绵阳市男男性行为人群性行为特征及多性伴影响因素分析

Characteristics of sexual behavior and factors influencing multiple sexual partners among men who have sex with men in Mianyang

目的了解男男性行为人群(MSM)性行为特征,分析多性伴影响因素。方法以四川省绵阳市辖区MSM为对象,在固定场所,用滚雪球抽样法进行抽样,对抽样人群进行问卷调查和血清学检测,采用单、多因素分析方法对MSM多性伴影响因素进行分析。结果共调查1 271人,年龄中位数为24岁,文化程度初中及以下占13.9%(177人)、高中及以上占86.1%(1 094人),婚姻状况未婚占81.9%(1 041人)。最近6个月男性肛交发生率为88.2%、商业性行为发生率为1.3%、异性性行为发生率为8.6%。最近1次肛交、最近6个月肛交每次均使用安全套的比例分别为92.9%、82.7%。近6个月肛交中位数为2次,多性伴发生率为24.2%。寻找性伴场所以网络型为主,占72.5%。多因素分析结果显示:多性伴发生可能性中,文化程度高中及以上者是初中及以下者的0.539倍,认识当地MSM朋友数5~9、≥10人分别是<5人的2.224、3.231倍,进入MSM圈子时间>1年是≤1年的2.279倍,有压力感受者是无压力感受者的2.422倍,近1周肛交数为2、≥3次者分别是≤1次者的1.931、3.231倍,HIV感染者是无感染者的1.938倍。结论 MSM多种性伴类型并存,以网络型性伴为主。文化程度、社会活动网、进入MSM圈子时间及压力感受、HIV感染与多性伴相关。

Objective To understand the current status of men who have sex with men （MSM）, and analyze factors influencing multiple sexual partners in MSM. Methods A snowball sampling method was used to recruit the MSM at a fixed place in Mianyang City, Sichuan Province. Questionnaire survey and serological test were conducted among the subjects. Univariate and multivariate logistic regressions were used to analyze influencing factors among multiple sexual partners in MSM. Results A total of 1 271 MSM were investigated, with a median age of 24 years. Of the participants, 177 （13.9%） had educational level at junior high school and below and 1 094 （86.1%） at high school and above, and 1 041 （81.9%） were unmarried. In the past 6 months, 88.2% of the subjects had male anal intercourse, 1. 3% had commercial sex behaviors, and 8.6% had heterosexual behaviors; 92.9% used condoms during anal sex in the last time and 82. 7%, each time in the recent 6 months. In the recent 6 months, the median of anal sex was 2 times, and 24.2% of MSM had multiple sexual partners. Main access to seeking sexual partners was based on the internet, accounting for 72.5% of the participants. In the multiple logistic regression model, the possibility of having multiple sex partners for subjects with educational level at high school and above was 0. 539 times of that for those at junior high school and below, for subjects with 5 to 9, and more than 10 local MSM friends was 2. 224 and 3. 231 times of that for those with less than 5 MSM friends, for subjects entering MSM circle for more than 1 year was 2. 279 times of that for those below 1 year, for subjects with stress was 2. 422 times of that for those without stress, for subjects having anal sex twice a week and more than three times a week was 1.931 and 3.231 times of that for those having anal sex once a week respectively, and for subjects with HIV infection was 1. 938 times of that for those without HIV infection （ P 〈 0.05 or P 〈0. 01 ）. Conclusion Various types of sexual partner coexist among MSM and the main access to seeking sexual partners was the internet. Educational levels, social network activity, the time of entering the MSM circle and stress perceived, and HIV infection were associated with the multiple sexual partners.