年轻男男性行为者首次同性性行为现状及安全套使用影响因素
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摘要
目的了解年轻男男性行为者(YMSM)首次同性性行为现状,分析首次同性性行为安全套使用影响因素。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,进行首次同性性行为等调查和血清学检测。首次同性性行为安全套使用影响因素单因素、多因素分析分别用X~2检验和非条件Logistic回归。结果共回收有效问卷350份,首次同性性行为平均年龄(18.0±2.266)岁,性伴过去认识61.9%、陌生人38.1%,54.9%来自互联网, 75.4%属自愿。首次同性性行为时50.9%了解艾滋病知识,66.4%使用安全套。未使用安全套原因59.8%不知道,17.9%无安全套。HIV阳性率在首次同性性行为安全套使用组(6.8%)与未使用组(11.7%)差异无统计学意义(X~2=2.320,P=0.128)。多因素分析结果,首次同性性行为年龄≥18岁(OR=2.371)、互联网/朋友介绍/自己接触获得性伴(OR=3.279)、了解艾滋病知识(OR=2.698),性伴相处坚持主张(OR=2.131)是首次同性性行为安全套使用的促进因素。结论 YMSM首次同性性行为年龄较小,知识知晓、性行为保护严重不足,HIV感染潜在风险大。其安全套使用与年龄、性伴获得途径、防治知识和自我意愿坚持相关,应针对性开展和强化早期学校健康教育。
Objective To understand the status of the first homosexual behavior in young men who have sex with men(YMSM)and analyze the influencing factors of using condoms of the first homosexual behavior. Methods The YMSM in Mianyang city,Sichuan Province were taken as objects, and a snowball sampling method was used to recruit survey objects for the investigation about the first homosexual behavior etc and the serology examination. The single and multiple influential factors of using condoms of the first homosexual behavior were analyzed by Chi square test and Non-conditional Logistic regression respectively. Results A total of 350 valid questionnaires were collected,among which the average age of the first homosexual behavior was 18.0 ±2.266, sexual partners who had known each other in the past accounted for 61.9%,sexual partners who were strangers accounted for 38.1%, 54.9% of them sourced from the Internet, and 75.4% of them on a voluntary basis.During the first homosexual behavior, 50.9% of them had learned about the knowledge of AIDS, and 66.8% of them used condoms. The reason for not using condoms was that they didn't know to use accounted for 59.8%, and even 17.9% of them didn't have condoms. When the first homosexual behavior occurred, there wasn 't statistical significance for the difference between the HIV positive rate of using condoms group(6.8%) and that of not using group(11.7%)(X~2=2.320, P=0.128). The multiple-factor analysis results were as follows, the age of 18 years or older when the first homosexual behavior occurred(OR =2.371), acquiring a sexual partner by the Internet, friend introduction and personal contacting( OR =3.279),understanding HIV knowledge(OR=2.698), and standing up for themselves when they got along with sexual partners(OR=2.131)were promoting factors of using condoms of the first homosexual behavior. Conclusion The age of the first homosexual behavior in YMSM was younger, the degree of learning knowledge and sexual behavior protection were seriously insufficient,and the potential risk of HIV infection was high. Condom use was associated with age partners' access to prevention knowledge and self-adherence.Early school health should be targeted and strengthened.
Objective To understand the status of the first homosexual behavior in young men who have sex with men(YMSM)and analyze the influencing factors of using condoms of the first homosexual behavior. Methods The YMSM in Mianyang city,Sichuan Province were taken as objects, and a snowball sampling method was used to recruit survey objects for the investigation about the first homosexual behavior etc and the serology examination. The single and multiple influential factors of using condoms of the first homosexual behavior were analyzed by Chi square test and Non-conditional Logistic regression respectively. Results A total of 350 valid questionnaires were collected,among which the average age of the first homosexual behavior was 18.0 ±2.266, sexual partners who had known each other in the past accounted for 61.9%,sexual partners who were strangers accounted for 38.1%, 54.9% of them sourced from the Internet, and 75.4% of them on a voluntary basis.During the first homosexual behavior, 50.9% of them had learned about the knowledge of AIDS, and 66.8% of them used condoms. The reason for not using condoms was that they didn't know to use accounted for 59.8%, and even 17.9% of them didn't have condoms. When the first homosexual behavior occurred, there wasn 't statistical significance for the difference between the HIV positive rate of using condoms group(6.8%) and that of not using group(11.7%)(X~2=2.320, P=0.128). The multiple-factor analysis results were as follows, the age of 18 years or older when the first homosexual behavior occurred(OR =2.371), acquiring a sexual partner by the Internet, friend introduction and personal contacting( OR =3.279),understanding HIV knowledge(OR=2.698), and standing up for themselves when they got along with sexual partners(OR=2.131)were promoting factors of using condoms of the first homosexual behavior. Conclusion The age of the first homosexual behavior in YMSM was younger, the degree of learning knowledge and sexual behavior protection were seriously insufficient,and the potential risk of HIV infection was high. Condom use was associated with age partners' access to prevention knowledge and self-adherence.Early school health should be targeted and strengthened.
引文
[1]王毅,李六林,樊静,等.男男性行为者HIV检测场所偏好及影响检测原因[J].中国艾滋病性病,2018,24(2):164-169.
[2]陶毓敏,洪航,姜海波,等.宁波市男男性行为人群艾滋病知信行调查[J].预防医学,2018,30(3):317-319.
