年轻男男性行为者艾滋病高危行为应对方法及影响因素  

Coping strategies and factors influencing HIV/AIDS high-risk behaviors among young men who have sex with men

作　　者：王毅[1] 李六林[1] 周万明 樊静[2] 赵西和[1] 唐宇 何静[1] 刘江[3] 周力[2] 张晓军 WANG Yi;LI Liu-lin;ZHOU Wan-ming;FAN Jing;ZHAO Xi-he;TANG Yu;HE Jing;LIU Jiang;ZHOU li;ZHANG Xiao-jun(Mianyang Center for Disease Control and Prevention,Mianyang 621000, China;Mianyang Gay Love Group;Jiangyou Center for Disease Control and Prevention)

机构地区：[1]绵阳市疾病预防控制中心,四川绵阳621000 [2]绵阳同志关爱小组 [3]江油市疾病预防控制中心

出　　处：《华南预防医学》2019年第3期221-226,共6页South China Journal of Preventive Medicine

基　　金：四川省财政补助艾滋病防治项目(ZC2015007,SCWJWZC2016013);绵阳市应用技术研究与开发项目(15S-01-10)

摘　　要：目的了解年轻男男性行为者(YMSM)性伴艾滋病高危行为的应对方法,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,进行性伴高危行为应对方法、社会及性行为等调查和血清学检测。用χ^2检验、多因素logistic回归分析法分析高危行为应对方法的影响因素。结果共回收有效问卷362份,近6个月64.6%(159/246)的调查对象性伴有高危行为要求,顺从的占50.3%(80/159),劝说的占49.7%(79/159)。40.5%每次能劝说成功,劝说不成功后46.8%顺从、53.2%拒绝性行为。态度坚决(48.0%)、知识丰富(20.0%)是劝说成功的主要原因,对方强势(34.0%)、没耐心(27.7%)是劝说失败主要原因。顺从者HIV阳性率为22.5%,高于劝说者的10.3%(P<0.05)。多因素分析结果显示,性伴年龄选择比自己小/无特殊(OR=4.996,95%CI:1.091~22.878)、自我性取向态度无特殊/其他(OR=13.148,95%CI:1.233~140.240)、性角色均可(OR=2.282,95%CI:1.191~28.128)、近1周肛交高频率(OR=4.153,95%CI:1.143~15.090)、近6个月肛交有保护性(OR=31.924,95%CI:5.677~179.520)、近6个月有异性性行为(OR=12.976,95%CI:1.815~92.781)的YMSM高危行为应对方法更可能采取劝说,知晓性伴近6个月健康状况(OR=0.293,95%CI:0.092~0.938)者劝说可能性较小。结论 YMSM高危行为采用劝说或顺从比例相近。应对方法受性伴年龄、身份认同、性角色及性行为等影响,消极顺从增加了HIV感染风险。Objective To understand the coping methods of HIV/AIDS high-risk behaviors of young men who have sex with men(YMSM)and analyze the influencing factors. Methods YMSM were recruited in Mianyang City,Sichuan Province,by the snowball sampling method. A coping strategy questionnaire survey was conducted to investigate coping methods of sexual partners to high-risk behaviors,social and sexual behaviors,and they were tested serologically. A chi-square test and multivariate logistic regressions were used to analyze factors influencing high risk behaviors. Results A total of 362 valid questionnaires were collected. In the past six months,64.6%(159/246)of the respondents had high-risk behavioral requirements,50.3%(80/159)were obedient,and 49.7%(79/159)were persuasive. Of the respondents,40.5% could persuade successfully every time,46.8% were complied after unsuccessful persuasion,and 53.2% refused to have sexual behavior. Resolute attitude(48.0%)and rich knowledge(20.0%)were the main reasons for the successful persuasion. Strong opponents(34.0%)and impatience(27.7%)were the main reasons for failed persuasion. The positive rate of HIV was 22.5% in compliance group,higher than that in persuasion group 10.3%(P<0.05).Multivariate logistic regression showed that respondents who chose sexual partners younger than themselves or no special(OR=4.996,95%CI:1.091-22.878),had no special self attitude towards sexuality/others(OR=13.148,95%CI:1.233-140.240),had high frequency of anal intercourse in the past week(OR=4.153,95%CI:1.143-15.090),played both active and passive sexual roles(OR=2.282,95%CI:1.191-28.128),had protective anal sex in the past 6 months(OR=31.924,95%CI:5.677-179.520),and had heterosexual sex in the past 6 months(OR=31.924,95%CI:5.677-179.520)were more likely to persuade to reply to high-risk behavior;while those who knew about health state of their sex partners(OR=0.293,95%CI:0.092-0.938)were. Conclusion The proportion of persuasion and compliance in YMSM high-risk behavior was similar. Coping methods were influenced

关 键 词：男男性行为者 获得性免疫缺陷综合征 危险行为 因素分析 统计学 

分 类 号：R512.91[医药卫生—内科学]