乌鲁木齐市MSM对生态瞬时评估法调查性行为的依从性研究

Adherence to ecological momentary assessment of investigative sexual behavior among MSM in Urumqi

目的 了解乌鲁木齐市MSM对生态瞬时评估法(EMA)调查性行为的依从性及影响因素。方法 依托乌鲁木齐市社会组织通过网络招募MSM,基线调查问卷收集一般人口学特征及过去14天性行为特征,再连续14天通过生态瞬时评估调查问卷一日两次实时收集MSM性行为信息。采用Kappa一致性检验分别对EMA调查与基线调查和传统调查问卷的行为进行一致性分析;通过EMA问卷应答率反映MSM依从性,将问卷应答率≥80%的研究对象视为高依从性者,采用多因素Logistic回归探讨影响MSM对EMA调查性行为依从性的因素。结果 招募MSM 150名,78.67%的MSM为高依从性者,EMA调查MSM性行为的问卷应答率为80.48%,EMA调查提醒后3 h内的EMA问卷完成率为81.95%。≥30岁MSM对EMA调查性行为高依从性的可能是<30岁MSM的2.555倍(95%CI:1.044~6.257),不吸烟的MSM对EMA调查性行为高依从性的可能是吸烟MSM的3.233倍(95%CI:1.314~7.951)。此外,基线和EMA调查获得的MSM 14天同性性行为、使用毒品、吸烟及使用PrEP具有中等一致性,传统问卷调查和EMA调查获得的MSM使用安全套、使用毒品及吸烟具有中等一致性(Kappa值均>0.4)。结论 新疆乌鲁木齐市MSM对连续14天EMA调查性行为的依从性较高,短时间采用生态瞬时评估法调查MSM性行为具有较高的可行性,尤其是30岁及以上、不吸烟的MSM对EMA调查性行为的应答率较高。

Objective To understand the adherence and influencing factors of MSM to ecological momentary assessment(EMA) survey sexual behaviors in Urumqi. Methods Relying on Urumqi social organizations to recruit MSM through the internet. The baseline questionnaire was carried out to collect general demographic characteristics and sexual behavior behaviors in the past 14 days. After that, sexual behavioral information was collected twice a day through the EMA questionnaire for 14 consecutive days. The Kappa consistency test was used to analyze and compare the data obtained from the EMA survey, the baseline survey, and the traditional questionnaire. The response rate of the EMA questionnaire was used to reflect MSM compliance. Participants with ≥80% of the questionnaire response rate were considered as having high adherence. Multivariate logistic regression was used to explore the factors influencing the adherence of MSM to the EMA survey. Results 150 MSM were recruited, and 78.67% of them had high adherence. The EMA questionnaire response rate was 80.48%. The EMA questionnaire completion rate within three hours of receiving the EMA survey reminder was 81.95%. MSM ≥30 years old was 2.555 times(95%CI:1.044-6.257) more likely to be highly compliant with EMA survey sexual behaviors than those 30 years old. Smokers were 3.233 times more(95%CI:1.314-7.951) likely to comply with the EMA sexual behaviors than non-smokers. In addition, homosexual behavior in the past 14 days, drug use, smoking and using PrEP were found to be medium consistent between the baseline survey and the EMA survey. Condom use, drug use, and smoking were at medium consistency between the traditional questionnaire and EMA survey(Kappa>0.4). Conclusions MSM in Urumqi, Xinjiang showed high compliance to EMA survey behaviors for 14 consecutive days. It seemed feasible to investigate MSM sex behavior in a short time. In particular, MSM over 30 years old and non-smoking have a high response rate to the EMA survey sexual behaviors.