绵阳市MSM异性婚姻关系及时间与艾滋病高危行为关联性

Correlation between heterosexual marriage and marriage time and highrisk HIV behavior among married men who have sex with men in Mianyang city

目的了解男男性行为者(MSM)异性婚姻关系现状,分析婚姻时间与艾滋病高危行为的关联性。方法2017年1—10月,在四川省绵阳市采用滚雪球抽样法,进行MSM异性婚姻关系、性行为及血清学的横断面抽样调查。结果回收有效问卷1242份中,已婚234人(18.8%),婚姻时间平均(14.9±10.579)年,66.2%夫妻关系一般。婚后夫妻性生活平均每月(4.1±4.381)次,对夫妻性生活50.7%应付、32.4%配合,16.4%不和谐,18.7%无快感。夫妻性生活78.2%不使用安全套,77.3%认为没必要。结婚时间>15年组HIV阳性感染率12.6%,高于≤15年组4.6%(χ^2=4.792,P=0.029)。多因素分析结果,婚后主要是同性偶然性伴、近6个月多性伴者婚姻时间>15年可能性大,主要互联网寻找性伴、近1次肛交有保护婚姻时间>15年可能性小。结论MSM异性婚姻关系差,性生活消极,主观认识制约安全套使用。婚姻时间与艾滋病高危行为相关,婚姻时间长者HIV感染风险更大。

Objective To examine the prevalence of heterosexual marriage and the association of the marriage duration with human immunodeficiency virus(HIV)/AIDS related high risk behaviors among the men who have sex with men(MSM)in Mianyang city of Sichuan province.Methods We carried out a questionnaire survey on heterosexual marriage,sexual behavior and serologic examination among 1242 MSM recruited with snowball sampling in Mianyang city of Sichuan province between January and October 2017.Results Of the MSM surveyed,234(18.8%)were married to a woman;the married MSM reported an average marriage duration of 14.9±10.579 years and 66.2%of the MSM reported a general marital relationship.An average couple′s sexual activity of 4.1±4.381 times per month was reported by the MSM with heterosexual marriage and 50.7%,32.4%,18.7%,and 16.4%of the MSM reported careless,harmonious,disharmonious,and unsatisfactory couple′s sexual activities.There were 78.2%of the married MSM reporting no condom use in couple′s sexual activities and 77.3%denying the necessity of condom use in couple′s sexual activity.The HIV positive rate was 12.6%among the MSM with marriage duration of more than 15 years and was significantly higher than that(4.6%)among those with the duration of≤15 years(χ^2=4.972,P=0.029).Multivariate logistic analysis demonstrated that the MSM with the heterosexual marriage duration of more than 15 years were more likely to have occasional homosexual partners and multiple sexual partners during the latest 6 months but less likely to seek sexual partners via internet and to use condom in the latest anal sex.Conclusion Conjugal relation and sexual life are poor and the condom use is impeded by subjective cognition among the MSM with heterosexual marriage;the MSM’s marriage duration associates with HIV-related high risk behaviors and longer marriage duration predicts a higher risk of HIV infection.