长沙市男男性行为人群艾滋病相关高危行为及影响因素分析

Analysis of HIV/ AIDS High Risk Behavior and Influrencing Factors Among Men Who Have Sex with Men in Changsha

目的了解长沙市男男性行为人群(MSM)艾滋病相关高危行为及其影响因素。方法采用同伴推动法和分类滚雪球法招募MSM,对符合条件的MSM进行问卷调查、标本采集和HIV抗体检测。以高危性行为为应变量,以人口学特征、艾滋病知识知晓、干预服务覆盖等因素为自变量,进行二分类Logistic回归分析。结果共调查957名MSM,HIV感染率为3.5%(33/957)。最近6个月,89.4%(856/957)的MSM与同性发生过肛交性行为,无保护率为60.5%(511/845);6.0%(51/855)的MSM通过付钱的方式与男性发生过性行为,无保护率为30.0%(15/50);12.7%(108/852)的MSM为了得到钱与男性发生过性行为,无保护率为26.2%(28/107);最近6个月平均男性性伴数为4.79个,66.8%(534/799)的MSM有2个及以上男性性伴。最近1年,艾滋病干预服务覆盖率为71.9%(687/956),艾滋病相关知识知晓率为89.6%(857/956)。与男性首次性行为年龄<20岁、月收入高于2 000元、文化程度低、去浴室/酒吧/场所寻找性伙伴是发生多男性性伴的危险因素;与男性首次性行为年龄<20岁、文化程度高、在婚、干预服务未覆盖、艾滋病知识不知晓是发生无保护性肛交行为的危险因素。结论要继续提高MSM干预服务的覆盖率,针对性地强化浴室、酒吧会所等高危场所MSM的干预服务。

Objective To understand the high risk behavior and influencing factors associated with HIV/AIDS among men who have sex with men （MSM） in Changsha.Methods The MSM were recruited by respondent driven sampling （RDS） or snow ball sampling and were surveyed by face to face questionnaire.Serum was collected and HIV antibody was detected.Having high risk behaviors as dependent variable and demographic features,awareness of HIV and intervention coverage as independent variables,binary logistic regression analysis was made.Results A total of 957 MSM were tested,and HIV prevalence was 3.5 ％ （33/957）.During the past six months,89.4 ％ （856/957） MSM had anal sex with male partners,among which 60.5 ％ （511/845） were unprotected.6.0 ％ （51/855） reported that they had ever paid for sex with male,and the unprotected proportion was 30.0％ （15/50）.12.7％ （108/852）reported that they had ever sold sex to males,and 26.2％ （28/107） were unprotected.During the past six months,the average number of the male sexual partners was 4.79,and 66.8 ％ （534/799）MSM had two or more male sexual partners.In the past year,the coverage of intervention service was 71.9％ （687/956）,and the awareness rate of HIV was 89.6％ （857/956）.The risk factors for multiple male sexual partners included：first sex with males at age younger than 20 years old,,monthly income above 2000 Yuan,poor education,and looking for sexual partners in bathrooms or bars.The risk factors for unprotected anal sex with male partners included：first sex with males at age younger than 20 years,being well educated,being married,being not covered by interventions and poor AIDS knowledge.Conclusions The coverage of intervention services should be improved.Behavioral interventions to MSM in high risk sites like bathrooms and bars should be strengthened.