男男性行为者不同性角色HIV/梅毒感染及与相关行为特征的关系研究

Anal sex roles and related behaviors among men who have sex with men(MSM)and the HIV/syphilis infection in Mianyang city of China

目的了解男男性行为者(MSM)性角色及不同角色艾滋病病毒(HIV)/梅毒感染和相关行为特征。方法对2009年建立的MSM人群开放性研究队列在2010年随访调查基础上进行随访调查,不足基线调查样本部分,采用滚雪球采样法招募补足,应用自行设计制作的调查表,由专门人员面对面进行相关行为学和血清学的匿名调查。结果在有效调查的402例中,0号115例(28.6%),1号92例(22.9%),0.5号195例(48.5%)。不同性角色人口学及行为特征关联性的多因素分析,存在独立的统计学/边缘统计学关联的变量:1号与0号相比,年龄、职业、认识当地MSM朋友数、近6月性伴数、同时有过2个及以上固定性伴、习惯携带安全套(P<0.05或0.05<P<0.10);0.5号与0号相比,年龄、职业、近6月无保护性男性肛交、习惯携带安全套;1号与0.5号相比,收入、近6月无保护性男性肛交、同时有2个及以上固定性伴(P<0.05或0.05<P<0.10)。年龄较小、学生/教师/干部职员、认识当地MSM朋友数较多、近6月性伴数较多、不习惯携带安全套的比例0号较多;中低收入、体力劳动、近6月有无保护性男性肛交0.5号比例较高,同时有2个及以上固定性伴者1号较高。生物学检测结果,0号、1号、0.5号HIV累计发病率分别为6.3%、0、7.6%(似然比χ2=7.390,P=0.025),梅毒累计发病率分别为8.0%、2.3%、3.5%(χ2=1.985,P=0.371)。结论不同性角色具有不同的人口学、社会网络、性行为特征和HIV感染风险,在艾滋病防治中应针对性开展干预活动。

Objective To understand the HIV/syphilis infections and related behaviors among men who have sex with men （MSM） at different anal sex roles. Methods To follow up the MSM dynamic cohort established in 2009 in Mianyang city of China on the basis of 2010 follow-up survey. Snowball sampling was used to recruit additional subjects to meet the sample size. Self-designed questionnaire was used by trained professionals for the face-to-face survey. Results Of all 402 MSM subjects, roles of receptive, insertive and both were 115 （28.6%）, 92 （22.9%） and 195 （48.5%）, respectively. Age, occupation, number of local MSM friends, number of sexual partners during the last 6 months, having two more MSM partners at the same time and using condoms make significant differences between receptive group and insertive group （P〈0.05 or 0.05〈P〈0. 10） . Age, occupation, non-protected anal sex within recent 6 months and using condoms were signifi- cantly different between receptive group and both insertive and receptive group （P〈0.05 or 0. 05〈P〈0.10）.Income, non-protected anal sex during the last 6 months, having two or more MSM partners at the same time were significantly different between insertive group and both insertive and receptive groups （P〈0.05 or 0.05 〈P〈0.10）. The proportions of young people students/teachers/white collar employees, local MSM friends, number of sexual partners in the precious 6 months, number of MSMs who do not use condoms were higher in the insertive group. A higher proportion of low income, blue collar workers, MSMs without protective measures during previous 6 months was seen in the receptive group. Number of MSMs having two or more partners at the same time was higher in both insertive and receptive groups. The HIV cumulative incidence rates in insertive, receptive and both insertive and receptive groups were 6.3% , 0 and 7.6% , respectively （x2= 7. 390, P=0. 025） . The Syphilis cumulative incidence rates were 8.0% , 2.3% and 3.5% , respectively （x2 = 1. 985, P=0. 371）. Conclusions Different corresponding preventive measure should be taken to MSM pop ulation towards different sex roles and sexual behaviors.