MSM人群艾滋病相关社会环境、性伴网络、健康需求的定性分析

A qualitative study on AIDS associated social environment,sexual partner network and health service needs among MSM

目的了解浦东新区男男性行为人群(MSM,Man who has sex with man)艾滋病相关的社会环境、性伴网络、健康行为及健康需求情况,为针对该人群制定更加有效的干预措施提供依据。方法于2014年12月通过VCT(HIV Voluntary Counseling&Testing)、NGO组织(Non-Governmental Organizations)、网络同志聊天群等途径随机招募访谈对象,根据自行设计的半结构式访谈提纲开展访谈,样本量根据"信息饱和"原则确定,共访谈MSM对象30名。结果访谈结果提示上海地区MSM人群在男性人口中的的比例较高且流动性较大,网络媒体和手机软件是该人群寻找性伴的主要方式;一般情况下安全套使用率较高,但在年龄偏大、教育程度低以及固定性伴的MSM人群中安全套使用率较低;目前社会对男同存在不认同和歧视等现象,MSM人群对艾滋病防治工作的主要建议包括加强多部门合作、宣传教育、干预检测、队伍建设、传染源管理、药物研发、权益保护、社会保障及公益活动等。结论应加强MSM人群的宣传教育和行为干预,提高安全性行为意识,通过正面的宣传和引导营造更加包容的社会环境,开展综合措施预防艾滋病的传播。

Objective To know AIDS associated social environment, sexual partner network and health service needs among MSM in order to provide suggestions for better intervention measures against HIV. Methods In- depth interviews were con- ducted with self-designed semi- structural questionnaire in December, 2014 among 30 MSM from HIV Voluntary Counseling ＆ Testing （VCT） sectors, Non-Governmental Organizations （NCA）） and MSM network chat groups in Pudong, Shanghai. Sample size was determined according to the principle of information saturation. Results The interviews showed that the pro- portion of MSM was relatively high in Shanghai and they were more likely to move from one place to another. Internet media and mobile network were the most popular ways for MSM to seek their sexual partners. Generally speaking, MSM had formed a habit of using condoms to avoid HIV infection, but there wasn＇t consistent use of condoms among some MSM, especially those who were old or not well educated. Condoms were seldom used when MSM had sex with their regular sexual partners. MSM were not accepted by the mainstream of the society, and stigma and discrimination still existed. Measures like enhancing coordination a- mong multifunctional groups, publicity and education, HIV testing, team building, social security, infectious source manage- ment, drug development, protection of rights and interests, socially useful activity and so on were main suggestions for HIV pre- vention and control. Conclusions Comprehensive measures like enhancing publicity and education as well as behavior inter- vention, improving safe- sex trol the spread of HIV among MSM and creating an anti- discrimination social environment should be carried out to control the spread of HIV among MSM.