绵阳市男男性行为者无保护肛交和HIV感染的影响因素  

Related factors of unprotected anal sex and HIV infection among men who have sex with men in Mianyang City

作　　者：王毅[1] 周万明 樊静[2] 赵西和[1] 李川 王晓丽[3] 周力[2] 张晓军 王思源[2] Wang Yi;Zhou Wanming;Fan Jing;Zhao Xihe;Li Chuan;Wang Xiaoli;Zhou Li;Zhang Xiaojun;WangSiyuan(Institute for AIDS/STD Control and Prevention, Miany ang City Center for Disease Control and Prevention, Mianyang 621000, Sichuan , China;Mianyang Gay Love Group , Mianyang 621000 Sichuan , China;De part me nt of AIDS/ STD Centred and Prevention , Fucheng District Center for Disease Control and Prevention of Mianyang City, Mian vang 621000, Sichuan, China)

机构地区：[1]绵阳市疾病预防控制中心性病艾滋病防治所,四川绵阳621000 [2]绵阳同志关爱小组,四川绵阳621000 [3]绵阳市涪城区疾病预防控制中心性病艾滋病防治科,四川绵阳621000

出　　处：《国际流行病学传染病学杂志》2019年第1期19-24,共6页International Journal of Epidemiology and Infectious Disease

基　　金：2016年社会组织参与艾滋病防治基金(2016-2017510701PYDMSM001442-2016)。

摘　　要：目的了解男男性行为者(MSM)艾滋病疫情、知识及性行为现状,分析无保护肛交及HIV感染影响因素、方法2018年1—7月,以四川省绵阳市城区MSM为对象,用滚雪球抽样法招募调查对象进行艾滋病知识、性行为等调査和血清学检测,结果共调查和回收有效问卷410份,艾滋病知识知晓率96.8%,近1年干预服务覆盖率94.1%。385人(93.9%)主要以互联网/交友软件寻找性伴,近6个月肛交360人(87.8%)、商业性行为4人(1.1%)、异性性行为54人(13.2%),每次使用安全套的比例差异有统计学意义(χ^2=80.565,P<0.01)。HIV确证阳性率5.4%(22人),梅毒阳性率4.9%(20人)。大专及以上文化(OR=0.544),近1年接受过同伴教育(OR=0.387)者是无保护肛交发生的保护因素,HIV感染(OR=5.214)是其发生的危险因素;文化程度高(OR=0.472)、近1年接受过同伴教育(OR=0.182)是HIV感染的保护因素,双性恋(OR=6.815)、近6个月无保护肛交(OR=4.710)、梅毒螺旋体感染(OR=8.539)是HIV感染的危险因素<结论MSM知识与行为明显分离。文化程度、干预服务是无保护肛交、HIV感染保护因素;双性恋、无保护肛交者具更大HIV感染风险。Objective To explore AIDS epidemic situation, knowledge and sexual behavior of men who have sex with men (MSM) and analyze related factors of unprotected anal sex and HIV infection. Methods Between January and July in 2018, the MSM in Mianyang, Sichuan, as the subjects were recruited by the snowball sampling method, and the investigation of AIDS knowledge, sexual behaviors iiiid serological detection was implemented. Results A total of 410 valid questionnaires were collected totally, and awareness rate of AIDS knowledge was 96.8%, meanwhile coverage rate of intervention was 94.1% in nearly a year. A total of 385 subjects (93.9%) used Internet web or pal APP to seek sex partners. In nearly 6 months, 360 subjects (87.8%) had anal sex, and 4 subjects (1.0%) had commercial sex and 54 subjects (13.2%) had heterosex, in which rates of using condoms were 69.4%~75.0% and 29.6% respectively χ^2=80.565,P<0.01). Confirmatory positive rate was 5.4%(22 subjects) for HIV and 4.9%(20 subjects) for syphilis. Subjects with college degree or higher (OR=0.544) and educated by peers in nearly a year(OR=0.387) have a lower risk of unprotected anal sex and a higher risk of HIV infection(OR=5.214). The higher the level of education (OR=0.472) and people who have received peer education (OR=0.182) were less likely to be infected with HIV. Subjects who was bisexual (OR=6.815 ), having unprotected anal sex with TP infection (OR=8.539) had a higher risk. Conclusions Knowledge and behtiviors are obviously separated in MSM, in Mianvang. Education level and intervention are protj'ctive factors of unprotected anal sex and HIV infection, meanwhile subjects who is bisexual and have unprotected anal sex are more likely to be infected with HIV.

关 键 词：艾滋病 自愿咨询 梅毒 同伴教育 

分 类 号：R512.91[医药卫生—内科学] R181.3[医药卫生—临床医学]