年轻男男性行为者艾滋病预防服务覆盖现状及信息获取渠道关联因素分析
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摘要
目的了解年轻男男性行为者(YMSM)艾滋病(AIDS)预防服务覆盖现状,分析防治信息获取渠道关联因素。方法以四川省绵阳市15～24周岁YMSM为对象,用滚雪球抽样法招募调查对象,进行预防服务、信息渠道、性行为等调查和血清学检测。防治信息获取渠道关联因素单因素分析采用c2检验,多因素分析采用非条件logistic回归。结果共对362名YMSM进行调查,调查对象年龄中位数为21.0岁,大专及以上文化程度224人(占61.9%),学生213人(占58.8%)。预防服务覆盖率为78.6%(278/362),主要信息渠道为互联网,占62.4%(226/362),其次为朋友46.6%(168/362)、电视41.4%(150/362)、宣传材料40.6%(147/362)、学校34.0%(123/362)。以电视、宣传材料为信息渠道者艾滋病病毒(HIV)抗体阳性率低于其他信息渠道YMSM(均P<0.05)。多因素分析结果显示,大专及以上文化程度(OR=1.814)、学生(OR=1.880)、做过HIV检测(OR=1.807)、互联网寻找性伴者(OR=2.328)主要信息渠道为互联网渠道的可能性大,有抑郁症状者(OR=0.579)互联网渠道可能性小;接受同伴教育(OR=3.391)、固定性行为(OR=3.269)、偶然性行为者(OR=2.756)主要信息渠道为朋友渠道可能性大,肛交数≥2人者(OR=0.475)可能性小;坚持准备安全套(OR=0.280)、偶然性伴数(OR=0.301)、HIV-抗体阳性者(OR=0.142)主要信息渠道为电视渠道可能性小;接受同伴教育者(OR=5.022)主要信息渠道为宣传材料渠道较大,而有焦虑症状(OR=0.151)、HIV-抗体阳性者(OR=0.177)可能性较小。结论 YMSM预防服务覆盖率不高,互联网作为主要信息获取渠道的作用明显,电视、宣传材料传播效力较高,AIDS防治应充分利用和强化各类信息渠道的优点。
Objective To understand the status of the coverage of HIV/AIDS prevention servicesin young men who have sex with men(YMSM)and analyze factors influencing channels of prevention and treatment information access. Methods YMSM aged 15 to 24 years in Mianyang City,Sichuan Provincewere recruited by the snowball sampling method. Prevention services,information access channels,and sexual behavior were investigated and serological tests were conducted among the selected subjects. Datawere analyzed using the chi-square test or multivariate logistic regression model. Results A total of 362 YMSMs were surveyed,with a median age of 21.0 years. Of the respondents,224(61.9%)had the educa-tional level of college degree or above and 213(58.8%)were students. The coverage of prevention services was 78.6%(278/362). The main channels of obtaining information were the internet,accounting for62.4% of the participants(226/362),followed by friends(46.6%;168/362),television(41.4%;150/362),publicity materials(40.6%;147/362),and schools(34.0%;123/362). The HIV antibody positive rate in those who took the television and publicity materials as the information dissemination channels was lower than those who did not(all P<0.05). Multivariate logistic regression showed that,YMSMs who had a college degree or above(OR=1.814),were students(OR=1.880),had HIV tested(OR=1.807)or searched for sexual partners through the internet(OR=2.328)were more likely to take the internet as the main information channel,but those who had depressive symptoms were less likely(OR=0.579);those who accepted peer education(OR=3.391),had fixed sexual behavior(OR=3.269)or occasional sexual behavior(OR=2.756)were more likely to take friends as the main information channel,while those who had more than 2 anal sexual partners(OR=0.475)were less likely;those who insisted on using condoms(OR=0.280),had occasional sexual partners(OR=0.301)or were positive for HIV-antibody(OR=0.142)were less likely to take the television as the main information channel;the persons accepting peer education(OR=5.022)were more likely to take publicity materials as the main information channel,while those with anxiety symptoms(OR=0.151)and positive HIV antibody(OR=0.177)were less likely. Conclusion The coverage of AIDS prevention services for YMSM was not high. The internet played an obvious role in information dissemination. The disseminations of television and publicity materials were more prompt and efficient in communication.
Objective To understand the status of the coverage of HIV/AIDS prevention servicesin young men who have sex with men(YMSM)and analyze factors influencing channels of prevention and treatment information access. Methods YMSM aged 15 to 24 years in Mianyang City,Sichuan Provincewere recruited by the snowball sampling method. Prevention services,information access channels,and sexual behavior were investigated and serological tests were conducted among the selected subjects. Datawere analyzed using the chi-square test or multivariate logistic regression model. Results A total of 362 YMSMs were surveyed,with a median age of 21.0 years. Of the respondents,224(61.9%)had the educa-tional level of college degree or above and 213(58.8%)were students. The coverage of prevention services was 78.6%(278/362). The main channels of obtaining information were the internet,accounting for62.4% of the participants(226/362),followed by friends(46.6%;168/362),television(41.4%;150/362),publicity materials(40.6%;147/362),and schools(34.0%;123/362). The HIV antibody positive rate in those who took the television and publicity materials as the information dissemination channels was lower than those who did not(all P<0.05). Multivariate logistic regression showed that,YMSMs who had a college degree or above(OR=1.814),were students(OR=1.880),had HIV tested(OR=1.807)or searched for sexual partners through the internet(OR=2.328)were more likely to take the internet as the main information channel,but those who had depressive symptoms were less likely(OR=0.579);those who accepted peer education(OR=3.391),had fixed sexual behavior(OR=3.269)or occasional sexual behavior(OR=2.756)were more likely to take friends as the main information channel,while those who had more than 2 anal sexual partners(OR=0.475)were less likely;those who insisted on using condoms(OR=0.280),had occasional sexual partners(OR=0.301)or were positive for HIV-antibody(OR=0.142)were less likely to take the television as the main information channel;the persons accepting peer education(OR=5.022)were more likely to take publicity materials as the main information channel,while those with anxiety symptoms(OR=0.151)and positive HIV antibody(OR=0.177)were less likely. Conclusion The coverage of AIDS prevention services for YMSM was not high. The internet played an obvious role in information dissemination. The disseminations of television and publicity materials were more prompt and efficient in communication.
