绵阳市年轻男男性行为者艾滋病感染风险认识与行为分离及影响因素
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摘要
目的了解年轻男男性行为者(YMSM)艾滋病病毒(HIV)感染风险认识与行为分离现状,分析影响因素。方法以四川省绵阳市YMSM为对象。用滚雪球抽样法招募调查对象,进行风险认识、社会行为、性行为、心理等调查和血清学检测。结果共调查YMSM 355人。自认HIV感染风险很大9.3%(33人),较大5.1%(18人),较小48.2%(171人),很小27.0%(96人),无风险10.4%(37人)。近6个月肛交有保护性55.7%,认识与行为分离30.1%。认识与行为分离组HIV阳性率33.8%,高于不分离组的3.9%(χ~2=36.492,P<0.001)。多因素分析结果,社会歧视对自己影响小[比值比(OR)=6.711]、因性取向遭受伤害(OR=4.078)、不知晓艾滋病知识(OR=5.466)和HIV感染(OR=18.848),是认识与行为分离的促进因素;近6个月性行为坚持携带安全套是保护因素(OR=0.060)。结论 YMSM认识与行为分离较为普遍,与艾滋病知识、社会行为相关联,认识与行为分离极大地增加了HIV感染风险和防治难度,有效促进认识向行为转化是防治重点。
Objective To understand the status of risk recognition and separation between knowledge and action of HIV infection among young men who have sex with men(YMSM)and analyze the influencing factors.MethodsThe YMSM between the ages of 15-24 years in Mianyang city were recruited by the snowball sampling method,and the investigation was made to know their risk perception,social behavior,sexual behavior,and psychology followed by serological tests.Results 355 valid questionnaires were collected,and the risks of HIV infection reported by the MSM were 9.3%,the greatest,followed by 5.1% the greater,48.2% the smaller,and 27.0% the smallest.10.4% of MSM thought they were risk-free.In the last 6 months,55.7% had protective anal sex.30.1%thought they had separation between knowing and doing,among whom HIV positive rate was 33.8%,higher than that of others(χ~2=36.492,P<0.001).Multiple factors analysis showed little effect on themselves by social discrimination(OR=6.711),suffering from sexual orientation(OR=4.078),and unawareness of AIDS knowledge(OR=5.466),and HIV infection(OR=18.848),which resulted in separation between knowledge and behavior.Consistent condom use in six months was the protective factor(OR=0.060).Conclusion It is common for YMSM to have separation of knowing and doing,which is associated with HIV/AIDS knowledge,and social behavior,and will greatly increases the risks of HIV infection and difficulty in HIV prevention.
Objective To understand the status of risk recognition and separation between knowledge and action of HIV infection among young men who have sex with men(YMSM)and analyze the influencing factors.MethodsThe YMSM between the ages of 15-24 years in Mianyang city were recruited by the snowball sampling method,and the investigation was made to know their risk perception,social behavior,sexual behavior,and psychology followed by serological tests.Results 355 valid questionnaires were collected,and the risks of HIV infection reported by the MSM were 9.3%,the greatest,followed by 5.1% the greater,48.2% the smaller,and 27.0% the smallest.10.4% of MSM thought they were risk-free.In the last 6 months,55.7% had protective anal sex.30.1%thought they had separation between knowing and doing,among whom HIV positive rate was 33.8%,higher than that of others(χ~2=36.492,P<0.001).Multiple factors analysis showed little effect on themselves by social discrimination(OR=6.711),suffering from sexual orientation(OR=4.078),and unawareness of AIDS knowledge(OR=5.466),and HIV infection(OR=18.848),which resulted in separation between knowledge and behavior.Consistent condom use in six months was the protective factor(OR=0.060).Conclusion It is common for YMSM to have separation of knowing and doing,which is associated with HIV/AIDS knowledge,and social behavior,and will greatly increases the risks of HIV infection and difficulty in HIV prevention.
