广西龙州县男性多性伴人群性行为特征和安全套使用影响因素

HIV-related risk behaviors and associated factors of condom use among men with multiple sexual partners in Longzhou,Guangxi

目的分析农村地区成年男性多性伴人群的性行为学特征,探讨影响其坚持使用安全套的因素,为今后性病,尤其是艾滋病的防控工作提供科学依据。方法于2017-2019年在广西壮族自治区龙州县农村地区招募男性多性伴人群,获取知情同意后对其进行面对面问卷调查或电子问卷调查,同时采集5 mL静脉血检测艾滋病病毒(HIV)抗体、梅毒抗体和丙型肝炎病毒(HCV)抗体。使用Epi Data 3.1软件和SPSS 23.0软件进行数据整理和统计学分析,单因素分析使用χ^(2)检验,以最近3个月每次发生商业性性行为时坚持使用安全套为因变量进行非条件逐步Logistic回归分析。结果共调查1029名农村户籍的男性多性伴者,该人群以壮族(998名)、已婚(781名)、农民(877名)、初中及以下(952名)为主,艾滋病知识总体知晓率84.45%(869名),24.30%(250名)的发生商业性性行为时坚持使用安全套,高危性行为后HIV检测率9.52%(98名)。HIV、梅毒、HCV的感染率分别为0.29%、4.86%、0.49%。多因素分析结果显示,最近1年性伴数≥5个[比值比(OR)=3.32,95%可信区间(CI):1.94~5.69)]和高危行为后进行HIV检测(OR=2.40,95%CI:1.49~3.86)是坚持使用安全套的促进因素,而选择暗娼上门服务(OR=0.40,95%CI:0.21~0.76)是该人群不能坚持使用安全套的影响因素。结论广西龙州县男性多性伴人群危险性行为比例较高,需推动该人群正确使用及坚持使用安全套,并提高HIV检测率,以期实现2030年终结艾滋病流行的目标。

Objective To investigate the sexual behavior of men with multiple sexual partners(MSPs)in rural areas and to identify determinants associated with condom use,so as to provide evidence for curbing HIV/STI epidemic.Methods A study was conducted in Longzhou county of Guangxi during 2017-2019.Men with MSPs in rural areas were recruited and completed face-to-face or online questionnaires after written informed consent.Meanwhile,participants were tested for HIV,syphilis and HCV.EpiData 3.1 and SPSS 23.0 softwares were used for data collection and analysis.Univariate analysis was also conducted by chi-square test and non-conditional binary logistic regression method.Results A total of 1029 men with MSPs were recruited.Among them,the most were Zhuang ethnics,married,working as farmers and received middle school education or above.The prevalence of HIV,syphilis and HCV infections was 0.29%,4.86%and 0.49%,respectively.The overall awareness rate of AIDS knowledge was 84.45%(869/1029);24.30%(250/1029)reported consistent condom use with female sex workers(FSWs)in the last 3 months,and 9.52%(98/1029)conducted HIV testing after high-risk sexual behaviors.The result of multivariate logistic regression showed that having more than 5 sexual partners(OR:3.32,95%CI:1.49-3.86)and HIV testing after high-risk sexual behavior(OR:2.40,95%CI:1.34-3.41)were associated with consistent condom use.Furthermore,MSPs who had FSWs to their home were less likely to use condom(OR:0.40,95%CI:0.21-0.76).Conclusion Men with MSPs in Longzhou have a relatively high proportion of risk sexual behaviors.It is urgent to promote correct and consistent use of condom,and simultaneously raise awareness of HIV testing to curb the AIDS epidemic.