引文
[1]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.
[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,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.
[5]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.
[6]王毅,李六林,樊静,等.绵阳市男男性行为者艾滋病预防服务覆盖及影响因素分析[J].预防医学情报杂志,2016,32(4):325-330.
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[8]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施方案操作手册[R].北京:中国疾病预防控制中心,2012.
[9]吴文源.焦虑自评量表[J].中国行为医学科学,2008,10(行为医学量表手册特刊):124-125.
[10]舒良.自评抑郁量表和抑郁状态问卷[J].中国心理卫生杂志,1999(增刊):194-196.
[11]王毅,周万明,樊静,等. 2016年绵阳市男男性行为者艾滋病哨点监测结果分析[J].预防医学情报杂志,2017,33(12):1199-1204.
[12]金洁,罗艳,陈珺芳,等.浙江省杭州市男男性行为者HIV感染状况及影响因素分析[J].疾病监测,2015,30(8):639-643.
[13]白广义,王伟,张亚丽,等.河北省三城市男男性行为者安全套使用情况及影响因素分析[J].河北医药,2017,39(21):3322-3325.
[14]王娜,孙燕鸣,卢红艳,等.北京市年轻MSM人群HIV感染情况调查[J].中国艾滋病性病,2013,19(4):241-243.
[15]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.
[16]张鹏,袁兆康,徐群英,等.同伴教育模式对大学生男男性行为人群影响[J].中国公共卫生,2014,30(3):263-265.
[17]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.
[18]倪明健,胡知敏,李志军,等. 2013年新疆维吾尔自治区男男性行为人群个人和社会身份认同状况及与性相关行为的关系[J].中华预防医学杂志,2014,48(11):974-979.
[19] Rosario M,Hunter J,Maquen S,et al. The coming-out process andits adaptational and health-related associationsamong gay,lesbian,and bisexual youths:stipulation and exploration of a model[J].Am J Community Psychol,2001,29(1):133-160.
[20]石国政,康来仪,陈冬华,等.上海MSM人群对同志身份认同状况及其相关因素分析[J].中国艾滋病性病,2012,18(11):724-727.
[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,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.
[5]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.
[6]王毅,李六林,樊静,等.绵阳市男男性行为者艾滋病预防服务覆盖及影响因素分析[J].预防医学情报杂志,2016,32(4):325-330.
[7]王培玉.健康管理学[M].北京:北京大学医学出版社,2012:49-58.
[8]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施方案操作手册[R].北京:中国疾病预防控制中心,2012.
[9]吴文源.焦虑自评量表[J].中国行为医学科学,2008,10(行为医学量表手册特刊):124-125.
[10]舒良.自评抑郁量表和抑郁状态问卷[J].中国心理卫生杂志,1999(增刊):194-196.
[11]王毅,周万明,樊静,等. 2016年绵阳市男男性行为者艾滋病哨点监测结果分析[J].预防医学情报杂志,2017,33(12):1199-1204.
[12]金洁,罗艳,陈珺芳,等.浙江省杭州市男男性行为者HIV感染状况及影响因素分析[J].疾病监测,2015,30(8):639-643.
[13]白广义,王伟,张亚丽,等.河北省三城市男男性行为者安全套使用情况及影响因素分析[J].河北医药,2017,39(21):3322-3325.
[14]王娜,孙燕鸣,卢红艳,等.北京市年轻MSM人群HIV感染情况调查[J].中国艾滋病性病,2013,19(4):241-243.
[15]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.
[16]张鹏,袁兆康,徐群英,等.同伴教育模式对大学生男男性行为人群影响[J].中国公共卫生,2014,30(3):263-265.
[17]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.
[18]倪明健,胡知敏,李志军,等. 2013年新疆维吾尔自治区男男性行为人群个人和社会身份认同状况及与性相关行为的关系[J].中华预防医学杂志,2014,48(11):974-979.
[19] Rosario M,Hunter J,Maquen S,et al. The coming-out process andits adaptational and health-related associationsamong gay,lesbian,and bisexual youths:stipulation and exploration of a model[J].Am J Community Psychol,2001,29(1):133-160.
[20]石国政,康来仪,陈冬华,等.上海MSM人群对同志身份认同状况及其相关因素分析[J].中国艾滋病性病,2012,18(11):724-727.