黔东南苗族侗族自治州两社区老年男性的性需求及HIV危险性行为的相关因素  

A survey on sexual needs and factors of HIV risky sexual behaviors among elderly men at different ages in two communities of Qiandongnan Miao and Dong autonomous prefecture

作　　者：单多[1] 姚永明[2] 郑敏[2] 王方林 孙杰英 熊燃[1] 韩孟杰[1] 胡翼云[1] Shan Duo;Yao Yongming;Zheng Min;Wang Fanglin;Sun Jieying;Xiong Ran;Han Mengjie;Hu Yiyun(National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Division of AIDS Control and Prevention,Guizhou Center of Disease Control and Prevention,Guiyang 550004,China;Division of AIDS Control and Prevention,Center for Disease Control and Prevention of Qiandongnan Miao and Dong Autonomous Prefecture,Kaili 556000,China;Division of AIDS Control and Prevention,Kaili Center of Disease Control and Prevention,Kaili 556000,China)

机构地区：[1]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206 [2]贵州省疾病预防控制中心艾滋病性病预防控制所,贵阳550004 [3]贵州省黔东南苗族侗族自治州疾病预防控制中心,凯里556000 [4]贵州省黔东南苗族侗族自治州凯里市疾病预防控制中心,556000

出　　处：《中华预防医学杂志》2020年第11期1227-1231,共5页Chinese Journal of Preventive Medicine

基　　金：中美艾滋病防治合作项目(No.5NU2GGH001153)。

摘　　要：目的了解黔东南苗族侗族自治州(黔东南州)两社区不同年龄老年男性的性需求及HIV危险性行为的相关因素。方法2018年6—12月,采用横断面研究,在黔东南州选取有工作基础,且与疾病预防控制中心合作关系较好的两个社区,对到两社区卫生服务中心咨询或就诊的50岁及以上老年男性进行问卷调查,并进行HIV和梅毒抗体检测,两社区各200名。HIV快速检测初筛阳性者进行确证实验(WB)。采用多因素logistic回归分析最近1次与配偶/固定性伴无保护性行为的相关因素。结果400名老年男性中,50~64岁者占52.2%(209名),≥65岁者占47.8%(191名),HIV感染率为1.0%(4/400)。两年龄组的艾滋病知识知晓率分别仅为25.8%(54/199)和26.2%(50/191)。50~64岁者中,68.0%(142名)自我感觉性欲正常,73.6%(153名)自报性行为时每次都能阴茎勃起或基本勃起,52.9%(110名)多数时候射精有力。与≥65岁者相比,50~64岁者过去6个月与固定性伴发生性行为的比例(89.5%,179/200)、最近1次性行为未使用安全套的比例(93.8%,168/179)、发生过临时性行为(不包括商业性伴)的比例(11.0%,23/209),以及商业性行为的比例(3.8%,8/209)均更高。年龄为50~64岁(OR=2.70,95%CI:1.22~5.95)、平均月收入≤1000元(OR=2.79,95%CI:1.25~6.21)、没有使用过助性剂(OR=3.78,95%CI:1.65~8.67)是最近1次危险性行为的相关因素。结论该少数民族地区老年男性艾滋病知识知晓率普遍偏低,与≥65岁组比,50~64岁组性行为更活跃,性需求更高。50~64岁组、经济水平较低和性能力良好者更容易发生HIV危险性行为。Objective To understand sexual needs and factors of risky sexual behaviors among elderly men at different ages in two communities of Qiandongnan Miao and Dong autonomous prefecture and provide basis for targeted HIV prevention and intervention.Methods Two communities in the prefecture were selected as study sites.Questionnaire surveys were carried out among elderly men aged 50 and over who visited or consulted in the communities from June to December 2018,and they were tested for HIV and syphilis antibodies.Results Among 400 elderly men,209(52.2%)were 50-64 years old,and 191(47.8%)were above 65 years old.They were mainly Miao people,accounting for 66.3%(265/400),and 235(58.8%)had an education no more than 6 years.HIV awareness of the two age groups were only 25.8%(54/199)and 26.2%(50/191),respectively.Among those aged 50-64,142(68.0%)felt normal sexual desire,and 153(73.6%)reported penile erections or erections in most cases whenever sex,and 52.9%(110)ejaculated most of the time.HIV prevalence was 1.0%(4/400).Compared with the over 65-year-old group,the proportion of having sex with spouse/stable partners(89.5%,179/200),proportion of no condom use with their spouse/stable sexual partners during the most recent sex(93.8%,168/179),proportion of having casual sex(11.0%,23/209)and commercial sex(3.8%,8/209)were all higher among 50-64 age group.In comparison to those aged over 65 years old,average monthly income>3000,and use of sex helper,aged 50-64(OR=2.70,95%CI:1.22-5.95),average monthly income≤1000 yuan(OR=2.79,95%CI:1.25-6.21),and no use of sex helper(OR=3.78)(95%CI:1.65-8.67)were related factors of HIV risky sexual behavior last time.Conclusion Elderly men in the minority prefecture had low HIV awareness.Compared with those≥65 years old,the 50-64 age group had more active sexual behaviors and higher sexual needs.Those from 50-64 age group,with lower economic level and good sexual ability were more likely to have HIV risky sexual behaviors.

关 键 词：HIV 老年男性 危险性行为 

分 类 号：R512.91[医药卫生—内科学]