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目的对广东省连州市男男性行为者(MSM)艾滋病/性传播疾病危险行为及影响因素进行研究,为科学防控提供依据。方法 2014年10月至2015年8月,通过同伴推动法(RDS),结合“滚雪球法”、网络征募等多种方法招募MSM,进行面对面的问卷调查和血清学检测。调查内容为一般人口学特征、性行为情况、艾滋病干预服务情况、艾滋病相关知识知晓情况,并对高危行为影响因素进行回归分析。结果共招募312名MSM,平均年龄(30.53±11.52)岁,学历以高中或中专及以下为主(占58.65%),涉及多种职业,学生、工人(各占22.44%)和服务业(占20.19%)较多,婚姻状况以未婚为主(占61.86%,193/312),自我性取向认定以同性恋最多(占62.18%,194/312)。共有235人答对6道或以上问题,占75.32%。最近1年干预服务覆盖率为31.41%。最近6个月79.81%(249/312)的调查对象曾经与男性发生过肛交,与男性发生肛交时,每次使用安全套的仅占24.10%(60/249),最近一次使用安全套的比例为44.18%(110/249);28.85%曾经与女性发生性行为,每次使用安全套的仅占14.44%。HIV抗体阳性率为12.18%,HBs Ag阳性率为5.92%,梅毒抗体阳性率为2.96%,无检出HCV抗体阳性。多因素logistic回归分析显示,与男性首次性行为年龄≥20岁的调查对象发生多男性性伴行为的可能性较低(OR=0.44),月均收入>3 000元的调查对象更易发生多男性性伴行为(OR=4.66),文化程度越高(OR=0.30)与男性无保护性肛交性行为发生的可能性越低,未自愿开展相关疾病检测(OR=3.39)、男性性伴为非固定性伴或者两者都有者(OR=1.73)与男性无保护性肛交性行为发生的可能性越高。结论连州市MSM HIV感染率高,艾滋病防治知识水平较低,高危行为普遍存在,需采取同伴教育、网络干预、学校教育等针对性的宣传干预措施。
Objective To study the risk behaviors and influencing factors of HIV / AIDS among men who have sex with men (MSM) in Lianzhou City, Guangdong Province, and to provide basis for scientific prevention and control. Methods From October 2014 to August 2015, MSM was recruited through peer-driven method (RDS), combined with “snowballing method” and online recruitment, and conducted face-to-face questionnaires and serological tests. The survey included general demographic characteristics, sexual behaviors, HIV / AIDS intervention services and awareness of HIV / AIDS related knowledge, and conducted regression analysis on the influencing factors of high-risk behaviors. Results A total of 312 MSMs were recruited, with an average age of 30.53 ± 11.52 years. The academic records were mainly in high school, secondary technical school and below (accounting for 58.65%), involving a variety of occupations, students, and workers (22.44% each) Accounting for 20.19%). The marital status was mainly unmarried (61.86%, 193/312), and the highest self-orientation was homosexuality (62.18%, 194/312). A total of 235 people answered 6 or more questions, accounting for 75.32%. The coverage of intervention services in the recent year was 31.41%. In the last 6 months, 79.81% (249/312) of the respondents had had anal sex with men. Only 24.10% (60/249) of them used condoms each time they had anal sex with men, and the proportion of the most recent condom use was 44.18 % (110/249); 28.85% used to have sex with women, accounting for only 14.44% of each using condoms. The positive rate of HIV antibody was 12.18%, the positive rate of HBsAg was 5.92%, the positive rate of syphilis antibody was 2.96%, and no HCV antibody was detected. Multivariate logistic regression analysis showed that there was a lower probability of having more male partners than those with male first sex for more than 20 years (OR = 0.44) and those with monthly income> 3,000 (OR = 4.66), the higher the education level (OR = 0.30), the lower the possibility of unprotected anal sex with men, and the unwilling to carry out the related disease testing (OR = 3.39) The odds of having unprotected anal sex with males or both (OR = 1.73) were higher. Conclusions MSM HIV infection rate is high, HIV / AIDS prevention and treatment knowledge level is low, and high risk behaviors are common in Lianzhou City. Special targeted interventions such as peer education, internet intervention and school education are required.