青年男男性行为者性行为安全套准备现状及影响因素
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摘要
目的了解青年男男性行为者(young men who have sex with men,YMSM)安全套准备现状,分析影响因素。方法以四川省绵阳市15～24岁YMSM为对象,用滚雪球抽样法招募调查对象,进行安全套准备、社会及性行为等调查和血清学检测。安全套准备影响因素单、多因素分析分别用χ~2检验、非条件Logistic回归。结果共回收有效问卷362份,近6个月有肛交245人中,57.1%坚持准备安全套,42.9%不坚持准备。不准备原因40.0%认为对方会准备、23.8%有没有无所谓、12.4%怕人看见。准备发生性行为时没有安全套34.4%不使用、30.5%去购买、22.9%不发生性行为、12.4%采取非插入性行为。HIV阳性率在安全套不坚持准备组为17.1%,高于坚持准备组的7.9%(χ~2=4.865,P=0.027)。多因素分析结果,有收入,当地居住时间>1年,接受预防服务,近6个月肛交有保护性者更倾向坚持准备安全套;公开性取向,近6个月有固定性行为、有偶然性行为更倾向不坚持准备安全套(P均<0.05)。结论 YMSM实际性行为安全套准备的自主性普遍不足,依赖性制约明显。安全套坚持准备有效减少了高危行为和HIV感染风险,应继续得到加强。
Objective To understand the status of condom preparation in young men who have sex with men(YMSM) and analyze influencing factors. Methods YMSM in Mianyang city,Sichuan province,were recruited by the snowball sampling method, and an investigation on condom preparation, social behaviors and sexual behaviors and serological tests were carried out.Chi-square test and unconditional logistic regression were respectively used for mono-and multi-variate analysis of factors influencing preparation of condoms. Results A total of 362 valid questionnaires were collected; among respondents with anal sex in the recent six months, 57.1% were persistent in preparation of condoms, and 42.9% were not. Among those who were not persistent in preparation of condoms,40.0% thought their sexual partners would prepare condoms, 23.8% thought to use or not to use condoms was not a serious matter,and 12.4% did not prepare condoms because they did not want to be seen. If there were no condoms for sex,34.4% would not use condoms,30.5% were going to buy condoms, 22.9% would not have sex, and 12.4% were to have non-intrusive sexual behavior. The HIV positive rate was 17.1% in the group with persistent condom preparation,higher than that in the group without persistent condom preparation(7.9%)(χ~2=4.865,P=0.027). Multivariate analysis results showed people who had incomes, lived locally for>1 year, received preventive services and used condoms in sex during the recent six months tended to be persistent in preparation of condoms;people who came out,had fixed sexual behaviors in the recent six months or occasional sexual behaviors tended not to be persistent in preparation of condoms(all P<0.05).Conclusion There was a general lack of autonomy in condom preparation in YMSM during actual sexual behaviors. Persistence in condom preparation can effectively reduce the risk of the high-risk sexual behaviors and the HIV infection and needs continually enhancing.
Objective To understand the status of condom preparation in young men who have sex with men(YMSM) and analyze influencing factors. Methods YMSM in Mianyang city,Sichuan province,were recruited by the snowball sampling method, and an investigation on condom preparation, social behaviors and sexual behaviors and serological tests were carried out.Chi-square test and unconditional logistic regression were respectively used for mono-and multi-variate analysis of factors influencing preparation of condoms. Results A total of 362 valid questionnaires were collected; among respondents with anal sex in the recent six months, 57.1% were persistent in preparation of condoms, and 42.9% were not. Among those who were not persistent in preparation of condoms,40.0% thought their sexual partners would prepare condoms, 23.8% thought to use or not to use condoms was not a serious matter,and 12.4% did not prepare condoms because they did not want to be seen. If there were no condoms for sex,34.4% would not use condoms,30.5% were going to buy condoms, 22.9% would not have sex, and 12.4% were to have non-intrusive sexual behavior. The HIV positive rate was 17.1% in the group with persistent condom preparation,higher than that in the group without persistent condom preparation(7.9%)(χ~2=4.865,P=0.027). Multivariate analysis results showed people who had incomes, lived locally for>1 year, received preventive services and used condoms in sex during the recent six months tended to be persistent in preparation of condoms;people who came out,had fixed sexual behaviors in the recent six months or occasional sexual behaviors tended not to be persistent in preparation of condoms(all P<0.05).Conclusion There was a general lack of autonomy in condom preparation in YMSM during actual sexual behaviors. Persistence in condom preparation can effectively reduce the risk of the high-risk sexual behaviors and the HIV infection and needs continually enhancing.
引文
[1]王毅,李六林,樊静,等.男男性行为者HIV检测场所偏好及影响检测原因[J].中国艾滋病性病,2018,24(2):164-169.
[2]陶毓敏,洪航,姜海波,等.宁波市男男性行为人群艾滋病知信行调查[J].预防医学,2018,30(3):317-319.
[3]迟富利,涛波,杨景元,等.内蒙古男男性接触者HIV感染相关影响因素调查[J].实用预防医学,2018,25(2):219-222.
