男男性行为者对HIV感染预期影响的认知评价及关联因素
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摘要
目的了解男男性行为者(MSM)对艾滋病病毒(HIV)感染预期影响的自我认知评价,分析关联因素。方法2016年2-11月采用滚雪球抽样法,对四川省绵阳市MSM进行自行填写问卷的匿名行为学调查及HIV、梅毒检测。结果合格调查1 170人,对HIV感染预期影响的认知评价:最担心影响前途占7. 6%、伤害家人占33. 5%、损害健康占57. 5%、其他占1. 4%,不同感染预期影响认知评价HIV阳性率分别依次为1. 1%、9. 2%、5. 3%、6. 3%,差异有统计学意义(χ2=10. 553,P=0. 014)。感染预期影响认知评价的关联因素多因素分析,担心影响前途与损害健康相比:年龄<20岁、年龄20～<30岁、不知晓艾滋病知识、生理需要为第一需要、性伴数≥2人、高频率肛交、近6个月肛交有保护性者担心影响前途比例较高,互联网型寻找性伴较低;担心伤害家人与损害健康相比:年龄<20岁、高中及以下文化、在婚及离异/丧偶、社区朋友数<5人、获得过预防服务、生理需求为第一需要、性伴数≥2人、高频率肛交者担心伤害家人的比例较高,近6个月肛交有保护性、互联网型寻找性伴较低;担心伤害家人与影响前途比:社区朋友数<5人者担心伤害家人比例较高,未婚、不知晓艾滋病知识、生理需求为第一需要、近6个月肛交有保护性者较低(均P<0. 05)。结论 MSM对HIV感染预期影响认知评价以担心损害健康、伤害家人为主,预期认知评价与人口学及性行为特征和HIV感染风险相关联,担心伤害家人者风险更大。
Objective To investigate the self-cognitive evaluation of expected impact of HIV infection among men who have sex with men(MSM),and to analyze its related factors. Methods The snowball sampling method was used to recruit MSM in Mianyang City,Sichuan Province from February to November in 2016. A self-filled anonymous questionnaire survey on behavioral science was conducted,and then HIV and syphilis detection was performed. Results A total of 1,170 available questionnaires were gathered,and the cognitive evaluation of expected impact of HIV infection was as follows: 7.6% worried about the impact on the future,33.5% the hurt to the family,57.5% damage to health,and 1.4% others. The cognitive evaluation was affected by different infection expectation,and HIV-positive rates of MSM with different infection expectation,including worrying about the impact on the future,the hurt to the family,damage to health and others,were 1.1%,9.2%,5.3% and 6.3% respectively,showing statistically significant differences(χ2= 10.553,P = 0.014). Multi-factor logistic analysis showed that factors associated with HIV infection expectation affected cognitive evaluation. The proportions of worrying about the impact on the future in MSM aged < 20 years,aged 20-< 30 years,without HIV/AIDS-related knowledge,considering physiological need as the first need,with two or more sexual partners,with high frequency anal sex and with protective anal sex in the last six months were higher than those of worrying about damage to health,while the proportion of worrying about the impact on the future in MSM seeking sexual partners on the Internet was lower than that of worrying about damage to health. The proportions of worrying about the hurt to the family in MSM aged < 20 years,with educational background of senior high school and below,being married and being divorced/widowed,having less than five community friends,receiving preventive services,considering physiological need as the first need,with two or more sexual partners,and with high frequency anal sex were higher than those of worrying about damage to health,while the proportions of worrying about the impact on the future in MSM with protective anal sex in the last six months and seeking sexual partners on the Internet were lower than those of worrying about damage to health. The proportion of worrying about the hurt to the family in MSM having less than five community friends was higher than that of worrying about the impact on the future,while the proportions of worrying about the hurt to the family in MSM being unmarried,without HIV/AIDS-related knowledge,considering physiological need as the first need,and with protective anal sex in the last six months were lower than those of worrying about the impact on the future(all P< 0.05). Conclusions The self-cognitive evaluation of expected impact of HIV infection shows that most of the MSM worry about the damage to health and the hurt to the family. Cognitive evaluation of HIV infection expectation is correlated with the characteristics of demography and sexual behavior and the risk of HIV infection,and MSM worrying about the hurt to the family are more risky.
