绵阳市男男性行为人群随访队列艾滋病知识及相关行为变化研究

Cohort Study of Knowledge About AIDS and Related Behavioral Changes Among MSM

目的了解绵阳市男男性行为者(MSM)随访队列艾滋病知晓及高危行为变化动态。方法 2009年采用应答推动抽样法(RDS)在绵阳招募调查符合条件的艾滋病病毒(HIV)阴性的MSM建立随访研究队列,1年后进行相关行为学随访调查,分析知识知晓及相关行为变化。结果在155例随访者中,平均年龄(27.0±7.8)岁,艾滋病知识知晓率平均97.0%,较基线的95.5%显著上升(χ2=4.499,P=0.034)。随访较基线调查,近1年做过HIV检测,HIV知识信息来自宣传材料、互联网的比例上升显著(χ2=7.315、4.209、10.356,P=0.007、0.040、0.001);寻找性伴场所变化差异有统计学意义(χ2=15.918,P=0.003),酒吧型减少,公园型、网络型上升。近1周平均男男肛交次数、近6月性伴居住城市数分别从基线的1.77次、2.92个下降为随访的0.80次、1.33个,差异有统计学意义(t=4.329、24.270,P均=0.000)。近6月男男肛交做"0"、口交安全套使用率差异有统计学意义(χ2=4.939、8.001,P=0.029、0.018),肛交做"0"每次使用安全套从42.2%上升到51.0%,口交从11.1%下降到3.3%。近6月男男肛交数、女性性行为、商业性行为,近1次、近6月男男肛交、阴道交及做"1"肛交安全套使用率差异无统计学意义。结论绵阳市MSM研究队列艾滋病知晓率提高,高危行为有一定改变,但多性伴、无保护性行为仍较明显,应继续加大行为干预力度。

Objective To investigate the awareness of knowledge about AIDS and the dynamic changes of high-risk sexual behaviors among MSM in Mianyang City. Methods The MSM who did not affected by HIV in Mianyang City were recruited by Responded-driven Sampling（RDS） in 2009.One-year later,a follow-up cohort study was conducted among them to survey the related behaviors.And the awareness of knowledge and the changes of related behaviors were analyzed. Results Among the 155 follow-up men,the average age was（27.0±7.8） years,the average awareness rate of knowledge about AIDS was 97.0% which was significantly higher than the base line（95.5%）,（χ2=4.499,P=0.034）.Compared with the base line research,the proportions of doing the HIV test in the past one-year and acquiring HIV knowledge from publicity materials and Internet showed a significant increase（χ2=7.315,χ2=4.209,χ2=10.356,P=0.007,P=0.040,P=0.001）.The changes of the places where MSM sought sexual partners showed statistically significant（χ2=15.918,P=0.003）,MSM bars decreased,while MSM parks and Internet increased.The average times of insertive anal intercourse with male sex partner（s） in the past one-week and the number of sexual partners＇ living city in the past 6 months decreased to 0.80 and 1.33 during the follow-up from 1.77 and 2.92 of the base line,and the difference was statistically significant（t=4.329,t=24.270,both P=0.000）.There were statistically significant differences in the rate of MSM who being ＂0＂ in insertive anal intercourse and the rate of condom use during oral sex in the past six months（χ2=4.939,χ2=8.001,P=0.029,P=0.018）.The percentage of MSM who being ＂0＂ in insertive anal intercourse using condoms each time increased from 42.2% to 51.0%,while the percentage of using condoms each time in oral sex decreased from 11.1% to 3.3%.No statistically significant difference was found in the rate of condom use among the times of insertive anal intercourse with male sex partner（s）,female sex behavior,and commercial sex behavior in the past six months,insertive anal intercourse with male sex partner（s）,vaginal sexual intercourse,and MSM who being ＂1＂ during insertive anal intercourse in the last sex and the past six months. Conclusions The awareness of AIDS of MSM in Mianyang City increased,and the high-risk sexual behaviors had a certain change,but multiple sexual partners and unprotected sexual behaviors were still obvious.Intervention efforts need to be continuously strengthened.