基于BLUED社交软件的男男性行为人群HIV危险感知水平影响因素研究

目的 了解男男性行为(men who have sex with men,MSM)人群HIV危险感知现状及影响因素。方法 通过网络社交平台,采用便利抽样选取北京地区的MSM人群,获得其HIV危险感知水平、性行为特征等数据,采用有序多分类logistic回归模型分析确定HIV危险感知的影响因素。结果 458名参与者中有73.8%处于中等危险感知水平。以低程度危险感知组为参照,性行为中偶尔使用安全套保护措施(OR=2.97, 95%CI:1.22~7.19)、并不知晓肛交性伴HIV感染状况(OR=1.98, 95%CI:1.25~3.16)、合并有其他性病诊断(OR=2.29, 95%CI:1.30~4.05)以及过去12个月内进行过多次HIV检测者(OR=2.28, 95%CI:1.31~3.98)HIV危险感知水平更高。结论 对MSM人群主观风险感知和客观实际行为间的差异原因仍需开展广泛研究。深入理解MSM人群在危险感知和行为决策实践之中存在的心理压力和矛盾,同时采取以行为改变理论为实践指导、具有文化适应性的风险评估咨询和教育服务计划,深化MSM人群对不安全性行为与感染风险之间的关系认知和最终的行为转化。

Factors influencing HIV risk perception among MSM by using BLUED social communication

Objective To understand the current status of HIV risk perception and its affecting factors amongmen who have sex with men (MSM). Methods A convenience sampling method was used to recruit MSM in Beijing through a social application platform, and the data about HIV self-perceived risk level and sexual behavior characteristics were collected. An ordinal multi-classification logistic regression model was used to analyze and identify factors influencing HIV risk perception. Results Among 458 participants, 73.8% were identified as medium risk perception. The group with low risk perception was used as the reference, MSM who occasionally used a condom during anal sex (OR=2.97, 95%CI:1.22-7.19), MSM who didn't know their anal sex partners' status of HIV infection (OR=1.98, 95%CI:1.25-3.16), MSM with additional STD diagnosis(OR=2.29, 95%CI:1.30-4.05), and MSM with several HIV tests in the past 12 months(OR=2.28, 95%CI:1.31-3.98) had a high HIV risk perception. Conclusion Causes for the differences between MSM' subjective risk perception and objective actual behavior still need to be widely studied. We should thoroughly understand the psychological stress and contradiction between the risk perception and behavior decision-making practice of MSM; meanwhile, taking the behavior change theory as the practical guidance, holding risk assessment consultations and adopting an education service plan with cultural adaptability are conducive to building upMSM's cognition of the relationship between unsafe sexual behavior and infection risk as well as their ultimate behavior transformation.