男男性行为者安全套使用及影响因素分析

目的 了解男男性行为者(men who have sex with men,MSM)安全套使用状况,并分析影响因素.方法 通过MSM同伴招募调查对象,在MSM活动场所进行安全套使用等相关因素的匿名现场问卷调查.结果 共调查400人,最近1次、近6个月不同性伴肛交/阴道交安全套使用率差异均有统计学意义(分别有x2=21.82,P＜0.001和x2=28.26,P＜0.001),男性、男男卖性使用率较高(73.8％、66.7％,45.5％、46.2％),男男买性、女性使用率较低(47.1％、47.9％,29.4％、30.1％).单因素分析显示,不同年龄、近6个月男男肛交数,近1年是否做过HIV检测并知道结果、接受润滑剂免费发放、接受过同伴教育,艾滋病知识是否来源于咨询服务、宣传材料发放,是否知道性伴从不用安全套、是否知道性伴健康状况,不同场所寻找性伴这10个方面近6个月男男肛交安全套坚持使用率差异有统计学意义(x2=4.043、9.850、6.663、7.525、5.213、4.208、10.042、4.121、12.319、8.456,均有P＜0.05).多因素非条件Logistic回归分析中,最终进入回归模型的有年龄、做过HIV检测并知道结果、艾滋病知识来源于宣传材料发放、不知道性伴健康状况、寻找性伴的场所,近1年做过HIV检测并知道结果(OR=0.074)、艾滋病知识来源于宣传材料发放( OR=0.409)、以酒吧/歌舞厅/会所(OR=10.495)、浴室/公园/公厕(OR =36.601)、互联网(OR=10.807)为主要性伴寻找场所者近6个月男男肛交安全套坚持使用率较高,年龄≥35岁(OR=0.330)、不知道性伴健康状况(OR =0.892)安全套坚持使用率较低.结论 MSM人群安全套使用较低,受年龄、预防性服务、健康意识等多种因素影响,应针对性加大行为干预力度.

The use of condoms among MSM and the influencing factors

Objective To find out the current situation of the use of condoms among men who have sex with men（MSM）,and analyze the influencing factors.Methods The Respondent-driven Sampling（RDS） was used,the anonymous self-administered questionnaire was adopted for investigation.Results 400 persons including both gays and straight people were surveyed,the difference of the occupation coefficient of condoms use in the latest or past six months sex action among those persons had statistical significance（χ2=21.82,P0.001;χ2=28.26,P0.001）,straight men and men prostitute had a higher occupation coefficient（73.8%,66.7%,45.5%,46.2%）,men who have sex with men prostitute and women had a lower occupation coefficient（47.1%,47.9%,29.4%,30.1%）.Single factor analysis showed that persons of different ages,the times of anal sex in the past 6 months,had a HIV test within one year or not,received free lubricant and publicized material or not,awareness of the healthy situation of sex partners or not,places to find sex partners,and constant use of condoms in the past 6 months had statistical significance（χ2=4.043,9.850,6.663,7.525,5.213,4.208,10.042,4.121,12.319,8.456,P0.05）.Multifactor analysis showed the coincidental factors which enter the regression model finally were different ages,had a HIV test within one year or not,received free lubricant and publicized material or not,awareness of the healthy situation of sex partners or not,places to find sex partners（P0.05）,had a HIV test within one year or not（OR=0.074）,received free lubricant and publicized material or not（OR=0.409）.Persons who found their sex partners in bars/dance hall/pubs（OR=10.495）,public base houses/parks/toilets（OR=36.601）,on the Internet（OR=10.807） had a higher occupation coefficient,persons older than 35 years（OR=0.330）,unaware of the healthy situation of the sex partners（OR=0.892） had a lower occupation coefficient.Conclusions The occupation coefficient of using condoms among MSM is at a relatively low level,it was influenced by multifactor such as age,consciousness of health situation,etc.The pointed references should therefore be reinforced.