上海市青少年男男性接触者性行为安全认知和社会状况调查

Qualitative Study on Safety Awareness and Social Status of Homosexual Behavior among Young Men Who Have Sex with Men in Shanghai

[目的]了解青少年男男性接触者（ young men who have sex with men, YMSM ）性行为安全认知和社会状况，为进一步在YMSM中开展艾滋病（ acquired immunodeficiency syndrome, AIDS ） 相关高危行为干预提供科学依据。[方法]采用无记名方式，运用自编的调查问卷、抑郁自填问卷（self-rating depression scale，SDS）、焦虑自填问卷（self-rating anxiety scale，SAS）和半结构式访谈提纲，对28名YMSM进行问卷调查和个人深入访谈。[结果]研究对象年龄16～19岁，平均（18．11±0．83）岁；22人近半年有肛交性行为，其中仅10人每次肛交均使用安全套；15人有过一夜情。研究对象对安全性行为认知较差，19人与性伴讨论过此问题；多数人认为安全套相对安全且购买方便，但主动购买者较少（11人），不喜欢使用安全套者占多数；对一夜情态度较开放。多数人认为自己行为是后天形成的，主要受性别认同环境、不愉快经历、同性恋信息和家庭教育方式4方面的影响。多数能感受到来自家人等方面的压力，抑郁和焦虑症状检出率分别为32．14％和25．00％。[结论]YMSM中同性性行为安全认知较差且心理压力较大，应加强AIDS健康教育，提倡单一固定性伴侣和安全性行为，推广使用安全套，提供有利于青少年健康成长的支持性环境，为YMSM健康营造和谐氛围。

[ Objective J To analyze safety awareness of homosexual behaviors among young men who have sex with men （ YMSM ）and provide scientific evidence for advanced intervention in AIDS risk behaviors among them. [ Methods ] Anonymous questionnaires, including self-composed questionnaire, self-rating depression scale （ SDS ） and self-rating anxiety scale （ SAS ）, as well as semi-structural interview outline were conducted among 28 YMSM. [ Results ] The age distribution among interviewees was from 16 to 19 years old and the mean age was 18.11 ＋ 0.83. Of them 22 YMSM had anal sex in the past 6 months, but only 10 persons used condom each time. Fifteen YMSM had one night stand behavior. Some men had wrong awareness of safe sexual behaviors. Nineteen YMSM had talked about safe sexual behaviors with their partners. Although the majority of interviewees thought condom was relative safe and convenient to be bought, only 11 men would buy it initiatively. Most men wouldn＇t like to use condom. The majority of interviewees thought MSM was acquired, for example, environment for sex identity, disagreeable experience, stimulus of homosexuality information and family education, all of those caused them to become MSM. They felt pressure from family, and the rates of depression and anxiety of them were 32.14% and 25.00%, respectively. [ Conclusion ] AIDS risk sexual behaviors are widespread among YMSM. Health education for YMSM should be emphasized and safe sex, condom use and single sexual partner should be advocated and health and harmonious environment should be prepared.