开远市嫖客人群安全套使用状况及相关因素分析

Condom use among clients and its associated factors in Kaiyuan city

目的了解开远市嫖客人群与不同性伴安全套使用状况及其在商业性行为中未坚持使用安全套的相关因素。方法采取"外展人员招募"与"滚雪球抽样"招募研究对象,访谈式问卷收集数据,SPSS 20.0分析数据。结果 225名嫖客中,最近一年74.2%(167人)发生过商业性行为,57.3%(129人)有固定性伴,39.6%(89人)存在非婚性伴。最近一年58.2%(131人)的嫖客有两种及以上性伴,其中32.8%(43/131)存在与两种及以上性伴均不坚持使用安全套的情况。最近一年未坚持使用安全套的比例商业性伴为27.5%,固定性伴为82.2%,非婚性伴为59.6%。多因素Logistic回归分析表明,在婚/同居[比值比(OR)=0.359,95%可信区间(CI):0.141～0.916]、个人收入≥2 000元/月(OR=0.376,95%CI:0.143～0.986)的嫖客在最近一年商业性行为中更可能坚持使用安全套,而最近1年每月嫖娼次数>1(OR=3.913,95%CI:1.164～13.152)的嫖客更可能不坚持使用安全套。结论嫖客与多种性伴间未坚持使用安全套的行为,为将HIV向一般人群传播提供了可能。嫖客在最近一年商业性行为中仍有很高比例未坚持使用安全套,此行为受多因素影响,应有针对性采取干预措施。

Objective To understand condom use of clients with different kinds of sex partners,and associated factors in Kaiyuan city.Methods The subjects were recruited through a combination of outreach and snowball sampling.After informed consent,a questionnaire was used to collect data by interview.SPSS20.0 was used to analyze the data.Results A total of 225 clients were surveyed.74.2%(167/225)of them had commercial sex in the past year;57.3%(129/225)had fixed sex partners;39.6%(89/225)had non-marital sex partners;58.2%(131/225)had two or more kinds of sex partners,of whom 32.8%(43/131)reported they did not use condom consistently in sexual behaviors with two or more kinds of sex partners.In the past year,27.5%of clients reported to have inconsistent condom use with commercial sex partners,82.2%with fixed sex partners,and 59.6%with non-marital sex partners.Multivariate logistic regression analysis showed that clients with marital status/cohabitation(OR=0.359,95%CI:0.141-0.916),with personal monthly income more than 2000 CNY(OR=0.376,95%CI:0.143-0.986)were more likely to use condom consistently in commercial sex in the past year,and those having commercial sex more than once per month in the past year were more likely to use condom inconsistently(OR=3.913,95%CI:1.164-13.152).Conclusion There is still a high proportion of clients who use condom inconsistently in commercial sex in the past year,which is more likely to transmit HIV from the high-risk groups to general population.Therefore,targeted interventions should be taken to prevent HIV spreading.