天津市个体和会所男性性工作者艾滋病高危行为特征分析

Analysis of high risk behavior of AIDS among self-employed and club-employed MSWs in Tianjin

目的通过对天津市个体和会所男性性工作者（MSWs）艾滋病高危行为的特征进行分析,为开展针对性的有效干预提供依据。方法依托艾滋病综合干预服务站,2014年12月至2015年6月,通过网络动员和干预现场动员招募MSWs,签署知情同意书,然后进行包括人口学、性行为、药物滥用等内容的问卷调查及HIV抗体检测。对个体和会所MSWs的特征进行比较,用SPSS 19.0进行统计分析。结果调查个体MSWs 168人,会所MSWs162人。与会所MSWs相比,个体MSWs本地户籍比例高（16.7%vs 1.9%）,在天津生活时间一般≥3个月（52.9%vs 15.7%）,兼职比例高（33.9%vs 2.5%）,月收入水平〉5 000元的比例高（83.3%vs 53.7%）,性取向以同性恋为主（77.4%vs 42.0%）（P〈0.05）。个体MSWs发生首次插入性性行为的性伴多为男性（85.1%vs48.8%）,发生首次插入性性行为的年龄大多在18岁以前（51.8%vs 37.7%）,且近一个月肛交次数、近一个月发生群交的比例、无保护性行为发生的比例都高于会所MSWs（P〈0.05）。87.5%的个体MSWs联系客人的方式以网络/交友软件为主,而会所MSWs 99.4%以别人介绍为主（P〈0.05）。个体MSWs的药物滥用比例高（73.2%vs 52.5%）、性病感染率高（22.0%vs 5.6%）,且缺乏定期检测的习惯（10.1%vs 29.0%）（P〈0.05）。结论与会所MSWs相比,个体MSWs从业地点较为固定,性取向以同性恋为主,主要通过新媒体联系客人,性行为次数更多,群交和药物滥用比例更高,更容易发生无保护性行为,感染艾滋病的风险更高,应动员各级各部门加大对该类亚人群的干预力度。

Objective To understand the difference of characteristics of HIV high risk behaviors between selfemployed and club-employed male sex workers（MSWs）in Tianjin and to provide evidence for effective intervention measures.Methods Based on HIV/AIDS comprehensive intervention service stations,we recruited MSWs through internet and on-site intervention between Dec 2014 and Jun 2015.With informed consent,we collected the data of their demographic characteristics,sexual behavior,drug abuse,etc.by aquestionnaire survey,and tested their HIV antibody.Then comparison was made between the two groups and SPSS 19.0 was used for statistical analysis.Results 168 self-employed MSWs and 162 club-employed MSWs were surveyed.Comparison of the two groups showed that more self-employed MSWs had local household registration（16.7% vs 1.9%）,lived in Tianjin for more than 3 months（52.9% vs 15.7%）,had high proportion of part-time jobs（33.9% vs 2.5%）and their monthly income〉5000 yuan（83.3% vs 53.7%）and more were homosexual（77.4% vs 42.0%）（P〈0.05）.More self-employed MSWs＇ first sexual partner were men（85.1% vs 48.8%）and more had their first insertions before the age of 18（51.8%vs 37.7%）.In addition,self-employed MSWs had higher rates of anal intercourse and group intercourse in the last month than club-employed MSWs（P〈0.05）.Self-employed MSWs contacted the sexual clients mainly via the network or dating software（87.5%）,while club-employed MSWs did it by introduction of their friends（99.4%）（P〈0.05）.Self-employed MSWs had higher rates of drug abuse（73.2% vs52.5%）,STD infection（22.0% vs 5.6%）and lacked HIV testing（10.1% vs 29.0%）（P〈0.05）.ConclusionSelf-employed MSWs＇ working place is more fixed compared with the club-employed MSWs＇,and their sexual orientation is mainly homosexual.They seek the sexual partners mainly through new media,and have higher rates of sexual behavior,group sex and drug abuse,unprotected behavior,and the risk of HIV infection.Therefore,intervention of this population should be strengthened.