年轻男男性行为者艾滋病高危行为应对方法及影响因素

doi:10. 13217/j. scjpm. 2019. 0221

摘要/Abstract

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χ²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。

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

Abstract: 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 by age, identity, sex role and sexual behavior,and passive compliance increased the risk of HIV infection.

Key words: Young men who have sex with men, Acquired immunodeficiency syndrome, Dangerous behavior, Factor analysis, statistical

中图分类号:

R512.91

王毅, 李六林, 周万明, 樊静, 赵西和, 唐宇, 何静, 刘江, 周力, 张晓军. 年轻男男性行为者艾滋病高危行为应对方法及影响因素[J]. 华南预防医学, 2019, 45(3): 221-226.

WANG Yi, LI Liu-lin, ZHOU Wan-ming, FAN Jing, ZHAO Xi-he, TANG Yu, HE Jing, LIU Jiang, ZHOU li, ZHANG Xiao-jun. Coping strategies and factors influencing HIV/AIDS high-risk behaviors among young men who have sex with men[J]. South China Journal of Preventive Medicine, 2019, 45(3): 221-226.

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