2015－2017年绵阳市年轻男男性行为者安全套使用及影响因素

目的 了解年轻男男性行为者(young men who have sex with men, YMSM)安全套使用现状,分析影响因素。 方法 2015年9月－2017年6月,以四川省绵阳市15～24岁YMSM为对象,用滚雪球抽样法招募调查对象,进行安全套使用、社会及性行为等调查和血清学检测。安全套使用影响因素单因素分析用χ²检验,多因素分析用非条件logistic回归。 结果 共回收有效问卷362份,近6个月安全套每次使用率男性肛交55.31%、商业性伴42.11%、固定性伴49.38%、偶然性伴58.10%,异性性伴39.29%。不使用安全套26.83%因自己、46.34%因性伴不愿意,其原因固定性伴29.27%、不舒服23.17%、没必要14.63%。艾滋病病毒抗体阳性率随近6个月肛交安全套使用频率降低呈上升趋势(χ²_趋势=16.82,P=0.000)。多因素分析显示,干部职员(OR=16.058,OR95%CI: 1.95～132.55)、对自己性取向自豪(OR=100.82,OR 95%CI:8.68～1170.39)、近1年接受宣传材料发放(OR=5.37,OR 95%CI: 1.12～25.72)、防治知识来源宣传材料(OR=4.07,OR 95%CI: 1.05～15.81)、性伴不使用安全套采取劝说处理(OR=3.889,OR95%CI: 8.14～293.10)、性伴相处坚持主张(OR=16.058,OR 95%CI: 1.03～14.70)、近6个月肛交每次准备安全套(OR=12.01,OR 95%CI: 3.18～45.43)是安全套使用促进因素。 结论 YMSM安全套使用率不高,性伴制约作用明显,预防服务、身份认同、意愿坚持等与其相关,应针对性开展行为干预。

Condom use and its influencing factors among young men who have sex with men in Mianyang city, 2015-2017

Objective To investigate the current status of condom use among young men who have sex with men (YMSM), and to analyze its influential factors. Methods YMSM aged 15 to 24 years in Mianyang city, Sichuan province, as the survey subjects, were recruited by the snowball sampling method from September 2015 to June 2017. Condom use, social behavior and sexual behavior were surveyed, and serological examination was performed. Chi-square test was used to analyze the influential factors for condoms use, and non-conditional logistic regression analysis was used to analyze the multiple factors. Results A total of 362 valid questionnaires were retrieved. The percentages of using condoms every time when having anal sex with men, having sexual behavior with commercial sexual partners, with regular sexual partners, with occasional sexual partners and with when heterosexual partners in the past six months were 55.31%, 42.11%, 49.38%, 58.10% and 39.29%, respectively. The percentages of YMSM without condom use owing to themselves, sexual partners, regular sexual partners, uncomfortableness, and unnecessariness were 26.83%, 46.34%, 29.27%, 23.17% and 14.63%, respectively. The positive rate of HIV antibody showed an upward tendency as the declining frequency of condom use in anal sex in the past six months (χ²_tendency=16.82, P=0.000). Multivariate analysis revealed that the factors contributing to condom use were officials and staff members (OR=16.058, OR95%CI:1.95-132.55), pride of sexual orientation (OR=100.82, OR95%CI:8.68-1,170.39), receiving publicity materials for nearly one year (OR=5.37,OR95%CI:1.12-25.72), acquiring prevention and treatment knowledge frompublicity materials (OR=4.07, OR95%CI:1.05-15.81), persuading sexual partners who refused to use condoms (OR=3.889, OR95%CI: 8.14-293.10), insisting on using condoms when getting along with sexual partners (OR=16.058, OR95%CI: 1.03-14.70) and preparing condoms every time for anal sex in the past six months (OR=12.01, OR95%CI: 3.18-45.43). Conclusions The percentage of condom use is low among YMSM, and sexual partners have a significant restrictive effect on their partners, which is correlated with preventative services, status identity, self-adherence, etc. Therefore, behavioral interventions should be targeted.