浙江省男男性行为者的异性性行为特征及其无保护异性性行为影响因素分析

Heterosexual behaviors and influencing factors of unprotected heterosexual behaviors among men who have sex with men in Zhejiang Province

目的了解男男性行为者(MSM)的异性性行为特征及其无保护异性性行为的影响因素, 为艾滋病的防控工作提出更有针对性的策略。方法 2022年10月至2023年3月, 依托杭州市、金华市、嘉兴市、宁波市的社会组织, 以横断面的研究方法对1 993名MSM开展调查, 选取最近6个月发生过异性性行为者作为研究对象。问卷内容包括一般人口学特征、社会心理情况、艾滋病知识、同性性行为和异性性行为特征等。采用多因素Logistic回归分析法分析无保护异性性行为的影响因素。结果共调查1 993名MSM, 其中38.7%(772/1 993)发生过异性性行为, 14.7%(293/1 993)最近6个月发生过异性性行为。最近6个月女性性伴侣数量为1人者占93.2%(273/293), 2~5人者占6.1%(18/293), >5人者占0.7%(2/293)。91.1%(267/293)仅与固定性伴侣发生性行为, 58.0%(170/293)发生过无保护异性性行为。多因素Logistic回归分析显示, 拥有女性性伴侣的MSM最近6个月发生无保护异性性行为的影响因素为已婚、有过婚姻或同居(OR=1.925, 95%CI: 1.114~3.550)、最近6个月压力不大(OR=1.988, 95%CI: 1.114~3.550)、最近6个月无男性固定性伴侣(OR=3.857, 95%CI: 2.182~6.817)、最近6个月发生无保护同性性行为(OR=3.120, 95%CI: 1.601~6.082)、最近6个月接受过社会组织开展的安全套使用宣传(OR=2.080, 95%CI: 1.143~3.785)、目前认为自己的HIV感染风险一般或较高(OR=2.244, 95%CI: 1.304~3.860)。结论 MSM存在异性性行为和同性性行为交织的现象, 且无保护异性性行为发生率高。婚姻、压力、同性性行为特征、安全套使用宣传教育等因素与MSM发生无保护异性性行为相关。

Objective To understand the characteristics of heterosexual behaviors and the influencing factors of unprotected heterosexual behaviors among men who have sex with men(MSM),and to propose more targeted strategies for AIDS prevention and control.Methods From October 2022 to March 2023,a cross-sectional study was conducted among 1993 MSM through social organizations in Hangzhou,Jinhua,Jiaxing,and Ningbo cities.Participants who reported heterosexual behavior in the past six months were selected as the study subjects.The questionnaire included demographic characteristics,psychosocial status,knowledge of AIDS,characteristics of homosexual and heterosexual behaviors.Influencing factors of unprotected heterosexual behaviors were analyzed by multivariate Logistic regression analysis.Results A total of 1993 MSM were surveyed,of whom 38.7%(772/1993)had engaged in heterosexual behavior,14.7%(293/1993)had engaged in heterosexual behavior in the last six months.Of these who had heterosexual partners in the past six months,93.2%(273/293)had one partner,6.1%(18/293)had 2-5 partners,and 0.7%(2/293)had more than five partners.Additionally,91.1%(267/293)only had sex with regular partners,and 58.0%(170/293)reported unprotected heterosexual behavior.Multivariate Logistic regression analysis showed that the factors influencing the occurrence of unprotected heterosexual behaviors in the last six months among MSM included being married or having been married/cohabiting(OR=1.925,95%CI:1.114-3.550),low stress in the last six months(OR=1.988,95%CI:1.114-3.550),no regular homosexual sex partners in the last six months(OR=3.857,95%CI:2.182-6.817),having unprotected homosexual behaviors in the last six months(OR=3.120,95%CI:1.601-6.082),receiving condom use promotion from social organizations in the last six months(OR=2.080,95%CI:1.143-3.785),self-identified risk of HIV infection as average or high(OR=2.244,95%CI:1.304-3.860).Conclusions MSM exhibit a phenomenon of intertwined heterosexual and homosexual behaviors,with a high incidence of unprotected heterosexual behaviors.Factors such as marital status,stress levels,characteristics of homosexual behaviors,and condom use education are associated with unprotected heterosexual behaviors among MSM.