广州市908名男男性行为者异性性行为特征及其影响因素

Characteristics and influencing factors of heterosexual sexual behavior among 908 men who have sex with men in Guangzhou

目的 了解广州市MSM异性性行为特征及其影响因素。方法 采用方便抽样的方法对自主前来门诊咨询检测的MSM进行问卷调查,共纳入908名MSM。使用χ2检验或Fisher确切概率法比较基本人口学特征和性行为特征的组间差异。将P<0.1的变量纳入Logistic回归模型进行多因素分析,采用OR值及其95%CI描述MSM发生异性性行为的影响因素。结果 本研究共调查908名MSM,最近半年发生异性性行为的有183人,占比20.15%。单因素分析结果显示,MSM最近半年发生异性性行为与年龄、户籍、婚姻状况、学历、职业、个人月收入、性向、首次同性性行为年龄和性角色有关,差异均有统计学意义(P均<0.05)。多因素分析结果显示,具有以下特征的MSM更可能发生异性性行为,年龄>27岁(OR=1.697,95%CI:1.078~2.673,P=0.022)、婚姻状况为已婚/离异/同居/丧偶(OR=5.172,95%CI:2.797~9.562,P<0.001)、学历为高中及以下(OR=2.398,95%CI:1.319~4.360,P=0.004)、性向为异性恋(OR=11.027,95%CI:2.026~60.013,P=0.005)、双性恋(OR=7.541,95%CI:4.711~12.070,P<0.001)和不确定(OR=3.406,95%CI:1.780~6.519,P<0.001)、性角色为插入方/被插入方(OR=2.928,95%CI:1.284~6.680,P=0.011)和插入方(OR=4.476,95%CI:1.837~10.905,P=0.001)。结论 广州市MSM发生异性性行为的比例较高,应重点关注已婚、高中及以下学历、性向为双性恋和性角色为插入方的MSM,加强对其的针对性干预和健康知识宣教。

Objective To understand the characteristics of heterosexual behavior among MSM in Guangzhou and its influencing factors. Methods A total of 908 MSM who came to the outpatient clinic for consultation and testing were investigated by convenience sampling. Differences between groups in basic demographic characteristics and sexual behavior characteristics were compared using Chi-square test or Fisher ’s exact test.Variables with P < 0.1 were included in logistic regression models for multivariate analysis, and ORs and their 95% CIs were used to describe factors influencing heterosexual sex among MSM. Results A total of 908 MSM were investigated in this study and 183(20.15%) had heterosexual sex in the last six months. Univariate analysis showed that heterosexual sex among MSM in the last six months was associated with age, household registration, marital status, education, occupation, personal monthly income,sexual orientation, age at first homosexual sex and sexual role, and the differences were statistically significant(P<0.05 for all).Multivariate analysis showed that MSM with the following characteristics were more likely to have heterosexual sex,age > 27 years(OR=1.697, 95%CI: 1.078-2.673, P=0.022), marital status of married/divorced/cohabiting/widowed(OR=5.172, 95%CI: 2.797-9.562, P<0.001), education of high school or below(OR=2.398, 95%CI: 1.319-4.360, P=0.004),sexual orientation of heterosexuality(OR=11.027, 95%CI: 2.026-60.013, P=0.005), bisexuality(OR=7.541, 95%CI: 4.711-12.070, P<0.001) and indeterminate(OR=3.406, 95%CI: 1.780-6.519, P<0.001). sex roles of versatile(OR=2.928, 95%CI:1.284-6.680, P=0.011) and insertive(OR=4.476, 95%CI: 1.837-10.905, P=0.001). Conclusions The proportion of heterosexual sex among MSM in Guangzhou was high. Attention should be paid to married MSM, high school education or less, bisexual orientation and sexual role as inserters.Targeted intervention and health knowledge education should be strengthened.