艾滋病高发区男男性行为人群HIV感染者的高危行为特征分析
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摘要
目的了解艾滋病高发区男男性行为人群中HIV感染者的高危行为特征,为开展MSM人群艾滋病防治工作提供建议。方法通过"滚雪球"方式在艾滋病抗病毒治疗门诊中招募研究对象进行问卷调查,分析男男性行为人群HIV感染者的高危行为特征。结果调查男男性行为人群HIV感染者358例,年龄平均(25.3±5.6)岁,以18～25岁为主(占64.5%);文化程度以大专为主(占62.3%);职业分布广,以服务业、学生居多(分别占20.9%、30.4%);婚姻情况为未婚居多(占63.7%)。调查对象的性伴特征,男性固定性伴(RMP)、女性固定性伴(RFP)、男性偶然性伴(OMP)和男性商业性伴(CMP)的比例分别为22.9%、12.9%、58.9%、5.3%;3个月内RMP、RFP、OMP、CMP的MSM无保护性肛交行为发生率,分别为96.3%、87.0%、72.0%、42.1%,差异具有统计学意义(χ2=36.78,P<0.001);RMP、RFP、OMP、CMP的MSM在性行为时主动提出使用安全套所占比例分别为29.3%、56.5%、31.8%、94.7%,差异具有统计学意义(χ2=38.91,P<0.001);RMP、RFP、OMP、CMP的MSM告知有关HIV检测结果意愿所占比例分别为56.1%、26.1%、33.2%、5.3%,差异有统计学意义(χ2=24.85,P<0.001)。结论艾滋病高发区男男性行为人群中HIV感染者存在高危性行为特征,对在MSM中开展预防性病艾滋病干预措施影响较大。面对不同性伴类型的MSM,需提供具有针对性的干预措施;无保护性肛交在RMP、OMP、RFP中所占的比例较高,需重点干预无保护性肛交行为。
Objective To understand the characteristics of high-risk behaviors of HIV infection among MSM population in the high incidence area of AIDS,and provide the suggestions of HIV prevention and treatment for MSM population.Methods MSM participants were recruited from the AIDS antiretroviral treatment clinic by "snowballing" method,a questionnaire survey was conducted,and the characteristics of high-risk behaviors of HIV infection among men who had sex with men population were analyzed.Results A total of 358 cases were investigated,the average age was(25.3±5.6) years old,mainly 18 to 25 years old(64.5%); the education level was mainly junior college(62.3%); the occupation was widely distributed,which was mainly occupied in the service industry(20.9%) and students(30.4%);the marital status was mostly unmarried(63.7%).The investigation of their sexual partners indicated that the regular male partner(RMP),the regular female partner(RFP),occasional male partner(OMP),and commercial male partner(CMP) were accounted for 22.9%,12.9%,58.9%,and 5.3%,respectively.The incidence of unprotected anal sexual behavior among MSM who had RMP,RFP,OMP,and CMP within 3 months was the highest,which were 96.3%,87.0%,72.0%and 42.1%,and the difference was statistically significant(χ2=36.78,P<0.001).The proportion of active condom use in MSM sexual behavior was 29.3%,56.5%,31.8%,and 94.7%,and the difference was statistically significant(χ2=38.91,P< 0.001).The proportion of willingness to inform HIV test results was 56.1%,26.1%,33.2%and 5.3%,respectively; the difference was statistically significant(χ2=24.85,P<0.001).Conclusion The intricate characteristics of sexual behavior have great impact on the prevention of STD and AIDS interventions for MSM.The different targeted interventions are necessary provide for MSM with different types of sexual partners.Unprotected anal sex is accounted for a high proportion among RMP,OMP,and RFP,and the intervention is needed to focus on the reduction of the behavior of unprotected anal sex.