引文
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[5]张鹏,林涛,赵希畅,等.MSM性行为特征及安全套使用影响因素分析[J].中国艾滋病性病,2015,21(6):534-535.
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[11]杨永平,李晓霞,蔡文德,等.深圳市龙岗区男男性接触者艾滋病防治知识知晓率及影响因素分析[J].华南预防医学,2016,42(5):443-446.
[12]王毅,周万明,樊静,等.绵阳市2017年男男性行为者艾滋病哨点监测及HIV感染影响因素分析[J].华南预防医学,2017,44(2):101-105.
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[14]郑迎军,王再幸,许娟,等.男男性接触者社会心理特征[J].中国行为医学科学,2004,13(6):655-657.
[15]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.
[16]王毅,李六林,樊静,等.男男性行为人群应对方式现状及与人口学特征的关系[J].中国病毒病杂志,2016,6(5):351-355.
[17]Defechereux PA,Mehrotra M,Liu AY,et al.Depression and oral FTC/TDF pre-exposure prophylaxis(Prep)among men and transgender women who have sex with men(MSM/TGW)[J].AIDS Behav,2016,20(7):1478-1488.
[18]彭小雪,李林涛,齐杰,等.深圳市男男性行为者焦虑和抑郁状况及其相关因素分析[J].中国艾滋病性病,2017,23(7):630-633.
[19]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):561-864.
[20]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.
[2]王毅,李六林,徐杰,等.四川省绵阳市男男性行为人群队列研究HIV新发感染及影响因素[J].中华预防医学杂志,2015,49(1):66-69.
[3]佘敏,李劲,周健,等.贵阳市2010—2014年MSM人群HIV感染者性行为情况[J].中国性科学,2016,25(11):68-72.
[4]王毅,李六林,樊静,等.绵阳市MSM艾滋病知识及不同地区肛交保护性和影响因素[J].现代预防医学,2017,44(5):872-876.
[5]张鹏,林涛,赵希畅,等.MSM性行为特征及安全套使用影响因素分析[J].中国艾滋病性病,2015,21(6):534-535.
[6]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].中国学校卫生,2018,30(3):317-3196.
[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施方案操作手册[S].北京:中国疾病预防控制中心,2012.
[8]吴文源.焦虑自评量表:行为医学量表手册[M].北京:中华医学电子音像出版社,2005:213-214.
[9]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.
[10]王毅,李六林,张光贵,等.男男性行为者艾滋病相关认知态度与行为分离现状和影响因素研究[J].中华疾病控制杂志,2014,18(10):951-955.
[11]杨永平,李晓霞,蔡文德,等.深圳市龙岗区男男性接触者艾滋病防治知识知晓率及影响因素分析[J].华南预防医学,2016,42(5):443-446.
[12]王毅,周万明,樊静,等.绵阳市2017年男男性行为者艾滋病哨点监测及HIV感染影响因素分析[J].华南预防医学,2017,44(2):101-105.
[13]百度百科.知信行模式[EB/OL].[2018-04-26],https://baike.baidu.com/item/%E7%9F%A5%E4%BF%A1%E8%A1%8C%E6%A8%A1%E5%BC%8F/8684202?fr=aladdin.
[14]郑迎军,王再幸,许娟,等.男男性接触者社会心理特征[J].中国行为医学科学,2004,13(6):655-657.
[15]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.
[16]王毅,李六林,樊静,等.男男性行为人群应对方式现状及与人口学特征的关系[J].中国病毒病杂志,2016,6(5):351-355.
[17]Defechereux PA,Mehrotra M,Liu AY,et al.Depression and oral FTC/TDF pre-exposure prophylaxis(Prep)among men and transgender women who have sex with men(MSM/TGW)[J].AIDS Behav,2016,20(7):1478-1488.
[18]彭小雪,李林涛,齐杰,等.深圳市男男性行为者焦虑和抑郁状况及其相关因素分析[J].中国艾滋病性病,2017,23(7):630-633.
[19]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):561-864.
[20]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.