基于知识-动机-行为技巧理论的男男性行为者HIV检测影响因素研究

Prior HIV testing and related factors among men who have sex with men-based on information-motivation-behavior skills(IMB)theory

目的以知识-动机-行为技巧(IMB)理论为基础分析影响MSM检测行为的相关因素,为扩大检测策略提供参考依据。方法采用自行设计的网络调查问卷收集武汉市MSM的人口学特征、性行为、检测信息、动机、技巧和检测行为等,采用非条件Logistic回归模型和结构方程模型分析该人群近6个月接受HIV检测的影响因素。结果297名研究对象中,64.3%近6个月做过HIV检测,多因素分析结果显示HIV检测行为技巧得分高(OR=1.22,95%CI:1.06~1.41),性伴数≥2(OR=1.87,95%CI:1.03~3.41),性行为坚持使用安全套(OR=2.92,95%CI:1.19~7.20),性角色为插入方(OR=2.02,95%CI:1.06~3.86),做过性病检测(OR=3.62,95%CI:2.02~6.48)与HIV检测呈正相关。IMB结构方程模型结果显示,行为技巧会直接影响HIV检测行为(路径系数=0.19,P=0.007),而检测知识和检测动机有间接影响。结论个体行为因素和心理因素均会影响MSM的HIV检测行为,应将两者相结合,针对检测意愿较低的MSM开展针对性的干预措施。

Objective To understand the prevalence and determinants of HIV testing among men who have sex with men(MSM),based on the Information-motivation-behavior skills(IMB)theory and provide a reference for expanding the detection.Methods A self-designed online questionnaire was used to collect the participants’demographic characteristics,sexual behaviors,testing information,motivation,behavior skills,and HIV testing behaviors.We used the unconditional logistic regression model and structural equation model to analyze the determinants of HIV testing.Results Among the total 297 participants,64.3% had a history of HIV testing in the past six months.The results of multivariate analysis showed individuals who had high scores on HIV testing behavior skills(OR=1.22,95%CI:1.06~1.41),the number of sexual partners≥2(OR=1.87,95%CI:1.03~3.41),insist on using condoms for sex(OR=2.92,95%CI:1.19~7.20),conducts as insertive partners(OR=2.02,95%CI:1.06~3.86)and having a history of STD testing(OR=3.62,95%CI:2.02~6.48)was positively correlated with HIV testing.In addition,the IMB structural equation model results showed that behavioral skills directly affected HIV testing(path coefficient=0.19,P=0.007),while information and motivation have an indirect impact.Conclusion Both individual behavioral factors and psychological factors could affect the HIV testing behavior of MSM.Therefore,combined interventions should be tailored targeting MSM with low willingness to test.