Objective To understand the characteristics of high-risk behaviors of HIV infection among MSM population in the high incidence area of AIDS,and provide the suggestions of HIV prevention and treatment for MSM population.Methods MSM participants were recruited from the AIDS antiretroviral treatment clinic by "snowballing" method,a questionnaire survey was conducted,and the characteristics of high-risk behaviors of HIV infection among men who had sex with men population were analyzed.Results A total of 358 cases were investigated,the average age was(25.3±5.6) years old,mainly 18 to 25 years old(64.5%); the education level was mainly junior college(62.3%); the occupation was widely distributed,which was mainly occupied in the service industry(20.9%) and students(30.4%);the marital status was mostly unmarried(63.7%).The investigation of their sexual partners indicated that the regular male partner(RMP),the regular female partner(RFP),occasional male partner(OMP),and commercial male partner(CMP) were accounted for 22.9%,12.9%,58.9%,and 5.3%,respectively.The incidence of unprotected anal sexual behavior among MSM who had RMP,RFP,OMP,and CMP within 3 months was the highest,which were 96.3%,87.0%,72.0%and 42.1%,and the difference was statistically significant(χ2=36.78,P<0.001).The proportion of active condom use in MSM sexual behavior was 29.3%,56.5%,31.8%,and 94.7%,and the difference was statistically significant(χ2=38.91,P< 0.001).The proportion of willingness to inform HIV test results was 56.1%,26.1%,33.2%and 5.3%,respectively; the difference was statistically significant(χ2=24.85,P<0.001).Conclusion The intricate characteristics of sexual behavior have great impact on the prevention of STD and AIDS interventions for MSM.The different targeted interventions are necessary provide for MSM with different types of sexual partners.Unprotected anal sex is accounted for a high proportion among RMP,OMP,and RFP,and the intervention is needed to focus on the reduction of the behavior of unprotected anal sex.
引文
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[6]葛宪民,唐振柱,朱秋映,等.广西2010—2015年艾滋病流行特征及趋势分析[J].中国艾滋病性病,2017,23(1):40-43.
[7]王毅,李六林,樊静,等.绵阳市男男性行为人群性行为特征及多性伴影响因素分析[J].华南预防医学,2017,43(1):1-6.
[8]王毅,李六林,樊静,等.不同文化程度男男性行为者的性行为特征及HIV感染现状[J].预防医学情报杂志,2018,34(9):1162-1168..
[9]刘乃鹏,陈芳,张月,等.HIV阳性男男性行为者对男性固定性伴性传播危险分析[J].中华疾病控制杂志,2016,20(12):1240-1243.
[10]张振开,周芸,徐芳,等.HIV阳性结果配偶告知对艾滋病高危行为的影响[J].应用预防医学,2016,22(4):315-317.
[11]卢姗,孙坤,李培龙,等.山东省青岛市男男性行为人群固定性伴无保护性肛交行为的通径分析[J].疾病监测,2018,33(10):844-848.
[2]陈琳,马瞧勤,周欣,等.浙江省HIV感染MSM人群的性伴网络特征分析[J].预防医学,2018,30(6):545-548.
[3]唐日新,李倩,张璟.同性恋伴侣关系研究[J].江西师范大学学报(哲学社会科学版),2015,48(4):131-135.
[4]朱秋映,刘玄华,沈智勇,等.广西HIV新近感染病例的流行病学调查分析[J].中国艾滋病性病,2018,24(8):785-787.
[5]孟琴,蓝光华,沈智勇,等.广西2006—2016年男男性行为者HIV感染流行病学特征及趋势分析[J].中国艾滋病性病,2018,24(2):155-158.
[6]葛宪民,唐振柱,朱秋映,等.广西2010—2015年艾滋病流行特征及趋势分析[J].中国艾滋病性病,2017,23(1):40-43.
[7]王毅,李六林,樊静,等.绵阳市男男性行为人群性行为特征及多性伴影响因素分析[J].华南预防医学,2017,43(1):1-6.
[8]王毅,李六林,樊静,等.不同文化程度男男性行为者的性行为特征及HIV感染现状[J].预防医学情报杂志,2018,34(9):1162-1168..
[9]刘乃鹏,陈芳,张月,等.HIV阳性男男性行为者对男性固定性伴性传播危险分析[J].中华疾病控制杂志,2016,20(12):1240-1243.
[10]张振开,周芸,徐芳,等.HIV阳性结果配偶告知对艾滋病高危行为的影响[J].应用预防医学,2016,22(4):315-317.
[11]卢姗,孙坤,李培龙,等.山东省青岛市男男性行为人群固定性伴无保护性肛交行为的通径分析[J].疾病监测,2018,33(10):844-848.