男男性行为人群性取向告知与艾滋病病毒检测:社会规范与自我效能的链式中介作用

Sexual orientation disclosure and HIV testing uptake among men who have sex with men:chain mediating effect of HIV testing social norms and self-efficacy

目的分析男男性行为人群(MSM)中性取向告知、艾滋病病毒(HIV)检测社会规范、HIV检测自我效能和HIV检测的关系。方法2019年8月至12月在山东省11个城市招募MSM并开展网络匿名调查,采用偏差校正的非参数百分位Bootstrap法进行链式中介效应分析。结果在调查的924名MSM中,37.1%(343/924)将自己的性取向告知医务工作者,83.8%(774/924)进行过HIV检测。Spearman秩相关分析表明,性取向告知、HIV检测社会规范、HIV检测自我效能和HIV检测之间两两呈正相关(P<0.05)。Bootstrap链式中介效应检验表明,性取向告知与HIV检测的关系中,HIV检测自我效能的中介作用大小为0.163(95%CI:0.075~0.283),HIV检测社会规范和自我效能的链式中介作用大小为0.022(95%CI:0.006~0.052)。结论艾滋病防治工作需要开展MSM人群性取向告知干预措施,并提高HIV检测社会规范和自我效能,以提高我国MSM人群HIV检测率。

Objective To explore the relationship among sexual orientation disclosure,social norms,self-efficacy and uptake of human immunodeficiency virus(HIV)testing among men who have sex with men(MSM).Methods Participants were recruited in 11 cities of Shandong Province during Aug.and Dec.,2019,and were investigated with an anonymous online survey.The chain mediating effect was analyzed with non-parametric bootstrap method with bias correction.Results Among 924 participants,37.1%(343/924)disclosed their sexual orientation to health professionals and 83.8%(774/924)had received HIV testing.Spearman correlation analysis showed that there was significantly positive correlation between sexual orientation disclosure,HIV testing social norms,HIV testing self-efficacy and HIV testing uptake(P<0.05).Bootstrap test showed that between sexual orientation disclosure and HIV testing uptake,the mediating effect of HIV testing self-efficacy was 0.163(95%CI:0.075-0.283),and the chain mediating effect of HIV testing social norms and self-efficacy was 0.022(95%CI:0.006-0.052).Conclusion It is necessary to carry out MSM sexual orientation disclosure intervention and improve HIV testing social norms and self-efficacy to promote HIV testing uptake among MSM in China.