男男性行为者儿童期性虐待经历对艾滋病高危行为及心理影响  

The impact of childhood sexual abuse on the development of AIDS related high risk behaviors and psychological appearances among men who have sex with men

作　　者：于增照[1] 张北川[2] 李秀芳[2] 汪宁[3] 史同新[1] 储全胜[4] 

机构地区：[1]青岛大学医学院附属医院皮肤科,山东青岛266003 [2]青岛大学医学院附属医院性健康中心 [3]中国疾病预防控制中心性病艾滋病预防控制中心 [4]青岛市疾病预防控制中心

出　　处：《中华流行病学杂志》2009年第1期14-17,共4页Chinese Journal of Epidemiology

基　　金：国家“十五”科技攻关资助项目（2004BA719A02）

摘　　要：目的探讨男男性行为者（MSM）儿童期性虐待（CSA）经历对其成年后艾滋病高危行为及心理影响状况。方法采用定向抽样（“滚雪球”）法进行横断面调查。对9城市2147例MSM的有效匿名问卷进行分析，比较CSA经历者与无此经历者艾滋病高危行为及心理影响差异。结果CSA经历者累计同性性伴数（中位数20.0个）、累计同性肛交性伴数（中位数10.0个）、累计女性性伴数（中位数3.0个）、近6个月同性肛交性伴数（中位数3.0个）均高于无此经历者；近1年曾参加群交百分率（30.8％）、向同性“买”性百分率（19.2％）、性交出血百分率（36.7％）、去外地并与陌生男性性交百分率（37.3％）均高于无此经历者；近一次肛交时安全套使用率（67.3％）低于无此经历者；认为暴露性取向会明显受到歧视和严重伤害百分率（75.6％）、曾有过强烈的自杀念头百分率（34.7％）、曾有过自杀行为百分率（24.3％）均高于无此经历者。结论CSA经历增加了MSM受害者成年后艾滋病高危行为，亦对其心理产生不良影响；亟需加强对有CSA经历的MSM心理健康干预，特别是艾滋病干预。Objective To study the AIDS related high risk behaviors and psychological appearances among men who have sex with men （MSM） who ever experienced childhood sexual abuse （CSA）. Methods Target sampling for a cross-sectional study was developed and valid anonymous questionnaires were adopted to compare the differences of high risk behaviors related to AIDS and psychological appearances betwen those with or without CSA experiences among 2147 MSM from nine cities. Results Compared to corresponding ones without CSA experience, CSA group had a significant larger numbers in the following events： total sexual partners, anal sex episodes with same sex, female sexual partners and anal sex in the previous six months, with the figures of median as 20.0, 10.0, 3.0, 3.0 respectively. In the previous year, 30.8% of them had ever participated in ‘group sex＇ , 19.2% ever exchanged money for sex, 36.7% bled while having sexual intercourse, 37.3% had sex with male partners away from his own region. All the above said figures were higher than non-CSA group, with significant differences. It also appeared that CSA experience had an impact on significant lower rate of condom use （67.3%） in the last anal sex. Those with CSA experience had more psychological problems which appeared as： 75.6% considered they would suffer from serious discrimination if their sexual orientation ever disclosed, 34.7% had a strong intention of suicide and 24.3% ever having had suicidal attempts. The differences of the two groups showed statistical significance. Conclusion CSA experience not only increased the number of AIDS related high risk behaviors in adulthood, but also had negative impact on their psychological appearances. It is of urgent need to carry out psychological intervention approaches to target on MSM with CSA experiences while childhood sexual education and rights assurance towards iuvenile population should also not be neglected.

关 键 词：艾滋病 男男性行为者 儿童期性虐待 高危性行为 

分 类 号：R512.91[医药卫生—内科学]