南京市不同性角色MSM的行为特征及HIV和梅毒感染现状

Sexual behavior and HIV/syphilis infection among MSM with different sexual roles in Nanjing

目的了解南京市不同性角色男男性行为者(MSM)的行为特征及艾滋病病毒(HIV)、梅毒感染现状,为制定更有针对性的干预措施提供依据。方法在知情同意的前提下,采用分类滚雪球法招募MSM,开展问卷调查,收集人口学、行为学等信息,并进行HIV、梅毒抗体血清学检测。结果共调查MSM 2 377人,根据最近6个月肛交时的性角色分为三组:插入组800人(33.66%)、被插入组615人(25.87%)和双向组962人(40.47%),三组在平均年龄、文化程度、在婚比例、同性恋自我认同比例、艾滋病知识知晓率、第一次肛交年龄、最近6个月与同性肛交的频率、男性性伴总数、与同性商业性行为时安全套使用频率、与异性性行为频率方面,差异有统计学意义(P<0.05)。三组梅毒感染率分别为7.63%、8.29%和6.55%,差异无统计学意义(χ~2=1.79,P=0.41);HIV感染率分别为7.00%、13.50%和13.62%,差异有统计学意义(χ~2=22.76,P<0.05)。多因素Logistic回归分析结果显示,被插入组感染HIV的风险是插入组的1.98倍[95%可信区间(CI)∶1.38~2.85],双向组感染HIV的风险是插入组的2.13倍(95%CI∶1.53~2.97)。结论南京市不同性角色MSM具有不同的人口学、行为学特征,插入组、被插入组和双向组感染HIV的风险依次增高,应根据各自的特点制定更有针对性的干预措施。

Objective To understand the sexual roles and its relationship with the related behaviors and HIV/ syphilis infection among men who have sex with men （MSM） in Nanjing City. Methods With informed consent, MSM were recruited by snowball sampling for a face to face questionnaire survey and serological test for HIV/syphi- lis. The same questionnaire was used to acquire the information of demography and sexual behaviors. Results A to- tal of 2377 MSM were recruited. The MSM were classified into 3 groups according to the sexual roles in anal sex be- havior during the past 6 months： insertive group of 800 MSM （33.66%）, receptive group of 615 MSM （25.87%）, and both insertive and receptive group of 962 MSM （40.47%）. The difference of the average age, the educational background, the rate of marriage, its identification of homosexuality, the awareness rate of HIV knowledge, the age of having anal sex for the first time, the frequency of having anal sex in the past 6 months, the number of sexual partners, the frequency of using condom in buying or selling sex with men, and the rate of having sex with female a- mong the 3 groups were significant （P〈0.05）. The syphilis prevalence rates in the three groups were 7.63%, 8.29 % and 6.55 % ,with no significant difference （X^2= 1.79 P= 0.41）. The HIV prevalence rates in the insertive, receptive and both groups were 7.00%, 13.50% and 13.62% respectively, with significant difference （X^2 =22.76 P〈0.05）. The multivariate logistic regression showed that compared to those with insertive role, those with recep- tive role and both roles had higher HIV infection risks, with OR 1.98 （95M CI ： 1.38-2.85） and 2.13 （95% CI ： 1.53-2.97） respectively. Conclusion The features of demography,sexual behaviors are different in different groups of sex roles. The receptive group has higher HIV infection risks than the insertive group, the group of both roles have the highest. Based on these significant difference, we should consider specific interventions in MSM with dif- ferent sexual roles.