成都市青年学生男男性行为者扩大HIV检测阻碍因素调查

A survey of barriers to expanding HIV testing among male students who have sex with men in Chengdu

目的了解在成都市18~24岁学生MSM中扩大HIV检测面临的相关阻碍因素。方法于2018年5-6月在全市采用方便抽样的形式,通过培训后的学生MSM调查员,使用流行社交软件招募认识的学生MSM进行调查,内容包括人口学信息、接受检测面临的阻碍或顾虑因素、性行为和社交生活、对性向的看法、艾滋病基本知识、既往检测情况等信息。结果共纳入535名调查对象,其中有320人(59.8%)最近1年做过HIV检测。接受检测面临的阻碍或顾虑因素主要是"我担心/害怕我的检测结果为阳性"(80.7%)、"我觉得/担心检测点的地理位置不方便"(74.8%)和"我觉得/担心周围人发现我去做HIV检测后会产生异样眼光"(74.6%)。多因素分析结果显示:接触过MSM社会组织(a OR=2.54,95%CI:1.67~3.87,P<0.001)、有过同性肛交性行为(a OR=2.36,95%CI:1.31~4.26,P=0.004)、有过同性临时性伴(a OR=1.63,95%CI:1.09~2.46,P=0.019)、知道暴露后预防用药(PEP)(a OR=1.75,95%CI:1.11~2.74,P=0.015)、艾滋病相关知识得分越高者(a OR=1.18,95%CI:1.03~1.36)最近1年HIV检测概率增加;与最近1年感染性病者相比,不清楚自己性病感染状况者(a OR=0.23,95%CI:0.05~0.98,P=0.047)检测概率减少。结论成都青年学生MSM中近1年内HIV检测比例仍然较低,扩大HIV检测存在个人层面和环境层面的双重障碍,为此,有必要进一步破除障碍,开展针对性宣教以及精准干预学生MSM措施。

Objective The study aimed to evaluate the barriers to expanded HIV testing behaviors among students who are men having sex with men(MSM) aged 18-24 in Chengdu. Methods In May to June 2018, MSM was recruited using convenience sampling by the trainers, through popular social software to recruit students. The contents surveyed included demographic information, obstacles or concerns to be tested, sexual behavior and social life, attitude towards sexual orientation, basic knowledge of AIDS, and past testing. Results 535 subjects were recruited, among them, 59.8%reported having received an HIV test in the past 12 months. Barriers to HIV testing included fear of being diagnosed with HIV(80.7%), inconvenient location of testing sites(74.8%), and fear of negative attitudes from people around(74.6%).The positive factors associated with HIV test included affiliation to MSM-oriented organizations(a OR=2.54, 95%CI: 1.67-3.87), anal sex(a OR=2.36, 95%CI: 1.31-4.26), causal sexual partners(a OR=1.63, 95%CI: 1.09-2.46), do know postexposure prophylaxis(a OR=1.75, 95%CI: 1.11-2.74), and the higher level of HIV knowledge(a OR=1.18, 95%CI: 1.03-1.36). Those whom unknown status of other sexually transmitted diseases(STDs)(a OR=0.23, 95%CI: 0.05-0.98) tested less compared with those with STDs infection. Conclusion Student MSM still had a lower proportion of HIV testing in the past 1 year in Chengdu. Environment and personal barriers to promoting HIV testing existed. Therefore, it is necessary to further remove barriers, carry out targeted publicity, education, and accurate intervention among student MSM.