男男性接触者同性性行为特征及安全性行为影响因素研究

The characteristics of homosexual behavior and factors associated with safe sexual behavior among men who have sex with men

目的了解男男性接触者（men who have sex with men,MSM）同性性行为特征及安全性行为的影响因素,为开展MSM人群艾滋病综合防治提供建议。方法通过滚雪球的方式招募MSM进行面对面的调查,采用逐步后退法的logistic回归分析确定影响安全性行为的因素。数据采用SPSS12.0软件作统计学处理,率的比较用χ2检验,P〈0.05为差异有统计学意义。结果本研究共调查MSM951人,过去一年接受咨询检测服务的比例占44.5%,最近一次与最近6个月同男性发生肛交时安全套使用率分别为69.6%与38.3%。多因素logistic回归分析结果显示：月收入（AOR=0.86,95%CI：0.77~0.96）、最近一年是否做过艾滋病病毒（HIV）检测（AOR=0.65,95%CI：0.48~0.87）、过去一年是否接受过干预服务（AOR=0.64,95%CI：0.43~0.97）、第一次与男性发生性行为时的性角色（AOR=0.75,95%CI：0.62~0.92）、最近6个月发生性行为的男性性伴数（AOR=1.33,95%CI：1.04~1.71）是影响安全性行为的独立影响因素。结论 MSM人群安全套使用率低,接受咨询检测服务的比例低,仍存在艾滋病在该人群快速传播的风险,应切实加大对该人群的行为干预。

Objective To analyze the characteristics of homosexual behavior and the factors associated with safe sexual behavior among men who have sex with men（MSM）,and provide evidences of comprehensive HIV infection intervention strategies for the population.Methods A snowball sampling method was used for MSM population in the study with a face-to-face interview.Factors associated with sexual behavior were determined by backward stepwise logistic regression.Results The study had 951 subjects of MSM.44.5% of MSM received counseling and HIV test in the most recent year.The rates of condom use were 69.6% and 38.3% respectively for the most recent anal sex and for recent six months.A multivariate logistic regression analysis indicated that monthly income（AOR=0.86,95% CI：0.77-0.96）,HIV test in the last year（AOR=0.65,95% CI：0.48-0.87）,receiving the intervention in the last year（AOR=0.64,95% CI：0.43-0.97）,the sexual role of the first sex with man（AOR=0.75,95% CI：0.62-0.92）,number of male sexual partners in recent six months（AOR=1.33,95% CI：1.04-1.71）were independent variables of safe sexual behavior.Conclusion Low rates of condom use and seeking voluntary counseling testing（VCT）services suggested the requirement of urgent intervention measures for the prevention of HIV transmission among the population of MSM.