Objective To investigate the self-cognitive evaluation of expected impact of HIV infection among men who have sex with men(MSM),and to analyze its related factors. Methods The snowball sampling method was used to recruit MSM in Mianyang City,Sichuan Province from February to November in 2016. A self-filled anonymous questionnaire survey on behavioral science was conducted,and then HIV and syphilis detection was performed. Results A total of 1,170 available questionnaires were gathered,and the cognitive evaluation of expected impact of HIV infection was as follows: 7.6% worried about the impact on the future,33.5% the hurt to the family,57.5% damage to health,and 1.4% others. The cognitive evaluation was affected by different infection expectation,and HIV-positive rates of MSM with different infection expectation,including worrying about the impact on the future,the hurt to the family,damage to health and others,were 1.1%,9.2%,5.3% and 6.3% respectively,showing statistically significant differences(χ2= 10.553,P = 0.014). Multi-factor logistic analysis showed that factors associated with HIV infection expectation affected cognitive evaluation. The proportions of worrying about the impact on the future in MSM aged < 20 years,aged 20-< 30 years,without HIV/AIDS-related knowledge,considering physiological need as the first need,with two or more sexual partners,with high frequency anal sex and with protective anal sex in the last six months were higher than those of worrying about damage to health,while the proportion of worrying about the impact on the future in MSM seeking sexual partners on the Internet was lower than that of worrying about damage to health. The proportions of worrying about the hurt to the family in MSM aged < 20 years,with educational background of senior high school and below,being married and being divorced/widowed,having less than five community friends,receiving preventive services,considering physiological need as the first need,with two or more sexual partners,and with high frequency anal sex were higher than those of worrying about damage to health,while the proportions of worrying about the impact on the future in MSM with protective anal sex in the last six months and seeking sexual partners on the Internet were lower than those of worrying about damage to health. The proportion of worrying about the hurt to the family in MSM having less than five community friends was higher than that of worrying about the impact on the future,while the proportions of worrying about the hurt to the family in MSM being unmarried,without HIV/AIDS-related knowledge,considering physiological need as the first need,and with protective anal sex in the last six months were lower than those of worrying about the impact on the future(all P< 0.05). Conclusions The self-cognitive evaluation of expected impact of HIV infection shows that most of the MSM worry about the damage to health and the hurt to the family. Cognitive evaluation of HIV infection expectation is correlated with the characteristics of demography and sexual behavior and the risk of HIV infection,and MSM worrying about the hurt to the family are more risky.
引文
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[16]王毅,徐杰,李志军,等.绵阳市男男性行为者近6月性行为特征及其影响因素分析[J].现代预防医学,2013,40(1):64-69.
[2]吴均林.艾滋病相关心理问题及干预策略[M].北京:人民卫生出版社,2010:37-89.
[3]倪永康,王云霞,刘早玲.乌鲁木齐市男男性行为者HIV新发感染及危险因素研究[J].实用预防医学,2018,25(6):683-684.
[4]张莉,周枫,杨雪盈,等.男男性行为大学生HIV感染风险自我认识及影响因素[J].中国学校卫生,2016,37(8):1140-1142,1146.
[5]中国疾病预防控制中心性病艾滋病预防控制中心.全国艾滋病哨点监测实施方案操作手册[Z].北京:中国疾病预防控制中心,2012.
[6]豆瓣.马斯洛层次需求理论[EB/OL].(2011-03-24)[2017-05-11]. https://www. douban. com/note/141671667/.
[7] 36健康网.性年龄[EB/OL].(2011-10-31)[2017-06-14]. http://xbk. 39. net/xbk/9b9ad. html.
[8]张胜康.不同文化人群艾滋病问题社会学研究[M].成都:四川大学出版社,2008:107-183.
[9]蔺云.新时期中国家庭核心价值观初探[D].苏州:苏州财经大学,2015.
[10]王毅,李六林,张光贵,等.男男性行为者婚姻状况及其艾滋病相关行为特征调查[J].实用预防医学,2012,19(12):1772-1175.
[11]曹越,李十月,路亮,等.已婚与未婚MSM特征及与同伴交往状况比较[J].中国公共卫生,2014,30(10):1333-1336.
[12]王毅,李六林,樊静,等.绵阳市离异/丧偶男男性行为者人口学及性行为特征分析[J].中国热带医学,2017,17(5):480-484.
[13]郭卉,吴尊友.在婚男男性接触者婚姻状况与性行为特征研究现状[J].疾病监测,2010,25(8):651-654.
[14] Verma RK,Collumbien M. Homosexual activity among rural Indian men:implications for HIV interventions[J]. AIDS,2004,18(13):1845
[15]王毅,李六林,樊静,等.绵阳市MSM的肛交频率及影响因素[J].中国艾滋病性病,2015,21(9):786-790.
[16]王毅,徐杰,李志军,等.绵阳市男男性行为者近6月性行为特征及其影响因素分析[J].现代预防医学,2013,40(1):64-69.