广西344名MSM艾滋病非职业暴露后预防服务需求及其影响因素分析

Demand for non-occupational post-exposure prophylaxis and its influencing factors among 344 men who have sex with men in Guangxi

目的分析广西部分地区男男性行为者(MSM)对艾滋病非职业暴露后预防(nPEP)服务的需求及其影响因素。方法采用方便抽样的方法在广西部分地区招募MSM。通过面对面问卷调查,收集其社会人口学特征、艾滋病相关知识、高危行为、服务利用及对nPEP服务需求等基本信息。采用χ~2检验对不同特征调查对象的nPEP服务需求进行单因素分析,采用非条件二分类Logistic回归模型分析nPEP服务需求的影响因素,计算比值比(OR)和95%可信区间(CI)值,以P<0.05为差异有统计学意义。结果共获得有效问卷344份。344人中,22.1%(76人)听说过nPEP,60.2%(207人)在告知nPEP相关服务和可能风险等标化内容后,表示存在该服务需求。仅57.6%(198人)最近半年每次同性肛交均使用安全套;27.3%(94人)曾经历过安全套意外破裂、滑脱或者被对方故意拔套等危险性行为。非条件二分类Logistic回归模型多因素分析显示,文化程度大专及以上(OR=0.28,95%CI:0.12~0.65)、半年内的性角色主要为插入方(OR=2.18,95%CI:1.26~3.76)、半年内固定性伴个数3个及以上(OR=8.37,95%CI:1.04~67.08)、认为当地MSM艾滋病疫情严重(OR=2.22,95%CI:1.24~3.97),为nPEP服务需求的影响因素。结论广西部分地区MSM对nPEP服务存在一定的需求。nPEP作为一项有效的生物干预措施,应在中国条件允许的情况下尽快开展,促进MSM主动求医行为,以减少MSM的HIV感染。

Objective To analyze the demand and influencing factors of non-occupational post-exposure prophylaxis（nPEP）among men who have sex with men（MSM）in Guangxi.Methods MSM were recruited by convenience sampling and face-to-face questionnaire survey was conducted to collect the information such as demographic characteristics,HIV/AIDS related knowledge,high risk behavior,service utilization and the demand of nPEP.Chisquare test was used to analyze the difference of nPEP demand among different characteristics of respondents.Logistic regression was used to analyze the influencing factors of nPEP demand,the OR（95%CI） value was calculated,and P0.05 was statistically significant.Results A total of 344 valid questionnaires were collected,and 22.1%（76/344） had heard of nPEP,and 60.2% （207/344）had the demand for the service after being informed of the standard content of nPEP and possible risks.Only 57.6%（198/344）of the respondents used condoms for homosexual sex each time in the past six months,and 27.3%（94/344） had the experiences in condom accidentally broken,slipped,being deliberately pulled out or other risk sexual behavior.Multivariate logistic regression analysis showed that the factors influencing the demand for nPEP services were the educational level of college or above（OR=0.28 95% CI：0.12-0.65）,the insertive homosexual role in the past six months（OR=2.18 95%CI：1.26-3.76）,3 fixed partners or more in the past six months（OR=8.37 95%CI：1.04-67.08）,local HIV/AIDS epidemic among the MSM thought to be serious（OR=2.22 95% CI：1.24-3.97）.Conclusion There is a certain demand for nPEP services among MSM.As an effective biological measure in the world,nPEP services should be carried out as soon as the conditions permit in our country,to promote the active health seeking behavior among MSM,in order to reduce HIV infection.