绵阳市年轻男男性行为者儿童期性虐待经历对个体行为及心理健康的影响

Impact of childhood sexual abuse experience on individual behavioral and mental health by young men who have sex with men

目的了解年轻男男性行为者（YMSM）儿童期性虐待（CSA）经历,分析对个体行为及心理健康的影响。方法以四川省绵阳市15~24岁YMSM为对象,用滚雪球抽样法进行招募、问卷调查和血清学检测。CSA对个体行为人及心理健康影响单因素分析用χ^2检验,多因素分析用非条件Logistic回归。结果共合格调查336人,有CSA经历者占5.4%（18人）。有、无CSA经历者的HIV感染率分别为16.7%（3/18）、8.2%（26/317）（删除不确定1人）。多因素分析结果：有焦虑症状[比值比（OR）=11.704,95%可信区间（CI）：1.567~87.412）]、曾有自杀念头（OR=49.017,95%CI：2.651~906.244）、因性向遭朋友或同事歧视（OR=17.544,95%CI：1.443~200.000）者,CSA经历发生率较高;近6个月做插入方肛交有保护性（OR=0.060 1,95%CI：0.005~0.721）较低。结论 YMSM的CSA发生率较高,对受害者行为及心理消极影响明显且长远,增加HIV感染风险。应加大未成年人保护,有针对性地开展CSA经历YMSM的心理及行为干预。

Objective To understand the childhood sexual abuse（CSA）experience of young men who have sex with men（YMSM）,and analyze the impact on individual behavioral and mental health.Methods A snowball sampling method was used to investigate the YMSM between 15-24 years old men in Mianyang,Sichuan province and followed by serological test for HIV infection.The single factor and multivariate analysis were made for the impact of individual behavioral and mental health by CSA.Results Among the qualified respondents 336 persons,5.4%（18/336）had CSA experience.The incidence of HIV infection was 16.7%（3/18）among those with CSA experience and 8.2%（26/317）without CSA experience and one case with indeterminate HIV testing result.The result of multivariate analysis showed that those with anxiety symptoms（OR=11.704,95%CI：1.567-87.412）,ever having the thought of suicide（OR=49.017,95%CI：2.651-906.244）,being discriminated by friends or colleagues due to sexual orientation（OR=17.544,95%CI：1.443-200.000）,had relatively high incidence of CSA,and the low rate of anal intercourse protection in the last 6 months（OR=0.0601,95%CI：0.005-0.721）.Conclusion The incidence of CSA among YMSM is much higher,which will have obvious and long-term adverse impact on their behavioral and mental health,and increase the risks of AIDS infection.The protection of YMSM should be strengthened and the psychological and behavioral intervention of YMSM experiencing CSA should be carried out.