绵阳市男男性行为者传统婚姻态度及结婚原因的关联因素

Heterosexual marriage attitudes and related factors of reasons for marriage of men who have sex with men in Mianyang city

目的了解男男性行为者(MSM)对传统婚姻的态度,分析结婚原因的关联因素。方法 2017年1—10月,在四川省绵阳市采用滚雪球抽样法,进行MSM传统婚姻态度、社会和性行为及血清学的横断面调查。结果回收有效问卷1 242份,对传统婚姻支持者占11.8%、理解49.1%、鄙视8.7%、无所谓30.4%。对与已婚MSM发生性行为80.1%无所谓、19.9%排斥。已婚者61.3%因外部压力(家庭压力58.7%)、38.7%因自我意愿结婚,平均年龄(25.3±3.049)岁。因自我意愿结婚的梅毒螺旋体(TP)累计感染率17.3%,高于因外部压力结婚的6.7%(χ~2=5.998,P=0.014)。多因素分析结果,双性恋及其他性向、夫妻感情好、婚后主要是偶遇同性性伴、TP累计感染者因自我意愿结婚可能性大,结婚年龄≥30岁,高中及以上文化、知晓艾滋病知识、近6个月无保护肛交者因外部压力结婚可能性大(P均<0.05)。结论 MSM对传统婚姻接受度高,婚姻更多是家庭压力和自我意愿体现,结婚原因与人口学特征、夫妻关系和性行为相关,迫于外力结婚者面临更大艾滋病感染风险。

Objective To understand the attitudes to heterosexual marriage of men who have sex with men(MSM)and analyze the related factors of reasons for marriage.Methods From Jan to Oct 2017,snowballing sampling method was applied in Miangyang city,Sichuan province for a cross-sectional survey to know their heterosexual marriage attitudes,social and sexual behaviors and serology among married MSM.Results 1 242 valid questionnaires were collected,among which 11.8%supported heterosexual marriage,49.1%expressed understanding,8.7%despised and 30.4%did not care.80.1%reported that they didn′t care to have sex with married MSM and 19.9%rejected.The average age of those married MSM was 25.3±3.049,of which 61.3%married due to external pressure,58.7%due to family pressure,and 38.7%due to self-will.The cumulative infection rate of syphilis spiral(TP)among the married group by self-will was 17.3%,higher than 6.7%among the group by external pressure(X2=5.998,P=0.014).Multivariate analysis showed that the MSM with the factors were more likely to marry due to their self-will including bisexual or other sexual orientation,good relationship between spouses,encountering same-sex partners after marriage,and accumulative TP infection.Those more likely to get married due to external pressure had the features of the age more than 30 years,awareness of HIV/AIDS knowledge,and having unprotected anal sex in the last six months(P<0.5).Conclusion MSM has a high acceptance of heterosexual marriage due to family pressure and self-will.The reasons for marriage are related to demographic characteristics,marital relationship and sexual behavior.And the MSM who marry under external pressure face greater risk of HIV infection.