深圳市青年男男性行为人群不同性角色的行为特征分析

Behavioral characteristics of different sexual roles among young men who have sex with men in Shenzhen

目的了解深圳市青年男男性行为人群(men who have sex with men,MSM)不同性角色的行为特征,为干预措施的制定提供参考依据。方法运用滚雪球法和同伴推动抽样法招募MSM进行问卷调查,以及梅毒和HIV的血清学检测,用χ2检验和Logistic回归进行性角色的行为特征分析。结果共调查613名MSM,其中性角色为被动型占30.18%(185/613),主动型占34.26%(210/613),均可型占35.56%(218/613)。无序Logistic回归分析结果显示,被动型MSM首次与同性发生肛交年龄低于20岁(aOR=0.39,95%CI:0.25~0.63)、感染梅毒和(或)HIV(aOR=2.98,95%CI:1.54~5.76)和近6月有使用rush的比例(aOR=1.89,95%CI:1.17~3.05)均高于主动型,但近6个月与性伴发生性行为时每次使用安全套(aOR=0.23,95%CI:0.13~0.43)、异性性行为的比例(aOR=0.14,95%CI:0.04~0.44)较低;均可型MSM年龄低于25岁(aOR=1.55,95%CI:1.01~2.37)、首次与同性发生肛交年龄低于20岁(aOR=0.58,95%CI:0.38~0.88)、感染梅毒和(或)HIV(aOR=1.58,95%CI:1.34~2.53)和近6月有使用rush的比例(aOR=1.70,95%CI:1.10~2.62)高于主动型。结论深圳市青年MSM以均可型和主动型为主。相比主动型,被动型和均可型MSM首次与同性发生肛交年龄≤20岁和近6个月有使用rush的比例更高,感染梅毒和(或)HIV的风险更大,有必要将性病艾滋病防控关口前移,青年MSM人群应减少rush的使用,提高梅毒和HIV的检测意识以及安全套的使用意识,降低感染风险。

Objective To understand behavioral characteristics of different sexual roles among young men who have sex with men(MSM)in Shenzhen,so as to provide basis for developing intervention measures.Methods MSM were recruited by snowball and respondent-driven sampling in Shenzhen.They were interviewed anonymously and tested for syphilis and HIV.Chi-square test and multivariate Logistic regression model were used to analyze the behavioral characteristics associated with the sexual roles.Results A total of 613 MSM were recruited for the survey,including receptive group accounting for 30.18%(185/613),insertive group accounting for 34.26%(210/613)and flexible group accounting for 35.56%(218/613).Unordered Logistic regression showed that,compared to the insertive group,the receptive MSM had higher proportions of having first anal sex under 20 years old(aOR=0.39,95%CI:0.25-0.63),having syphilis/HIV infection(aOR=2.98,95%CI:1.54-5.76)and using rush in the past 6 months(aOR=1.89,95%CI:1.17-3.05),while they had lower proportions of using condoms each time in the past 6 months(aOR=0.23,95%CI:0.13-0.43)and having heterosexual behavior(aOR=0.14,95%CI:0.04-0.44).Compared to the insertive group,the flexible MSM had higher proportions of the age under 25(aOR=1.55,95%CI:1.01-2.37),having first anal sex under 20 years old(aOR=0.58,95%CI:0.38-0.88),having syphilis/HIV infection(aOR=1.58,95%CI:1.34-2.53)and using rush in the past 6 months(aOR=1.70,95%CI:1.10-2.62).Conclusions Young MSM in Shenzhen are dominated by insertive group and flexible group.Compared with insertive MSM,the receptive and flexible MSM have higher proportions of having first anal sex under 20 years old and using rush in the past 6 months,and have higher risk of syphilis/HIV infection.It is necessary to move forward the prevention and control of sexually transmitted diseases and AIDS,reduce the use of rush among young MSM group,improve the awareness of syphilis/HIV detection and condom use,so as to reduce the risk of infection.