基于轨迹分析模型的男男性行为人群无保护性行为特征分析

Analysis of high-risk sexual behaviors among men who have sex with men based on trajectory model

目的:通过轨迹分析模型了解男男性行为(men who have sex with men,MSM)人群无保护性行为情况及其影响因素。方法:采用非概率抽样法在重庆和新疆地区招募并筛选出390名MSM进入研究,并在第12、24、36、48周进行随访问卷调查。利用轨迹分析模型对MSM人群进行无保护性行为轨迹特征分组并描述不同亚组轨迹特征,通过二元logistic回归分析其影响因素。结果:轨迹分析模型结果显示,调查对象可分为艾滋病病毒,即人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染"高风险组"和"低风险组",其中"高风险组"146人,"低风险组"244人,其2周无保护性行为次数分别为1.38次和0.43次。多因素分析结果显示,年龄、婚姻和月均收入具有统计学意义(P<0.05),低年龄者较高年龄者有更高可能被纳入"高风险组"(OR=0.95,95%CI=0.92~0.99);低收入人群相较于高收入的更易被纳入"高风险组"(OR=0.53,95%CI=0.34~0.82);和已婚相比,离异/丧偶的MSM更容易进入"高风险组"(OR=3.35,95%CI=1.34~8.37)。结论:轨迹分析模型直观地反映了MSM人群在无保护性行为上不同的发展轨迹,其中低年龄、低收入、离异/丧偶的MSM是HIV防治中的重点关注人群。

Objective：To exlpore high-risk sexual behavior and associated factors among men who have sex with men（MSM）though trajectory model. Methods：Totally 390 MSM were recruited with non-probability sampling method. Clinical follow-up and question-naire were carried out at 12 th,24th,36 th,48th week. MSM were divided into different subgroups through trajectory model and the highrisk sexual behaviors of different groups were described. Univariate and multivariate regression were used to analyze associated factors. Results：The subjects can be divided into high risk group（146 MSM）and low risk group（244 MSM）through trajectory model and high-risk sexual behavior times were 1.37 and 0.43 times in last two weeks,respectively. Multivariate analysis showed that age,marriage and income had statistical significant differences（P〈0.05）. The younger（OR=0.95,95%CI=0.92 to 0.99）,low-income（OR=0.53,95%CI=0.34 to 0.82）and divorced/widowed（OR=3.35,95%CI=1.34 to 8.37）participants had a higher chance of entering the high risk group. Conclusion：The trajectory analysis model can directly reflect the different development paths of MSM high-risk sexual behavior. The younger,low-income and divorced/widowed participants should be focused and the publicity of HIV related knowledge should be strengthened.