[4]王毅,李六林,樊静,等.四川省绵阳市MSM安全套携带现状及影响因素[J].中国艾滋病性病,2015,21(10):861-864.
[5]王毅,李六林,周万明,等.绵阳市15~24周岁男男性行为者HIV感染现状及影响因素[J].中国艾滋病性病,2018,24(6):576-580.
[6]曹越,孟详喻,翁鸿,等.中国青年男男性行为人群艾滋病相关行为及感染状况Meta分析[J].中华流行病学杂志,2016,37(7):1021-1027.
[7]中国疾病预防控制中心性病艾滋病预防控制中心.全国艾滋病哨点监测实方案操作手册[S].北京:中国疾病预防控制中心,2012.
[8]王毅,李六林,张光贵,等.男男性行为者艾滋病知识知晓及安全套使用现状调查[J].华南预防医学,2013,39(2):65-68.
[9]王毅,李六林,张光贵,等.男男性行为者艾滋病感染危险认知及影响因素分析[J].实用预防医学,2014,21(12):1416-1419.
[10]王金塔,郭燕丽,周建波,等.常州市男男性行为者人口流动与艾滋病高危行为关系的研究[J].卫生研究,2012,41(5):782-784.
[11]王毅,樊静,杨晓玲,等.男男性行为人群流动性行为及影响因素[J].中国公共卫生,2017,33(3):345-349.
[12]王毅,李六林,张光贵,等.男男性行为者公开性取向与艾滋病相关行为的关系研究[J].中国预防医学杂志,2013,14(10):727-731.
[13]徐洪吕,保武生,何俊,等.曲靖市男男性行为人群安全套使用影响因素分析[J].中国热带医学,2015,15(1):73-75.
[14]王毅,李六林,樊静,等.有同性固定性伴侣男男性行为者非专一性行为的影响因素研究[J].中华疾病控制杂志,2013,17(12):1025-1029.
[15]王培玉.健康管理学[M].北京:北京大学医学出版社,2012:58-64.
[16]蔡于茂,宋亚娟,刘惠,等.深圳市男男性行为者HIV风险感知的影响因素[J].中国艾滋病性病,2018,24(1):62-65.
[17]彭景舆,洪福昌,蔡于茂,等.MSM的HIV感染危险因素的交互作用研究[J].中国艾滋病性病,2015,21(2):132-137.
[2]陶毓敏,洪航,姜海波,等.宁波市男男性行为人群艾滋病知信行调查[J].预防医学,2018,30(3):317-319.
[3]迟富利,涛波,杨景元,等.内蒙古男男性接触者HIV感染相关影响因素调查[J].实用预防医学,2018,25(2):219-222.
[4]王毅,李六林,樊静,等.四川省绵阳市MSM安全套携带现状及影响因素[J].中国艾滋病性病,2015,21(10):861-864.
[5]王毅,李六林,周万明,等.绵阳市15~24周岁男男性行为者HIV感染现状及影响因素[J].中国艾滋病性病,2018,24(6):576-580.
[6]曹越,孟详喻,翁鸿,等.中国青年男男性行为人群艾滋病相关行为及感染状况Meta分析[J].中华流行病学杂志,2016,37(7):1021-1027.
[7]中国疾病预防控制中心性病艾滋病预防控制中心.全国艾滋病哨点监测实方案操作手册[S].北京:中国疾病预防控制中心,2012.
[8]王毅,李六林,张光贵,等.男男性行为者艾滋病知识知晓及安全套使用现状调查[J].华南预防医学,2013,39(2):65-68.
[9]王毅,李六林,张光贵,等.男男性行为者艾滋病感染危险认知及影响因素分析[J].实用预防医学,2014,21(12):1416-1419.
[10]王金塔,郭燕丽,周建波,等.常州市男男性行为者人口流动与艾滋病高危行为关系的研究[J].卫生研究,2012,41(5):782-784.
[11]王毅,樊静,杨晓玲,等.男男性行为人群流动性行为及影响因素[J].中国公共卫生,2017,33(3):345-349.
[12]王毅,李六林,张光贵,等.男男性行为者公开性取向与艾滋病相关行为的关系研究[J].中国预防医学杂志,2013,14(10):727-731.
[13]徐洪吕,保武生,何俊,等.曲靖市男男性行为人群安全套使用影响因素分析[J].中国热带医学,2015,15(1):73-75.
[14]王毅,李六林,樊静,等.有同性固定性伴侣男男性行为者非专一性行为的影响因素研究[J].中华疾病控制杂志,2013,17(12):1025-1029.
[15]王培玉.健康管理学[M].北京:北京大学医学出版社,2012:58-64.
[16]蔡于茂,宋亚娟,刘惠,等.深圳市男男性行为者HIV风险感知的影响因素[J].中国艾滋病性病,2018,24(1):62-65.
[17]彭景舆,洪福昌,蔡于茂,等.MSM的HIV感染危险因素的交互作用研究[J].中国艾滋病性病,2015,21(2):132-137.