青年男男性行为者性行为安全套准备现状及影响因素

Status and Influencing Factors of Preparation of Condoms During Sex in Young Men Who Have Sex With Men

目的了解青年男男性行为者(young men who have sex with men,YMSM)安全套准备现状,分析影响因素。方法以四川省绵阳市15～24岁YMSM为对象,用滚雪球抽样法招募调查对象,进行安全套准备、社会及性行为等调查和血清学检测。安全套准备影响因素单、多因素分析分别用χ~2检验、非条件Logistic回归。结果共回收有效问卷362份,近6个月有肛交245人中,57.1%坚持准备安全套,42.9%不坚持准备。不准备原因40.0%认为对方会准备、23.8%有没有无所谓、12.4%怕人看见。准备发生性行为时没有安全套34.4%不使用、30.5%去购买、22.9%不发生性行为、12.4%采取非插入性行为。HIV阳性率在安全套不坚持准备组为17.1%,高于坚持准备组的7.9%(χ~2=4.865,P=0.027)。多因素分析结果,有收入,当地居住时间>1年,接受预防服务,近6个月肛交有保护性者更倾向坚持准备安全套;公开性取向,近6个月有固定性行为、有偶然性行为更倾向不坚持准备安全套(P均<0.05)。结论 YMSM实际性行为安全套准备的自主性普遍不足,依赖性制约明显。安全套坚持准备有效减少了高危行为和HIV感染风险,应继续得到加强。

Objective To understand the status of condom preparation in young men who have sex with men(YMSM) and analyze influencing factors. Methods YMSM in Mianyang city,Sichuan province,were recruited by the snowball sampling method, and an investigation on condom preparation, social behaviors and sexual behaviors and serological tests were carried out.Chi-square test and unconditional logistic regression were respectively used for mono-and multi-variate analysis of factors influencing preparation of condoms. Results A total of 362 valid questionnaires were collected;among respondents with anal sex in the recent six months, 57.1% were persistent in preparation of condoms, and 42.9% were not. Among those who were not persistent in preparation of condoms,40.0% thought their sexual partners would prepare condoms, 23.8% thought to use or not to use condoms was not a serious matter,and 12.4% did not prepare condoms because they did not want to be seen. If there were no condoms for sex,34.4% would not use condoms,30.5% were going to buy condoms, 22.9% would not have sex, and 12.4% were to have non-intrusive sexual behavior. The HIV positive rate was 17.1% in the group with persistent condom preparation,higher than that in the group without persistent condom preparation(7.9%)(χ^2=4.865,P=0.027). Multivariate analysis results showed people who had incomes, lived locally for>1 year, received preventive services and used condoms in sex during the recent six months tended to be persistent in preparation of condoms;people who came out,had fixed sexual behaviors in the recent six months or occasional sexual behaviors tended not to be persistent in preparation of condoms(all P<0.05).Conclusion There was a general lack of autonomy in condom preparation in YMSM during actual sexual behaviors. Persistence in condom preparation can effectively reduce the risk of the high-risk sexual behaviors and the HIV infection and needs continually enhancing.