男性同性性接触者高危性行为与性病的调查研究

Survey of STD Prevalence and Related High Risk Sexual Behaviors in Chinese MSM

目的 调查男性同性性接触者 (MSM)性病（ STD）流行状况 ,并探讨与高危性行为的关系。方法 对 337例 MSM不记名问卷调查，包括 57例深入访谈。所得数据进行统计学分析。结果 87例（ 25.8％） MSM曾患 STD，近 1年 STD发病率为 7.7％。曾患 STD者同性性伴数多于未曾患 STD者 (P < 0.05)。前者在浴池 (P< 0.01)、公厕 (P< 0.01)寻找同性性伴，与当地同性陌生人和外地人发生性关系 (P< 0.01)，同性卖淫 (P< 0.01)、遭受同性性骚扰和被迫与同性性交 (P< 0.05)及近 1年内使用阴茎套出现破裂滑脱 (P< 0.01)等情况的应答人数百分比高于后者。多因素非条件 Logistic回归分析显示，同性陌生性伴、外地性伴是影响 MSM人群是否患 STD的主要因素。其相对危险度分别是 3.65和 2.60， 95％可信区间分别为 1.63～ 8.15和 1.23～ 5.52。结论性病已在我国 MSM人群中严重流行，并与该人群的高危性行为密切相关。

Objective To investigate STD epidemic situation and the related high risk sexual behaviors in Chinese men who have sex with men (MSM). Methods Anonymous questionnaires were performed in 337 MSM, including in-depth interviews with 57 persons. Statistical analyses were performed. Results Eighty-seven cases (25.8％ ) of MSM investigated suffered from STD. In the last year, 26 cases (7.7％ ) contracted STD. The number of same-gender sexual partners (SGSP) of the MSM with STD was more than that of the MSM without STD (P < 0.05). The following situations were more common in the MSM with STD than those in the MSM without STD: sex contacts in bathrooms (P< 0.01), toilets (P< 0.01), sex with same-gender strangers and non-local residents ( P< 0.01), same-gender prostitution (P< 0.01), same-gender sex harassment and coercive intercourse (P< 0.05), and the condom breakage and slip (P< 0.01), etc. Multivariate unconditional logistic regression analysis showed that strange SGSP and non-local SGSP were the main factors for STD prevalence. The relative risks were 3.65 and 2.60, with 95％ confidence interval (CI) of 1.63-8.15 and 1.23-5.52, respectively. Conclusion STDs are widely prevalent in Chinese MSM, and closely related to the high risk sexual behaviors.