中国大陆男同性性接触者的艾滋病高危行为及影响因素研究(一)

Study on HIV/AIDS High Risk Behavior and Its Factors among Men Who Have Sex with Men in China

目的 本文描述了中国大陆男同性性接触者（MSM）与HIV/AIDS/STD相关的高危行为、认识和某些影响因素。方法 通过自我填写问卷和当面访谈填写问卷两种形式,对426位男性进行了调查。结果 本组主要生活在大中城市、接受过较好教育、较为年轻的MSM,平均约18岁开始与同性性交。4/5以上有口-生殖器性交,半数以上有肛门性交行为。累计性伴中位数9人。2/5以上在近一年内有偶遇性性伴。约半数人在调查时有固定性伴,但仅少数人与性伴保持闭合性性关系。约 1/3已婚,近半数人与女性性交过。1/4曾患性传播疾病,近一年患病率为 6.81％。仅 1/10进行过HIV抗体检测,1人阳性。约 1/3使用过安全套,通常在少数情况下使用,只有2人坚持使用。不用安全套的原因主要是认为安全套能降低快感、自己无感染HIV的可能和性伴健康,虽然他们已普遍具有关于HIV传播的一般知识。结论 中国大陆部分MSM在性方面相当活跃,存在HIV在MSM中高水平流行的可能性。HIV在中国MSM中的流行速度高于90年代初中期在西方国家MSM中的流行速度,而且流行还会直接蔓延到妇女人群。由于社会文化等因素的阻力,对中国MSM的AIDS干预面临重大困难。

Objective To describe the high risk behavior, recognition and some factors associated with HIV/AIDS/ STD among men who have sex with men (MSM). Methods 426 MSM had been investigated by questionnaire and face to face interview. Results The MSM investigated, who live in big and middle cities and got better education, had experienced homosexual activities at the average age 18. Of 426 MSM, over 80% of them had the sexual experience of oral - genitals and half of them had anus sexual activities. The median of their sexual partners was 9. 40 % of them had had occasionally sexual partners for nearly one year and, half of them had regular sexual partners, but only had a few of them kept closed sexual relationship. 33.3% of them got married and, half of them had sexual experiences with females. In addition, 25% of them suffered from STD and, the annual incidence of STDs in them was 6. 81 % . Only had 10% of them tested for HIV and one was found to infect HIV. 33.3% or so of them used condoms infrequently and, only had two MSM insisted on condom use, although they had got the knowledge of how HIV transmits. Conclusion The possibility of HIV speed epidemic in MSM has existed because the MSM in China are so active as to their sexual activities. Also, the HIV epidemic in MSM will involve their female partners. In China, the intervention of preventing MSM from HIV/AIDS faces great difficulties because of the limitations coming from traditional social and cultural context.