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目的了解男男性行为人群(MSM)同性偶然性行为及其影响因素。方法对2009年绵阳市建立的MSM开放性研究队列进行随访调查,对随访不足基线调查样本部分,采用滚雪球采样法,依据队列纳入条件,招募补足调查对象,进行相关行为学和血清学调查。结果在调查的405例中,有偶然性行为的占83.7%(339/405),艾滋病病毒(HIV)确认感染率为7.7%(26/339),新发感染率5.8/100人年(13/224.9)。接受偶然性行为的占36.3%(147/405),53.6%(217/405)不反对也不接受,53.4%(181/339)在性欲未排解时寻找。寻找时先考虑是否看得上的占55.1%(223/405),是否健康的占51.6%(209/405),是否使用安全套的占19.5%(79/405)。寻找偶然性伴时76.1%(258/339)最担心感染上HIV;寻找之前每次准备安全套的占42.5%(144/339),不准备的占9.6%(39/405);51.9%(176/399)表示会发生无保护肛交。近6个月偶然性行为肛交每次使用安全套的占51.9%(83/160),8.1%(27/335)出现过安全套破损。多因素分析,年龄(OR=0.811~2.786)、职业(OR=3.044~11.847)、寻找性伴场所(OR=0.147)、随身携带安全套(OR=0.250)是偶然性行为的独立影响因素。结论偶然性行为是MSM人群极其普遍的性行为方式,受人口特征及寻找性伴场所等影响,其低保护性和催生的多性伴极大地增加了HIV感染和传播风险。
Objective To understand the same-sex incidental behaviors of MSM and its influencing factors. Methods A follow-up survey of the open MSM cohort established in Mianyang City in 2009 was conducted. For the follow-up survey samples of baseline survey, the snowball sampling method was used. According to cohort inclusion criteria, recruits were recruited to make up for the relevant behavioral and serological investigations. Results In the 405 cases investigated, 83.7% (339/405) had occasional sexual behaviors, HIV confirmed infection rate was 7.7% (26/339), and new infection rate was 5.8 / 100 years (13 / 224.9). 36.3% (147/405) received adventitious behavior, 53.6% (217/405) did not object or did not accept it, and 53.4% (181/339) looked for when libido was not resolved. Looking at the first account of whether the visible accounted for 55.1% (223/405), whether the health of 51.6% (209/405), whether the use of condoms accounted for 19.5% (79/405). When looking for occasional sexual partners, 76.1% (258/339) were most worried about HIV infection; 42.5% (144/339) did not prepare for condoms before looking for them; 9.6% (39/405) did not prepare; 51.9% 399) indicates that unprotected anal sex occurs. In the past 6 months, 51.9% (83/160) of condoms were used for occasional sexual intercourse and 8.1% (27/335) for condom damage. Multivariate analysis showed that age (OR = 0.811 ~ 2.786), occupation (OR = 3.044 ~ 11.847), search for sexual partners (OR = 0.147) and carry condom (OR = 0.250) were independent risk factors. Conclusions Incidental sexual behavior is an extremely common form of sexual behavior among MSM population. Influenced by demographic characteristics and sexual partners, the low-protection and induced polygamist greatly increase the risk of HIV infection and transmission.