成都市男男性行为人群涉药性行为聚类分析及其对高危性行为的影响  

Cluster analysis of sexualized drug use among men who have sex with men and its impact on high risk sexual behaviors in Chengdu

作　　者：陈晓婷 蔡宇琪 甘蓝霞 侯丰苏 杨潇 王晓冬 郝春[1] 顾菁[1] 郝元涛[1] 曹望楠[4] 李菁华 Chen Xiaoting;Cai Yuqi;Gan Lanxia;Hou Fengsu;Yang Xiao;Wang Xiaodong;Hao Chun;Gu Jing;Hao Yuantao;Cao Wangnan;Li Jinghua(School of Public Health,Sun Yat-sen University,Guangzhou 510080,China;Shenzhen Kangning Hospital,Shenzhen 518000,China;Chengdu Tongle Social Work Service Center,Chengdu 610000,China;School of Public Health,Peking University,Beijing 100191,China)

机构地区：[1]中山大学公共卫生学院,广州510080 [2]深圳市康宁医院公共卫生部,深圳518000 [3]成都同乐社会工作服务中心,成都610000 [4]北京大学公共卫生学院,北京100191

出　　处：《中华流行病学杂志》2023年第2期268-275,共8页Chinese Journal of Epidemiology

基　　金：国家科技重大专项(2018ZX10715004);国家自然科学基金(81803334)。

摘　　要：目的了解成都市MSM涉药性行为(SDU)特征及应用二阶聚类算法对其行为模式进行分类,并探索SDU与HIV高危性行为的关联,为制定预防艾滋病干预措施提供参考依据。方法2021年12月至2022年2月依托成都市MSM社会组织开展横断面调查,通过现场调查和同伴推荐招募MSM,收集社会人口学、SDU特征、性行为情况、STD诊断史和HIV感染等信息。对7项SDU特征进行二阶聚类分析,进一步采用单因素χ^(2)检验和多因素logistic回归分析SDU聚类模式与高危性行为的关联。结果共调查MSM 727人,近6个月SDU报告率为39.8%(289/727)。二阶聚类将报告SDU的MSM(SDU-MSM)聚成三类,单因素分析结果显示,三类MSM在月均收入、SDU所使用毒品类型、毒品使用方式、SDU频率、多种毒品或与药品混用、不坚持使用安全套和群交等变量间的差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,第三类报告SDU-MSM不坚持使用安全套的可能性是第一类的2.22(95%CI:1.06~4.66)倍;第三类和第二类报告SDU-MSM发生群交的可能性分别是第一类的2.82(95%CI:1.18~6.77)倍和8.78(95%CI:3.42~22.42)倍。结论成都市MSM中SDU报告率超过1/3,不同SDU-MSM聚类模式与高危性行为相关,SDU频率较高、毒品用量较大和有多种毒品或与药品混用的MSM更容易发生群交和不坚持使用安全套的高危性行为,增加HIV/STD感染风险,需加强SDU监测和干预力度。Objective To understand the characteristics of sexualized drug use(SDU)among men who have sex with men(MSM)in Chengdu and classify their behavioral patterns by applying the two-step cluster(TSC)algorithm and by exploring the association between SDU patterns and high risk sexual behaviors,in order to provide a reference basis for the development of HIV prevention interventions.Methods Supported by an MSM-friendly organization in Chengdu from December 2021 to February 2022,MSM were recruited by on-site survey and peer referral to collect information on sociodemographics,SDU characteristics,sexual behaviors,STD diagnosis,and HIV status.TSC was performed to classify the characteristics of SDU,and the differences between groups were compared.Chi-square test and multiple binary logistic regressions were used to identify the relationship between SDU clusters and HIV-related risk sexual behaviors.Results A total of 727 MSM were surveyed,and 39.8%(289/727)of the respondents reported SDU experience with a same-sex partner in the last six months.TSC clustered SDU-MSM into three behavioral pattern groups.There were significant differences in monthly income,types of drugs used for SDU,mode,frequency,polydrug use,multiple sexual partners,non-adherence to condom use,and group sex among the three groups of SDU-MSM(P<0.05).Multivariate binary logistic regression analysis showed that the third category of SDU-MSM was 2.22(95%CI:1.06-4.66)times more likely than the first category not to use condoms consistently;the third and second categories were 2.82(95%CI:1.18-6.77)times and 8.78(95%CI:3.42-22.42)times.Conclusions The prevalence of SDU among MSM in Chengdu was more than 1/3,and different SDU clustering pattern was associated with high-risk sexual behaviors.MSM with higher SDU frequency,drug use,and polydrug abuse are more difficult to adhere to condom use and more likely to have group sex and high risk sexual behaviors,increasing the risk of STD and HIV infection,and need to strengthen SDU surveillance and intervention.

关 键 词：艾滋病病毒 男男性行为者 涉药性行为 二阶聚类分析 高危性行为 

分 类 号：R512.91[医药卫生—内科学]