绵阳市2017年男男性行为者性行为特征及无保护措施肛交影响因素

目的 了解男男性行为者(men who have sex with men ,MSM)性行为特征,分析无保护措施肛交影响因素。 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行为学及血清学的横断面抽样调查,用χ²检验、Logistic回归模型进行无保护措施肛交影响因素的单因素及多因素分析。 结果 回收有效问卷1 242份,近6个月肛交91.6%,其中71.4%有保护措施。近6个月商业性行为1.7%,其中31.6%有保护措施。近6个月异性性行为9.7%,其中30.8%有保护措施。近6个月高频率肛交24.5%,多性伴50.3%。近6个月肛交无保护措施的艾滋病病毒阳性率10.5%,高于有保护措施的1.8%(χ²=41.837,P＜0.001)。多因素分析结果,年龄＞30岁(OR=1.627,95%CI: 1.192～2.221)、使用Rush(OR=2.122, 95%CI:1.293～3.482)者近6个月无保护措施肛交可能性更大,高中及以上文化(OR=0.401,95%CI:0.269～0.600)、艾滋病防治知识全对(OR=0.639, 95%CI:0.428～0.954)、近1年接受预防服务(OR=0.537,95%CI:0.312～0.923)、近6个月多性伴(OR=0.635, 95%CI:0.480～0.841)者近6个月无保护措施肛交可能性更小。 结论 MSM性行为复杂,无保护、多性伴普遍,大年龄、低文化、艾滋病防治知识不全对、未接受预防服务者发生无保护措施肛交的风险较大,应针对性开展行为干预。

Characteristics of sexual behavior and factors affecting unprotected analsex among MSM in Mianyang city, 2017

Objective To understand the characteristics of sexual behavior among men who have sex with men (MSM), and to analyze the factors affecting unprotected anal sex. Methods Based on snowball sampling method, a cross-sectional sampling survey of MSM behavior and serology was conducted in Mianyang city, Sichuan province from January to October in 2017. Chi-square test and Logistic regression model were used to analyze the single factor and multiple factors of unprotected anal sex. Results A total of 1,242 valid questionnaires were recovered. 91.6% of MSM had anal sex in the last six months, of which 71.4% adopted protective measures. 1.7% of MSM had commercial sex behavior in the last six months, of which 31.6% adopted protective measures. 9.7% of MSM had engaged in heterosexual behavior in the last six months, of which 30.8% adopted protective measures. 24.5% of MSM had a high frequency of anal sex in the last six months, and 50.3% had multiple sex partners. The positive rate of HIV was higher in MSM with unprotected anal sex in the last six months than those with protected anal intercourse (10.5% vs. 1.8%, χ²=41.837, P<0.001). Multivariate analysis showed that MSM aged above 30 years (OR=1.627, 95%CI:1.192-2.221) and MSM with rush poppers use (OR=2.122, 95%CI:1.293-3.482) were more likely to have unprotected anal sex in the last six months, while MSM with high school or above education background (OR=0.401, 95%CI:0.269-0.600), MSM with correct HIV/AIDS prevention and treatment knowledge (OR=0.639, 95%CI:0.428-0.954), MSM with preventive services in recent one year (OR=0.537, 95%CI:0.312-0.923) and MSM with multiple sex partners in the last six months (OR=0.635, 95%CI:0.480-0.841) were less likely to have unprotected anal sex in the last six months. Conclusions MSM’s sexual behavior is complex, and the risk of occurring unprotected anal sex is found to be higher in MSM without protection measures, MSM with multiple sex partners, MSM aged above 30 years, MSM with poor educational background, MSM with inadequate HIV/AIDS prevention and treatment knowledge and MSM without preventive services; and hence, behavioral interventions should be targeted.