基于动态轨迹分析的天津市男男性行为者性行为模式研究

Study on Sexual Behavior Pattern of Men Who Have Sex with Men in Tianjin based on Dynamic Trajectory Analysis

目的探究天津市男男性行为者行为模式的特征与变化趋势,识别高危人群。为未来的HIV防控工作提供理论支持。方法数据来自于天津市深蓝公共卫生服务中心与天津市疾控中心,采用滚雪球抽样的方式招募参与者,选取三个性行为指标(最近一次同性肛交是否使用安全套、最近六个月同性性行为安全套使用频率和最近六个月的同性性伴数量)来定义男男性行为者的性行为模式。使用轨迹分析模型识别不同变化趋势的亚组,通过logistic回归比较亚组间的HIV感染风险。结果最终纳入男男性行为者共计1093名,在随访期间共有78名参与者感染HIV,总体发病率为2.53/100人年。通过轨迹分析将参与者分为三个亚组,按照变化趋势分别命名为“低危行为组(consistently low risk,CL)”、“风险波动组(risk fluctuation,RF)”和“高危行为组(consistently high risk,CH)”。三个亚组在年龄、婚姻状况、首次性行为时间、是否发生异性行为和既往是否接受过卫生服务等特征上的差异具有统计学意义。logistic回归结果显示,相比于CL组,RF组和CH组有较高的HIV感染风险。结论男男性行为者中行为模式的变化趋势不尽相同。对于高危的HIV阴性人群,及时的行为改变并且长期维持下去可以将HIV感染风险保持在一个较低的水平。

Objective To explore the characteristics and trends of behavior patterns of men who have sex with men in Tianjin and identify high-risk groups.It provided a reference for future HIV prevention and control work.Methods According to Tianjin Shenlan public health service center and Tianjin CDC,with the method of snowball sampling to recruit participants,we selected three personality behavior variables(a recent homosexual anal whether or not to use condoms,the last six months sexual behavior and condom use frequency recent six months the number of sexual partner)to define the men who have sex with men′s sexual behavior.Trajectory analysis model was used to identify subgroups with different trends,and logistic regression was used to compare HIV infection risk among subgroups.Results A total of 1093 men who had sex with men were eventually included.A total of 78 participants were infected with HIV during the follow-up period,with an overall incidence rate of 2.53/100 person-years.Through trajectory analysis,participants were divided into three subgroups,which were respectively named as“consistently low risk group”,“risk fluctuation group”and“consistently high-risk group”according to their changing trends.There were statistically significant differences in age,marital status,age of first sexual activity,whether the three subgroups had heterosexual sex and whether they had received health services in the past.Logistic regression results showed that compared with the CL group,the CH group and the RF group had a higher risk of HIV infection.Conclusion There are different trends in behavioral models among men who have sex with men.For high-risk HIV negative people,timely and sustained behavior changes can keep the risk of HIV infection at a low level.