic regression models, self-perceived low and no risk of HIV perception was associated with sexual orientation（ OR =2.99, 95%CI = 1.25-7.19）, alcohol use in the past 12 months（ OR = 3.25, 95%CI = 1.41-7.52）, had sex after alcohol use（ OR =0.16, 95%CI = 0.05-0.48）, seeking sexual partners via internet（ OR = 2.96, 95%CI = 1.43-6.14）, prefer sex with elder gays（ OR= 3.09, 95%CI = 1.43-6.66）, had oral sex with casual sexual partners in the past 6 months（ OR = 0.25, 95%CI = 0.08-0.78）, and had history of sexually transmitted diseases（ OR = 0.21, 95%CI = 0.07- 0.58）. Conclusion MSM was the key population in preventing HIV spread among college students. Their knowledge level about STIs and HIV was limited and HIV infection risks were widely misunderstood. Therefore, it is urgent to strength the health education among college students with MSM, improving consciousness of risk prevention and abilities of self-protection.