3城市感染HIV MSM的多性伴状况及其影响因素分析

Status of multiple sexual partners and its correlates among HIV-positive men who have sex with men

目的调查艾滋病病毒(HIV)抗体阳性男男性行为者(MSM)拥有多性伴的状况,分析其影响因素,为完善相应艾滋病干预策略提供依据。方法在成都、重庆和广州市,采用"滚雪球"方法招募经男男性行为途径感染HIV者作为调查对象,进行电子问卷调查。调查内容包括社会人口学特征、健康状况、最近6个月的性行为和性伴种类、性伴告知状况和性感觉评分等。采用χ~2检验、t检验和非条件Logistic回归分别进行单因素和多因素分析。结果共调查HIV抗体阳性MSM 501人,其中20.6%(103人)报告最近6个月拥有2个及以上性伴(包括同性性伴和异性性伴),拥有两种类型的男性性伴(固定性伴、偶然性伴或商业性伴)的比例为39.8%(41/103),拥有女性性伴的比例为22.3%(23/103)。多因素Logistic回归分析结果显示,在婚、离异或丧偶,高中及以下文化,最近6个月有男性固定性伴、男性偶然或商业性伴、群交行为,将自己的HIV感染状况未告知全部固定性伴,性行为时饮酒、使用烷基亚硝酸盐和较高的性感觉评分,均与拥有多性伴密切关联。结论 HIV阳性MSM拥有多性伴状况普遍存在,多个性伴和多种类型性伴构成了"继续传播网络",因而急需完善性伴干预策略,以遏制HIV阳性MSM在同性和异性性伴间的继续传播。

Objective To investigate status of multiple sexual partners among HIV-positive men who have sex with men（MSM）and to examine the associated factors for development of HIV intervention strategies.MethodsHIV-positive MSM were recruited by using＂snowballing＂sampling and completed the online questionnaire after informed consent.The information was collected on social demographic characteristics,health status,sexual partners and HIV disclosure to sexual partners,and assessment of sexual sensation seeking as well.χ-2-test,t-test and nonconditional multiple logistic regression were used to examine the factors associated with multiple sexual partners among the participants.Results Totally 20.6%（103/501）of participants had two or more sexual partners during the past 6months.Of them,42.7%（41/103）had two types sexual partners（primary male sexual partners and casual or commercial male sexual partners）and 22.3%（23/103）had female sexual partners.The analysis of multiple logistic regression found that participants having multiple sexual partners were associated with the factors such as the groups who were married,divorced or widowed,with educational level below high school,having primary male sexual partners,casual or commercial male sexual partners in the past six months,experiencing in group sex,disclosing of their HIV-infection to none of their primary male sexual partners,alcoholics and alkyl nitrite users,and high sexual sensation seekers.Conclusion Multiple sexual partners are common among HIV-positive MSM.The numbers and types of sexual partners constitute a social network of HIV ongoing transmission.Therefore,it is urgent to developHIV intervention strategies targeted to the sexual partners.