男男性行为人群中新近感染HIV者确诊前后性行为变化分析

Change of risky sexual behaviors among men who have sex with men before and after recent identification of HIV diagnosis

目的：评估新近确诊感染HIV的MSM人群在确诊前后的性行为变化。方法在成都和天津，对新近确诊感染HIV的MSM人群进行回顾性调查，收集调查对象确诊前和确诊后6个月的性行为信息。对确诊前后6个月内的性行为进行比较（McNemarχ2检验），对确诊后6个月内的高危行为的影响因素进行logistic回归分析。结果共调查129名新近确诊的HIV感染者或患者，平均年龄为31.8岁，主要通过互联网寻找性伴。调查对象中发生无保护肛交性行为（UAI）的比例从确诊前的70.5%下降到确诊后的16.3%，性伴数＞1人的比例从确诊前的66.7%下降到确诊后的33.3%，有固定性伴的比例从确诊前的72.9%下降到确诊后的55.0%，有偶然性伴的比例从确诊前的62.8%下降到确诊后的31.0%。确诊前6个月内发生UAI、确诊后性伴数＞1人、确诊后有固定性伴是确诊后发生UAI的危险因素。常去互联网以外的其他场所寻找性伴、确诊后发生UAI、确诊后有固定性伴、确诊后未告知固定性伴是确诊后性伴数＞1人的危险因素。结论MSM人群HIV感染者在确诊后6个月内无保护肛交性行为下降显著，多性伴的情况也明显减少，但仍有部分感染者继续发生无保护性行为。

Objective To assess the change of sexual behaviors before and after HIV was recently identified among men who have sex with men（MSM）. Methods A retrospective study was conducted on recently identified HIV-infected MSM in Chengdu and Tianjin. A face-to-face questionnaire interview was administrated to collect sexual behaviors within six months,before and after HIV was diagnosed. Differences in sexual behavior before and after the diagnosis were assessed, using the McNemar χ 2 test. Logistic regression analysis was conducted to identify predictors for sexually risk behaviors. Results Of 129 HIV-infected MSM under survey,the average age was 31.8 years and the main venue in seeking male sex partners was through Internet. The proportions of MSM with unprotected anal intercourse （UAI） decreased from 70.5% before diagnosis to 16.3% after diagnosis and the percentage of having more than 1 partner decreased from 66.7%before diagnosis to 33.3%after diagnosis. After the diagnosis was made,there appeared a significant decrease in the percentage of persons who had one main partner from 72.9% to 55.0% and having casual partners declined from 62.8% to 31.0%. Data from multiple logistic regression analysis revealed that risk factors as UAI before diagnosis,more than 1 partner after diagnosis and having one main partner,were＆nbsp;all significantly associated with UAI after diagnosis. After the diagnosis was made for UAI,risk factors for‘having more than 1 partner’after diagnosis,would include：using Internet to seek for sexual partners,after diagnosis,having one main partner but not disclosing to him. Conclusion After the diagnosis was made,most HIV-infected MSM would reduce their high risk sexual behaviors but some continued to practice UAI.