基于生态瞬时评估的男男性行为者高危性行为影响因素分析  

Factors influencing high risk sexual behavior among men who have sex with men based ecological momentary assessment analysis

作　　者：陈珍 席苗苗 张泽文[1] 吕朝康 署丽盼·阿斯力别克 戴江红[1] CHEN Zhen;XI Miaomiao;ZHANG Zewen;LYU Chaokang;Shulipan·Aslibiek;DAI Jianghong(I.School of Public Health,Xinjiang Medical University,Urumqi 8300ll,Xinjiang Uygur Autonomous Region,China;Linghu People's Hospital of Zhejiang Province,Huzhou 313000,Zhejiang,China)

机构地区：[1]新疆医科大学公共卫生学院,乌鲁木齐830011 [2]浙江省湖州市菱湖人民医院,浙江湖州313000

出　　处：《中国艾滋病性病》2024年第9期924-929,共6页Chinese Journal of Aids & STD

基　　金：新疆艾滋病防控研究重点实验室开放课题(XJYS1706-2021009);国家自然科学基金(81560590)。

摘　　要：目的基于生态瞬时评估技术,探讨MSM高危性行为的危险因素。方法依托乌鲁木齐市社会组织,基于网络招募MSM,基线调查收集一般人口学特征及近14天性行为信息,使用生态瞬时评估法连续14天调查,基于“经验抽样”在一天内两次收集MSM性行为信息、毒品(精神活性物质)使用情况和“每日日记”调查方法收集调查对象过去24 h内的性行为、毒品使用情况以及计划性行为情况。采用广义估计方程模型分析乌鲁木齐市MSM发生高危性行为的影响因素。结果共纳入156名MSM,平均年龄(33.61±8.88)岁。基线调查中,MSM无套肛交(无保护肛交)发生率为17.3%(24人)。广义估计方程多因素结果显示,在经验抽样调查中,使用毒品(OR=4.084,95%CI:1.820~9.167)、性伴服用PrEP(OR=3.302,95%CI:1.139~9.572)是MSM发生高危性行为的危险因素。在每日日记调查中,服用PrEP(OR=6.400,95%CI:1.689~24.249)、使用毒品(4.404,95%CI:1.234~15.716)以及安全套使用意图(OR=6.684,95%CI:1.565~30.093)是MSM发生高危性行为的影响因素。结论生态瞬时评估调查显示MSM发生无套肛交性行为仍有一定比例,安全套的使用今后仍然是MSM社区HIV干预中的一项重要策略,尤其针对有计划发生性行为的MSM亚群。Objective This study aimed to identify risk factors associated with high risk sexual behavior among men who have sex with men(MSM)using ecological momentary assessment(EMA)techniques.Methods MSM were recruited online via social organizations in Urumqi.Initial surveys collected demographic and sexual behavior data from the preceding 14 days.EMA was employed over a continuous 14-day period using the"experience sampling"method to gather data on sexual behaviors and psychoactive substance use twice daily.Additionally,the"daily diary"method was used to collect data on sexual behavior,drug usage,and planned sexual activities from the previous 24 hours.Generalized estimating equation(GEE)models analyzed factors influencing high-risk sexual behavior among the MSM participants.Results The study included 156 MSM with an average age of 33.61±8.88 years.Baseline data indicated an incidence of unprotected sexual behavior of 17.31%.GEE multivariate analysis from the experience sampling survey found that drug use(OR=4.084,95%CI:1.820-9.167)and sexual partners'use of pre-exposure prophylaxis for HIV infection(PrEP)(OR=3.302,95%CI:1.139-9.572)were significant risk factors for high-risk sexual behavior.In the daily diary survey,use of PrEP(OR=6.400,95%CI:1.689-24.249),drug use(OR=4.404,95%CI:1.234-15.716),and the intention to use condoms(OR=6.684,95%CI:1.565-30.093)significantly influenced high risk sexual behavior.Conclusions Ecological momentary assessment highlighted that a notable proportion of MSM continue to engage in unprotected sexual behavior.Condom use remains a vital component of HIV prevention strategies within the MSM community,especially among those planning to engage in sexual activities.

关 键 词：男男性行为者 高危性行为 生态瞬时评估 

分 类 号：R512.91[医药卫生—内科学]