济南市未婚育的HIV阳性男男性行为者的婚育意愿及影响因素

Marriage and childbearing intention and influencing factors on unmarried and childless HIV-positive men who have sex with men in Jinan

目的了解未婚育HIV阳性MSM的婚育意愿现状及其影响因素。方法采用横断面设计,对济南市市中区865名未婚育的HIV阳性MSM进行问卷调查,收集其社会人口学资料及其他一般特征、病耻感、婚姻态度、婚育意愿等信息,采用二分类非条件Logistic回归模型分析其婚育意愿的影响因素。结果45.9%(397/865)的HIV阳性MSM可能或肯定要结婚,平均期望结婚年龄为(32.6±4.4)岁,54.6%(472/865)可能或肯定要生育,平均期望生育年龄为(35.0±4.5)岁。多因素Logistic回归结果表明:年龄≥32岁(OR=2.21,95%CI:1.58~3.09)、农村户籍(OR=1.54,95%CI:1.09~2.19)、独生子女(OR=1.78,95%CI:1.28~2.48)、受教育程度为大学本科以下(OR=1.79,95%CI:1.28~2.50)、双性恋(OR=1.67,95%CI:1.13~2.46)、近12个月曾与女性性交(OR=1.96,95%CI:1.14~3.36)、未将HIV阳性结果告知家人(OR=1.45,95%CI:1.02~2.06)、未患有梅毒(OR=1.66,95%CI:1.07~2.58)、除HIV阳性外无其他慢性病(OR=3.28,95%CI:2.33~4.62)、低病耻感(OR=2.83,95%CI:1.51~5.31)/(OR=2.41,95%CI:1.28~4.55)、对婚姻态度积极(OR=3.08,95%CI:2.26~4.22)的HIV阳性MSM婚姻意愿更强;年龄≥32岁(OR=2.56,95%CI:1.85~3.56)、农村户籍(OR=1.74,95%CI:1.24~2.45)、独生子女(OR=2.03,95%CI:1.47~2.81)、受教育程度为大学本科以下(OR=1.57,95%CI:1.14~2.15)、月收入≥4000元(OR=1.96,95%CI:1.43~2.68)、双性恋(OR=1.91,95%CI:1.30~2.81)、未将HIV阳性结果告知家人(OR=2.07,95%CI:1.48~2.89)、未患有梅毒(OR=1.60,95%CI:1.06~2.41)、HIV阳性诊断时间≥32个月(OR=1.54,95%CI:1.12~2.12)、除HIV阳性外无其他慢性病(OR=1.46,95%CI:1.07~2.01)的HIV阳性MSM生育意愿更强。结论有较高比例未婚育的HIV阳性MSM仍可能或肯定要婚育,那些年龄较大、农村户籍、独生子女、受教育程度较低、双性恋、未将HIV阳性结果告知家人、未患有梅毒、除HIV阳性外无其他慢性病的HIV阳性MSM婚育的可能性更高,亟需进一步研究促进其合理、合法实现婚育的策略与措施。

Objective To understand the status of marriage intention,childbearing intention and influencing factors of unmarried and childless HIV-positive MSM.Methods Using a cross-sectional design,a questionnaire survey was conducted among 865 unmarried and childless HIV-positive MSM in Shizhong District,Jinan City.Binary unconditional logistic regression model was used to analyze the influencing factors of their marriage intention and childbearing intention.Results 45.9%(397/865)of HIV-positive MSM reported that they might or must get married,with the average expected marriage age as(32.6±4.4)years old.54.6%(472/865)of them reported that they might or must have children,with the average expected reproductive age as(35.0±4.5)years old.Multivariate Logistic regression results showed that HIV positive MSM with characteristics as:age≥32 years old(OR=2.21,95%CI:1.58-3.09),rural household registration(OR=1.54,95%CI:1.09-2.19),being the only child(OR=1.78,95%CI:1.28-2.48),having an education level lower than a bachelor’s degree(OR=1.79,95%CI:1.28-2.50),being bisexual(OR=1.67,95%CI:1.13-2.46),having heterosexual sex in the past 12 months(OR=1.96,95%CI:1.14-3.36),failing to tell family members of HIV-positive results(OR=1.45,95%CI:1.02-2.06),syphilis-free(OR=1.66,95%CI:1.07-2.58),no other chronic diseases except AIDS(OR=3.28,95%CI:2.33-4.62),less stigma(OR=2.83,95%CI:1.51-5.31)/(OR=2.41,95%CI:1.28-4.55)and having a positive attitude towards marriage(OR=3.08,95%CI:2.26-4.22)was more willing to get married.Those MSM with characteristics as:age≥32 years old(OR=2.56,95%CI:1.85-3.56),with rural household registration(OR=1.74,95%CI:1.24-2.45),being an only child(OR=2.03,95%CI:1.47-2.81),having an education level lower than a bachelor’s degree(OR=1.57,95%CI:1.14-2.15),monthly income≥4000 yuan(OR=1.96,95%CI:1.43-2.68),being bisexual(OR=1.91,95%CI:1.30-2.81),failing to tell family members of HIVpositive results(OR=2.07,95%CI:1.48-2.89),syphilis-free(OR=1.60,95%CI:1.06-2.41),HIV good diagnosis time≥32 months(OR=1.54,95%CI:1.12-2.12),no other chronic diseases than AIDS(OR=1.46,95%CI:1.07-2.01)were more willing to have children.Conclusions Relatively high proportion of unmarried and childless HIV-infected MSM believed that they would or must get married and give birth.Those who are older,rural,an only child,less educated,or bisexual,have not informed their families regarding their HIV-positive results,are syphilis-free,and without other chronic diseases than HIV-positive were more likely to marry and have children.More comprehensive research is urgently needed on feasible strategies and measures to promote these people’s rational and legal realization of marriage and childbearing.