常德和张家界两市HIV阳性已婚男男性行为者性行为状况分析

Sexual behaviors of HIV positive married MSM in Changde and Zhangjiajie, China

目的了解常德和张家界两个城市艾滋病病毒(HIV)抗体阳性已婚男男性行为者(MSM)的性行为状况。方法在两市疾病预防控制中心的转介下,对城市所有注册的、能接触到的HIV阳性已婚MSM招募,通过问卷调查收集相关信息。结果本次共招募146人,130人(89.0%)的配偶在其确诊后进行了HIV检测,其中9人(6.9%)报告结果为阳性。在确诊HIV感染后,已婚MSM与配偶的性行为情况发生明显变化,发生性行为的占比由确诊前的89.7%(131人)降至35.6%(52人),与配偶每次性行为使用安全套的比例由确诊前的10.7%(14/131)增加到了86.5%(45/52),差异均有统计学意义(P <0.001)。41.8%(61/146)的HIV阳性已婚MSM仍会在婚后与同性发生性关系,其持续安全套使用频率为83.6%(51/61)。常德市调查对象在感染后与配偶发生性行为的比例以及与男性发生商业性行为的比例分别为41.6%(42/101)和17.8%(18/101),均高于张家界市的调查对象(10/45;2/45),差异有统计学意义(P <0.05)。结论防治工作中需重点关注HIV阳性已婚MSM,加强其婚内和婚外安全性行为教育,以预防HIV由高危人群向一般人群传播。

Objective To explore the sexual behaviors among HIV positive married men who have sex with men(MSM) in Changde and Zhangjiajie, Hunan province of China. Methods A questionnaire survey was conducted among registered HIV positive married MSM under the support of Changde and Zhangjiajie Center for Disease Control and Prevention. Results Among the married 146 MSM with HIV infection, 130(89.0%) of their female spouses had been tested for HIV, of which 9(6.9%) of them self-reported as HIV positive. After the diagnosis, their sexual behavior changed significantly and the rate of intercourse with their female spouses decreased from 89.7% to 35.6%(P < 0.001), while the frequency of consistent condom use with female spouses significantly increased from 10.7%(14/131) to 86.5%(45/52)(P < 0.001). In addition, 41.8%(61/146) of the MSM had anal sex with their male partners and 83.6%(51/61) used condom consistently. 41.6%(42/101) of the MSM had vaginal sex with female spouses, and 17.8%(18/101) had commercial sex with male partners in Changde, higher than those in Zhangjiajie(22.2%, 10/45;4.4%, 2/45)(P < 0.05). Conclusion AIDS prevention interventions should focus on HIV positive married MSM in the future, and the marital and extramarital sex education be strengthened to prevent AIDS spreading from the high-risk group to the general population.