绵阳市男男性行为者需求层次及关联因素分析

Hierarchy of needs and related factors of men who have sex with men in Mianyang

目的了解男男性行为者(MSM)需求层次,分析关联因素,指导艾滋病防治措施制定。方法以四川省绵阳市辖区MSM为对象,采用滚雪球抽样法招募调查对象,进行问卷调查和血清学检测,调查内容包括人口学特征、艾滋病知识、需求层次、社会活动网络、性行为等内容。关联因素单因素分析采用2检验,多因素分析采用logistic回归分析。结果共调查1 172人,需求层次结构为生理需求占20.1%(236/1 172)、安全需求占66.2%(776/1 172)、交友需求占8.4%(98/1 172)、尊重需求占2.5%(29/1 172)、自我实现需求占2.8%(33/1 172);不同需求层次调查对象艾滋病病毒(HIV)阳性率依次为11.4%(27/236)、4.5%(35/776)、7.1%(7/98)、3.4%(1/29)、3.0%(1/33),差异有统计学意义(P<0.05)。多因素分析结果显示,有独立统计学关联的变量:安全需求与生理需求相比:文化程度(OR=0.408)、社会活动网络(OR=0.374)、近1年做过HIV检测(OR=4.025)、近6个月肛交人数(OR=1.639)、近6个月肛交保护性(OR=9.165);交友需求与生理需求相比:婚姻状况(OR=2.763)、流动MSM(OR=1.919)、艾滋病知识(OR=5.207)、近6个月肛交人数(OR=2.809)、近6个月肛交保护性(OR=3.143)、互联网型性伴(OR=0.275);尊重/自我实现需求与生理需求相比:社会活动网络(OR=0.268)、艾滋病知识(OR=18.420)、近6个月肛交人数(OR=3.517)、近6个月肛交保护性(OR=5.108)、互联网型性伴(OR=0.318)(P<0.05或P<0.01)。结论 MSM处于低级需求层次,安全需求突出。人口学特征、性行为等与需求层次相关,生理需求占主导,MSM HIV感染和传播风险较大,是艾滋病防治重点人群。

Objective To understand the need hierarchy of men who have sex with men（ MSM）,analyze the related factors,and guide the formulation of AIDS prevention and control measures. Methods Snowball sampling method was used to recruit the MSM in Mianyang City,Sichuan Province,for questionnaire survey and serological test. The survey content included demographic characteristics,knowledge about HIV/AIDS,hierarchy of needs,social networks,and sexuality. Chi-squared test and logistic regression were used for univariate and multivariate analyses. Results A total of 1 172 MSM were surveyed. Of the hierarchy of needs,the physiological needs accounted for 20. 1%（ 236/1 172）,safety needs for66. 2%（ 776/1 172）,social belonging for 8. 4%（ 98/1 172）,esteem for 2. 5%（ 29/1 172）,and selfactualization for 2. 8%（ 33/1 172）. The positive rates of HIV infection at different levels of needs were11. 4%,4. 5%,7. 1%,3. 4% and 3. 0%（ P 〈0. 05）. In the multiple logistic regression model of independent statistical correlation variables,for safety needs to compare with physiological needs： education level（ OR = 0. 408）,social activity network（ OR = 0. 374）,having HIV tested in recent one year（ OR =4. 025）,persons having anal sex with in recent six months（ OR = 1. 639）,and protective anal sex in recent six months（ OR = 9. 165）; for making friends to compare with physiological needs： the marital status（ OR = 2. 763）,mobile MSM（ OR = 1. 919）,knowledge about HIV/AIDS（ OR = 5. 207）,persons having anal sex with in recent six months（ OR = 2. 809）,protective anal sex in recent six months（ OR = 3. 143）,and the internet-based sex partners（ OR = 0. 275）; for the esteem/self-actualization needs to compare with physiological needs： social activity network（ OR = 0. 268）,knowledge about HIV/AIDS（ OR = 18. 420）,persons having anal sex with in recent six months（ OR = 3. 517）,protective anal sex in recent six months（ OR = 5. 108）,and the internet-based sex partner（ OR = 0. 318）（ P〈 0. 05 or P〈 0. 01）. Conclusion MSM are at a low level of need hierarchy and requires a high level of safety needs. Demographic characteristics,sexual behavior,etc.,related to the hierarchy of needs. Physiological needs of MSM dominate the higher risk for HIV infection and spreading,which should be the focus of HIV/AIDS prevention and control.