[3]吕林芳,张金艳,赵丹鹤,等.北京市男男性行为者无保护性行为影响因素研究[J].中国艾滋病性病,2016,22(10):799-802.
[4]王毅,李六林,樊静,等.四川省绵阳市男男性行为者首次与近6个月同性性行为保护性之间的关系及内在一致性影响因素[J].中国病毒病杂志,2017,7(4):287-292.
[5]孙炀明,贾曼红,马艳玲,等.昆明男男性行为者早期性经历对HIV感染影响[J].中国公共卫生,2014,30(5):677-678.
[6]王毅,李六林,周万明,等.绵阳市15~24周岁男男性行为者HIV感染现状及影响因素[J].中国艾滋病性病,2018,24(6):576-580.
[7]曹越,孟详喻,翁鸿,等.中国青年男男性行为人群艾滋病相关行为及感染状况Meta分析[J].中华游行病学杂志,2016,37(7):1021-1027.
[8]王毅,李六林,樊静,等.四川省绵阳市MSM首次男男性行为及年龄大小与艾滋病相关因素的关系[J].职业与健康,2017,33(15):2092-2096.
[9]柏建芸,于茂河,柳忠泉,等.天津市730名青年学生MSM的HIV感染状况及影响因素[J].中国艾滋病性病,2015,21(12):1048-1051.
[10]戴丽萍,林玉虾,刘奇,等.广州市不同性角色MSM行为特征及艾滋病感染分析[J].中国公共卫生,2013,29(2):256-258.
[11]汤后林,张大鹏,吴玉华,等.男男性接触者性伴交往模式及行为特征研究[J].中华流行病学杂志,2007,28(2):144-147.
[12]王培玉.健康管理学[M].北京:北京大学医学出版社,2012:58-64.
[13]李秀芳,张北川,于增照,等.6城市1295例男男性行为者安全套使用相关状况调查概况[J].中国艾滋病性病,2010,16(5):449-452.
[14]郑建东,庞琳,徐杰,等.北京市大学生男男性行为者同性性行为特征分析[J].疾病监测,2011,26(6):450-453,457.
[15]王毅,李六林,樊静,等.四川省绵阳市MSM安全套携带现状及影响因素[J].中国艾滋病性病,2015,21(10):861-864.
[16]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.
[17]王毅,李六林,樊静,等.不同寻找性伴场所MSM的人口学及艾滋病相关行为特征分析[J].预防医学情报杂志,2015,31(9):673-678.
[18]于茂河,江国虹,斗智,等.天津市浴池男男性行为人群HIV新发感染队列研究[J].中华流行病学杂志,2016,37(3):362-366.
[2]陶毓敏,洪航,姜海波,等.宁波市男男性行为人群艾滋病知信行调查[J].预防医学,2018,30(3):317-319.
[3]吕林芳,张金艳,赵丹鹤,等.北京市男男性行为者无保护性行为影响因素研究[J].中国艾滋病性病,2016,22(10):799-802.
[4]王毅,李六林,樊静,等.四川省绵阳市男男性行为者首次与近6个月同性性行为保护性之间的关系及内在一致性影响因素[J].中国病毒病杂志,2017,7(4):287-292.
[5]孙炀明,贾曼红,马艳玲,等.昆明男男性行为者早期性经历对HIV感染影响[J].中国公共卫生,2014,30(5):677-678.
[6]王毅,李六林,周万明,等.绵阳市15~24周岁男男性行为者HIV感染现状及影响因素[J].中国艾滋病性病,2018,24(6):576-580.
[7]曹越,孟详喻,翁鸿,等.中国青年男男性行为人群艾滋病相关行为及感染状况Meta分析[J].中华游行病学杂志,2016,37(7):1021-1027.
[8]王毅,李六林,樊静,等.四川省绵阳市MSM首次男男性行为及年龄大小与艾滋病相关因素的关系[J].职业与健康,2017,33(15):2092-2096.
[9]柏建芸,于茂河,柳忠泉,等.天津市730名青年学生MSM的HIV感染状况及影响因素[J].中国艾滋病性病,2015,21(12):1048-1051.
[10]戴丽萍,林玉虾,刘奇,等.广州市不同性角色MSM行为特征及艾滋病感染分析[J].中国公共卫生,2013,29(2):256-258.
[11]汤后林,张大鹏,吴玉华,等.男男性接触者性伴交往模式及行为特征研究[J].中华流行病学杂志,2007,28(2):144-147.
[12]王培玉.健康管理学[M].北京:北京大学医学出版社,2012:58-64.
[13]李秀芳,张北川,于增照,等.6城市1295例男男性行为者安全套使用相关状况调查概况[J].中国艾滋病性病,2010,16(5):449-452.
[14]郑建东,庞琳,徐杰,等.北京市大学生男男性行为者同性性行为特征分析[J].疾病监测,2011,26(6):450-453,457.
[15]王毅,李六林,樊静,等.四川省绵阳市MSM安全套携带现状及影响因素[J].中国艾滋病性病,2015,21(10):861-864.
[16]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.
[17]王毅,李六林,樊静,等.不同寻找性伴场所MSM的人口学及艾滋病相关行为特征分析[J].预防医学情报杂志,2015,31(9):673-678.
[18]于茂河,江国虹,斗智,等.天津市浴池男男性行为人群HIV新发感染队列研究[J].中华流行病学杂志,2016,37(3):362-366.
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