有自杀意念的男同性爱者／双性爱者艾滋病高危行为研究

Study on high-risk behaviour and suicide associated risk factors related to HIV/AIDS among gayor bisexual men

目的探讨男同性爱者（gay）与双性爱者（Bi）中有自杀意念者的艾滋病高危行为特征，并分析其与自杀意念相关的危险因素。方法采用定向抽样法对gay／Bi人群进行横断面调查。从有效问卷中获取有自杀意念者，并依照自杀意念组的年龄隋况在无此意念者中选取比较组进行比较。结果调查的gay／Bi中有自杀意念者占20．2％。自杀意念组性向为同性、婚姻状况为未婚者多于比较组（P〈0．05）。自杀意念组在曾经向同性买性、近一年性交时曾出过血、曾去外地与陌生同性性交、16岁前曾遭受成年同性性虐待、有性施虐与受虐行为、有过主动或被动吻肛行为、有过主动或被动指交行为、每周饮酒至少一次或更多、曾因性向和／或同性性活动受到gay伤害、曾因性向和／或同性性活动受到异性爱者伤害等方面的比例显著高于对照组（P〈0．05）。多因素logistic回归模型提示曾因性向和／或同性性活动受到gay（WaldX^2=6．637，P=0．010）及异性爱者（IValdX^2=5．835，P=0．016）伤害是导致自杀意念产生的危险因素。结论有自杀意念的gay／Bi与艾滋病相关的高危性行为显著多于无此意念者。减少社会对gay与Bi人群的歧视及伤害可能对遏制艾滋病的流行有一定作用。

Objective Characteristics on AIDS high-risk behaviors in gay or bisexual menwith suicide ideas were explored and analyzed. Methods A cross-sectional survey was conducted with the snowball sampling method adopted. Subjects with suicide ideas were collected from responses to the valid questionnaires and subjects with no suicide ideas were collected from the age comparable men. Results The overall rate of gays or bisexuals with suicide ideas was 20.2% in this survey. The attitude for homogeneity and marital status among the unmarried was more than that among the comparable group （P〈0.05）. The rate of AIDS high-risk behaviors as same-sex sexual harassment, bleeding during sexual intercourse in the last year, coitus with unfamiliar same-sex partners in cities, suffering from adult same-sex sexual abuse before the age of 16, having had sexual abuse and abusive behavior, having had active or passive anal kiss, having had active or passive coitus with fingers, alcohol consumption weekly at least once or more, hurt by gays because of attitude and/ or same-sex sexual activity and hurt by heterosexual men because of attitude and/or same-sex sexual activity were significantly higher in gays and bisexual men with suicide ideas than those without （P〈 0.05）. Data from multivariate logistic regression models suggested that harm from gays （1ValdX^2= 6.637, P=0.010） and heterosexual men （IValdX^2=5.835, P=0.016） due to attitude on homosexual activity appear to be the risk factors causing the suicide ideas. Conclusion Reducing the social discrimination and harm towards gays and bisexual men could reduce the occurrence of the suicide ideas and have a positive effect on curbing the nrevalence of AIDS.