2014—2016年钦州市男性商业性行为者安全套使用情况及其影响因素分析

Analysis of status and influential factors of condom use among male clients of female sex workers in Qinzhou city from 2014 to 2016

目的了解2014—2016年钦州市男性商业性行为者（CFSWs）的人口学特点、艾滋病相关知识知晓情况和最近一年安全套的使用情况,并分析CFSWs坚持使用安全套的影响因素,为今后的防艾工作提供理论依据。方法按照《全国艾滋病哨点监测实施方案》,简单随机抽样收集2014—2016年钦州市1 200名CFSWs的健康调查问卷,使用SPSS 16.0软件,对其人口学特征、艾滋病相关知识进行统计,并对最近一年坚持使用安全套的相关因素进行多因素Logistic回归分析。结果 2014—2016年,每年调查400人,三年共1 200名CFSWs。其中以≥45岁的中老年人群、本地户籍、汉族、在婚、初中及以下、民工为主;AIDS相关知识知晓率整体较高,＂除2016年蚊虫叮咬会传播艾滋病吗？＂为74.0%外,其他均〉80%。在最近一年商业性行为中,CFSWs坚持使用安全套的比例三年依次为28.5%（96/337）、44.5%（178/400）、60.9%（218/358）;在与配偶/同居者的性行为中,CFSWs最近一年坚持使用安全套的比例三年依次为5.1%（17/335）、1.5%（4/268）、12.2%（40/328）,占比总体均较少。多因素Logistic回归分析表明,中高档场所、年龄〈45岁、大专及以上、在婚/同居、一次商业性行为费用≥100元,是最近一年坚持使用安全套的保护因素;低档场所、年龄≥45岁、初中及以下、未婚、一次商业性行为费用〈100元、既往艾滋病检测,是最近一年坚持使用安全套的危险因素。结论钦州市中老年人群较高的艾滋病相关知识知晓率和低的安全套坚持使用率相比,出现知行分离现象。应加大针对性宣传使用安全套的教育和寻找新的防艾措施。

Objective To understand the demographic features,awareness of AIDS knowledge and condom use in the past year among male clients of female sex workers（CFSWs）in Qingzhou from 2014 to 2016,to provide bases for future AIDS prevention among the group.Methods According to the National AIDS Sentinel Surveillance Protocol,we collected 1 200 questionnaires,to analyze the demographic characteristics and awareness of AIDS knowledge by using SPSS16.0.Logistic regression analysis was used to know the influential factors of condom use in the last year.Results Out of 1 200 CFSWs surveyed,the majority was elderly,local residents,civilian workers,Han ethnic and married/cohabitant,and with the educational level of middle/high school or technical secondary school.The overall rate of AIDS knowledge awareness was high（〉 80%）.Logistic regression analysis suggested that the protective factors of consistent condom use in their commercial sex last year included age less than 45 years,married/cohabitation,educational level from or higher than middle/high school or technical secondary school,visits to the high and middle class entertainment establishments,and the expenses of buying sex with more than 100 yuan,while the risk factors were the opposite.Conclusion The results show the separation between cognition of AIDS knowledge and sexual behaviors.More accessible intervention initiatives should be taken to prevent and control AIDS,such as condom use,and other intervention strategies.