青岛市男男性行为者心理状况及高危行为和人类免疫缺陷病毒检测状况调查

Mental health, high-risk behaviors and HIV testing status among men who have sex with men in Qingdao

目的 分析男男性行为者(men who have sex with men, MSM)心理健康状况、高危行为和人类免疫缺陷病毒(human immunodeficiency virus, HIV)检测情况,为制定艾滋病防治措施和干预策略提供依据。方法 以MSM监测哨点为依托,由社会组织参与收集当地MSM的行为特征和心理健康状况等信息,采集血样进行HIV和梅毒检测。结果 共调查MSM 368人,年龄(28.55±7.38)岁,未婚/离异者300人(81.52%),山东省户籍305人(82.89%),大专及以上文化程度307人(83.42%),最近6个月发生不安全肛交行为比例为88.00%,最近1年未接受过HIV检测的比例为22.83%,HIV阳性率为3.26%,梅毒阳性率为2.99%。MSM心理健康连续量表(mental health continuum, MHC)得分为(2.39±0.55)分,总分低于3分者占86.68%。情绪幸福感(emotional well-being, EWB)、社会幸福感(social well-being, SWB)和心理幸福感(psychological well-being, PWB)得分分别为(2.20±0.66)、(2.37±0.61)和(2.50±0.70)分。通过网络/交友软件寻找性伴、最近6个月发生不安全肛交行为、最近1年未接受过同伴教育、最近1年未接受过HIV检测、最近1年患过性病的MSM心理健康总评得分更低,差异有统计学意义(t=2.53,2.57,1.79,2.93,2.12,P均<0.05)。多因素logistic回归分析显示,该省户籍(OR=2.87,95%CI:1.26~6.52)、吸毒(OR=2.63,95%CI:1.28~5.38)、心理健康状况差(OR=3.29,95%CI:1.40~7.75)的MSM最近6个月发生不安全肛交行为的比例高;不知晓艾滋病知识(OR=3.21,95%CI:1.69~6.11)、吸毒(OR=3.14,95%CI:1.80~5.48)、心理健康状况差(OR=4.38,95%CI:1.28~14.95)的MSM最近1年未接受过HIV检测的比例高。结论 MSM心理健康状况差,心理健康状况与MSM人群发生不安全性行为和HIV检测相关。

Objective To understand the mental health status of men who have sex with men(MSM) and its impact on high-risk behaviors and HIV detection.Methods Information on demographic,sexual behaviors and mental health status were collected by social organization who worked for HIV/AIDS surveillance sentinel of MSM.Blood samples were drawn for serological tests on both HIV and syphilis antibodies.Results A total of 368 MSMs were included in this study,with the median age of(28.55±7.38) years,and 81.52%were unmarried/divorced,82.89% were registered in Shandong province,83.42% had college or higher education,88.00% had unsafe anal sex in the last 6 months,and 22.83% had not been tested for HIV in the most recent year.The positive rate was 3.26% for HIV and 2.99% for syphilis.The median score of mental health continuum was(2.39±0.55) and 86.68% of MSM had a total score of lower than 3.The median scores of emotional well-being,social well-being and phycological well-being were(2.20±0.66),(2.37±0.61) and(2.50±0.70).Those who found sex partners via internet or dating software,had unsafe anal sex in the last 6months,did not receive peer education in the last 1 year,had not been tested for HIV in the last 1 year,and had a sexually transmitted disease in the last 1 year had lower mental health score than others,the differences were statistically significant(t=2.53,2.57,1.79,2.93,2.12,P<0.05).Multivariate logistic regression analysis showed that MSM with household registration in Shandong(OR=2.87,95%CI:1.26-6.52),having drug experience(OR=2.63,95%CI:1.28-5.38) and with poor mental health(OR=3.29,95%CI:1.40-7.75) usually had a higher rate of unsafe anal sex in the last 6 months.Meanwhile,those with less HIV/AIDS knowledge(OR=3.21,95%CI:1.69-6.11),having drug experience(OR=3.14,95% CI:1.80-5.48)and with poor mental health status had a lower HIV testing rate(OR=4.38,95% CI:1.28-14.95).Conclusions The mental health of MSM in Shandong is poor.Mental health is associated with unsafe sex and HIV testing in MSM population.