广州市男男性行为者的异性性行为现状及其影响因素

Heterosexual behaviors and influencing factors among men who have sex with men in Guangzhou

目的了解广州市男男性行为者(MSM)近半年异性性行为现状及其影响因素。方法 2017年6月至2018年4月,通过MSM社区组织招募18岁及以上MSM进行匿名电子问卷调查,收集一般人口学资料、性行为特征、艾滋病知识、内化同性恋嫌恶(IH)和近半年异性性行为发生情况。采用χ2检验和多因素Logistic回归分析比较不同特征的MSM近半年异性性行为发生情况;基于叉生分析法,分别评价IH和有统计学意义的变量间的相乘与相加交互作用。结果 568名MSM平均年龄为(27.58±5.94)岁,近半年发生异性性行为比例为19.37%。非未婚[调整比值比(aOR)=9.38,95%可信区间(CI):4.77~18.42]、非同性恋性向(aOR=2.50,95%CI:1.51~4.15)和有IH者(aOR=1.81,95%CI:1.07~3.07)近半年发生异性性行为的风险较高;大专及以上文化程度(aOR=0.38,95%CI:0.22~0.64)和知晓艾滋病知识者(aOR=0.40,95%CI:0.23~0.69)近半年发生异性性行为的风险较低。叉生分析结果显示,IH与婚姻状况、性向存在影响MSM近半年发生异性性行为的联合作用,但未观察到统计学意义上的交互作用;未发现IH和文化程度、艾滋病知识存在联合作用。结论广州市MSM近半年异性性行为发生率较高,文化程度、婚姻状况、性向、艾滋病知识和IH是影响因素。

Objective To understand the status and influencing factors of heterosexual behavior among men who have sex with men(MSM) in Guangzhou. Methods Between Jun 2017 and April 2018, an anonymous electronic questionnaire investigation was implemented among MSM aged 18 years and over through community organizations.Information on sociodemographic and sexual characteristics, knowledge of AIDS, internalized homophobia(IH) and heterosexual behaviors in the past 6 months were collected. Chi-squared tests and multivariate logistic regressions were performed to analyze the above different information of heterosexual behaviors in the past 6 months among MSM. The multiplicative and addictive interaction between IH and statistically significant variables were evaluated based on the bifurcation analysis method. Results A total of 568 MSM aged(27.58±5.94) years old were included in this study. The rate of heterosexual behavior among MSM was 19.37%. The MSM with unmarried(aOR=9.38, 95%CI: 4.77-18.42), selfidentified as non-homosexual(aOR=2.50, 95%CI: 1.51-4.15) and IH(aOR=1.81, 95%CI: 1.07-3.07) were more likely to have heterosexual behavior in the past 6 months, while college education or above(aOR=0.38, 95%CI: 0.22-0.64) and awareness of AIDS knowledge(aOR=0.40, 95%CI: 0.23-0.69) were less. The results of bifurcation analysis showed that,IH and marital status and sexual orientation could jointly affect the heterosexual behavior of MSM. However, no statistical interactions were observed. No jointly actions affecting heterosexual behavior of MSM were found between IH and education level and knowledge of AIDS. Conclusion Relatively high rate of heterosexual behavior was noticed among MSM in Guangzhou. The influencing factors were education level, marital status, sexual orientation, AIDS knowledge and IH.