绵阳市年轻男男性行为者队列保持及影响因素分析

Cohort Retention and Influencing Factors Analysis of Young Men Who Have Sex With Men in Mianyang City

目的了解绵阳市年轻男男性行为者(YMSM)队列保持情况,分析影响因素。方法用滚雪球抽样法,在绵阳市招募15~24岁艾滋病病毒(HIV)检测阴性的YMSM进行队列基线调查,12个月后进行随访。采用SPSS 19.0软件进行χ2检验、Logistic回归模型分析队列保持的影响因素。结果入组队列328人,随访198人,队列保持率60.4%。毕业/工作变动离开(35.4%)、失去联系(24.6%)、不愿意再参加(21.5%)是失访主要原因。多因素分析,知晓艾滋病知识(OR=5.388)、近1年接受过安全套发放(OR=2.602)、自我性取向认识积极(OR=5.190)、焦虑症状中度/重度(OR=7.443)、近6个月口交有保护(OR=3.304)的队列保持率更高,梅毒感染(OR=0.208)的队列保持率更低。结论绵阳市YMSM队列保持率欠高,流动性是失访主要原因。队列保持与预防服务、自我认同、心理健康和风险行为有关。后续队列研究应针对性制定纳入标准和强化随访管理。

Objective To understand the cohort retention of young men who have sex with men in Mianyang City(YMSM),and analyze the influencing factors. Methods The human immunodeficiency virus(HIV) negative YMSM aged 15-24 years were recruited in Mianyang city by snowball sampling method to conduct a baseline survey of the cohort, and the follow-up surveys was conducted after 12 months. SPSS 19.0 software was used to perform chi-square test and Logistic regression method to analyze the influencing factors of cohort retention. Results There were 328 people enrolled in the cohort,and 198 were followed up,queue retention rate was 60.4%. Leaving after graduation/job change(35.4%), losing contact(24.6%) and unwilling to participate(21.5%)were the main reasons for the loss of follow-up. Multiple-factor analysis showed that cohort retention rates were higher in the cases with following characteristics, having knowledge of AIDS(OR=5.388),receiving condom in the past 1 year(OR=2.602),positive self-knowledge of sexual orientation(OR=5.190), moderate/severe anxiety symptoms(OR=7.443) and protective oral sex for the last 6 months(OR=3.304). While the cohort retention rate of cases with syphilis infection(OR=0.208) was lower. Conclusion The YMSM cohort retention rate is not high enough in Mianyang city, and the fluidity is the main reason for the loss of follow-up. Cohort retention is associated with preventive service, self-identification, mental health and risk behaviors. Targeted inclusion criteria should be established and follow-up management should be strengthened for subsequent cohort studies.