基于年轻男男性行为者随访队列的艾滋病相关行为变化及影响因素探讨

The Changes and Influencing Factors of AIDS-related Beheavior Based on the Follow-up Cohort of Young Men Who Had Sex With Men

目的了解年轻男男性行为者(young men who have sex with men,YMSM)艾滋病相关行为变化及影响因素。方法用滚雪球抽样法,在绵阳市招募符合条件的YMSM进行艾滋病相关行为的基线调查,实施行为干预后建立随访队列,观察12个月进行随访调查。通过广义估计方程分析YMSM行为变化,采用χ^(2)检验、Logistics回归分析其行为变化的影响因素。结果随访队列入组328人,随访调查198人(60.37%)。随访较基线调查:肛交、固定及偶遇性行为在近1次、近6个月的保护均提高(P均<0.05),近1次肛交有保护从83.33%(105/126)上升到91.55%(130/142),近6个月肛交有保护从61.90%(78/126)上升到80.99%(115/142)。多因素分析结果:无风险认识,性伴相处坚持主张、6个月肛交每次主动准备安全套、近6个月固定性行为的YMSM发生行为正向变化的可能增加(P均<0.05)。结论YMSM行为改变明显,干预方法切实有效。行为变化与风险认识和行为的自主性等有关,应针对性开展行为干预。

Objective To understand the changes and influencing factors of AIDS-related behavior between young men who have sex with men(YMSM).Methods According to the snowball sampling method,eligible YMSM was recruited in Mianyang city for baseline investigation of AIDS-related behaviors.A follow-up cohort was established after the implementation of behavioral intervention and after 12 months of observation.The behavioral changes of YMSM were analyzed by generalized estimation equations,and the influencing factors of their behavioral changes were analyzed by chisquare test and Logistics regression.Results Total of 328 people were included in the team and 198(60.37%)were followed up.Compared with the baseline investigation,the protection behavior of anal sex,fixation and occasional sex behavior in the last time and last 6 months were improved(P<0.05),protective behaviors of anal sex increased from 83.33%(105/126)to 91.55%(130/142)in the last time and increased from 61.90%(78/126)to 80.99%(115/142)in the last six months.The results of multivariate analysis:risk-free cognition,YMSM sexual partner insisted,prepared condoms every time for anal sex in the last 6 months and YMSM with fixed sexual behavior in the last 6 months had positive change may increased(P<0.05).Conclusion The behaviors of YMSM have changed obviously,and the intervention methods are effectively.Behavioral changes are related to risk perception and behavioral autonomy,and behavioral interventions should be targeted.