深圳市458例男男性接触者高危行为特征研究

High risk behaviors among 458 men who have sex with men in Shenzhen

目的了解男男性接触者(MSM)高危行为特征,为制定艾滋病性病防治策略提供参考依据。方法成立彩虹工作组,到同性恋者活动场所开展外展服务,发放健康教育资料;2006年4-9月,应用以场所为基础的抽样方法,在6家同性恋活动场所中抽取458例MSM。在知情同意原则下,一对一匿名填写调查问卷,问卷内容包括基本人口学资料、艾滋病知晓率、社会歧视、性取向、性伴性别、性行为方式、安全套使用及商业性行为等。结果共调查458例。性取向以同性恋和双性恋为主,分别占46.1%和42.6%。与男性初次性交年龄最小13岁,最大42岁,平均(21.4±4.6)岁。最近1年,26.6%MSM曾经和异性发生性接触,30.1%曾为男性提供商业性服务。51.5%与男性伴口交时不使用安全套;27.5%与男男性工作者发生肛交,每次用安全套比例为46.8%,47.8%与男性网友发生肛交,每次使用安全套比例为56.6%。89.1%有2个以上的性伴,主要通过互联网(43.9%)、桑拿或洗浴中心(42.8%)、酒吧或夜总会(36.0%)找寻男性伴。与男性伴发生性行为方式,肛交列于首位(占77.3%),其余依次为口交、"打飞机"、指交、臀交;最近1年,39.1%曾做过HIV检测,34.9%接受过预防艾滋病教育,17.5%在有性行为前经常喝酒,17.2%服用过精神科药物,6.8%MSM曾感染性病。结论MSM存在多种不同的高危性行为,应开展健康教育和行为干预,全面推广以性病门诊为依托的HIV/STI预防干预模式,高质量提供MSM友善的诊疗服务,最终将MSM人群的艾滋病性病感染率控制在较低水平。

Objective To investigate STD/AIDS related high risk behaviors among men who have sex with men（MSM） and provide evidence for policy development in Shenzhen. Methods A workgroup called rainbow was formed to conduct outreaches and recruitment in the MSM venues from April to September in 2006. 458 MSM were investigated from six homosexual venues using venue - based sampling method. Anonymous serf administered questionnaires were collected with informed consent including demography, HIV/AIDS knowledge, social stigma, sexual choices, gender of sex partners, sex - specific behavior patterns, condom use and commercial sexual behaviors. Results The proportion of gay and bisexual among 458 MSM were 46.1% and 42.6% respectively. The average age of having first sex with male was 21.4 ±4.6 years （minimum 13, maximum 42）. 26.6% MSM had sex with female in the past one year, 51.5% had oral sex with male without condoms, 30.1% served as money boys, 27.5% had anal sex with money boys and the proportion using condoms every time was 46.8%. 47.8% had anal sex with internet friends with 56.6% using condoms every time. Most MSM （89.1%） had more than one male sex partners and seek them through website （43.9%）, saunas and bathhouses （42. 8% ）, bars and night clubs （36. 0% ）. Anal sex was the main type （77.3%）, followed by oral sex, masturbation by others, sex with fingers by others,hip sex. In the past one year, 39.1% reported got HIV test, 34.9% received HIV education, 17.5% drank before sex, 17.2% took drugs and 6.8% had infected with STD. Conclusion High risk behaviors were prevalent in MSM population and deserved intensive health education and behavioral intervention using STD clinic based HIV and STI control and prevention strategies as well as good quality services to control HIV and STI epidemic.