Characteristic of sexual behavior and their associated factors among male and female partners of men who have sex with men
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摘要:
目的 了解安徽省男男性行为人群（men who have sex with men，MSM）与其男性性伴和女性性伴的性行为特征及影响因素。 方法 以合肥、芜湖和六安3个城市为研究现场，采用滚雪球法和网络招募法招募MSM人群，对符合纳入标准的MSM进行匿名问卷调查。采用多因素Logistic回归分析模型分析MSM人群最近6个月发生异性性行为的危险因素。 结果 共招募1 200名MSM，最近6个月78.3% MSM与男性性伴有过肛交性行为，20.9%与女性性伴有过异性性行为，16.5%最近6个月与男性性伴、女性性伴均有过性行为。最近6个月异性性行为中的安全套坚持使用率（29.9%）明显低于同性性行为的安全套坚持使用率（53.0%），在最近一次异性性行为中的安全套使用率（52.2%）也明显低于同性性行为中的安全套使用率（79.6%）（均有P < 0.05）。多因素分析结果显示，已婚（包括在婚/同居/离异/丧偶）、在调查城市居住时间>2年、有同性商业性行为的MSM更容易发生异性性行为。 结论 MSM人群存在较高比例的双性性行为，且安全套坚持使用率较低，应该加强对他们的性健康教育、风险感知教育和行为干预。 Abstract:Objective To understand the characteristic of sexual behavior and their associated factors among male and female partners of men who have sex with men in Anhui province. Methods Cross-sectional studies were conducted among MSM in Hefei, Wuhu and Liuan in Anhui province. MSM were recruited through "snowball sampling" and "internet-based recruiting", and eligible participant received an anonymous survey. Multivariate Logistic regression analysis model was used to identify risk factors associated with having sex with women in the last 6 months among MSM. Results Of the 1 200 MSM interviewed, 78.3% had anal sex with men, and 20.9% had vaginal intercourse with women, and 16.5% had sexual intercourse with both men and women in the past 6 months. Less MSM reported using condom every time with women (29.9%) in the past 6 months than with men (53.0%), and less reported using condom with women (52.2%) during the last sexual intercourse than with men(79.6%) (all P < 0.05). The results of mutivariate Logistic regression analysis showed that MSM who were married(including currently married/cohabitating/divorced/widowed), lived more than 2 years in the surveyed city, and had commercial sex with men were more likely to have sex with women. Conclusions There was a high proportion of bisexual behavior and low rate of condom use among MSM. It should strengthen the sexual health education, risk perception education and behavioral intervention among MSM. -
Key words:
- MSM /
- Male partners /
- Female partners /
- Sexual behavior /
- Risk factors
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表 1 研究对象的基本情况[n(%)]
Table 1. Basic situation of the subjects [n(%)]
变量 调查人数
(n=1 200)最近6个月有异性性行为 χ2值 P值 是(n=251) 否(n=949) 年龄(岁) 61.944 < 0.001 16~ 279(23.3) 23(9.2) 256(27.0) 25~ 558(46.5) 107(42.6) 451(47.5) ≥35 363(30.3) 121(48.2) 242(25.5) 与异性的婚姻状况 166.914 < 0.001 未婚 759(63.3) 71(28.3) 688(72.5) 已婚(包括在婚/同居/离异/丧偶) 441(36.8) 180(71.7) 261(27.5) 户籍所在地 3.211 0.073 本省 1 111(92.6) 239(95.2) 872(91.9) 外省 89(7.4) 12(4.8) 77(8.1) 在调查城市居住时间(月) 16.506 0.001 < 6 69(5.8) 15(6.0) 54(5.7) 7~ 50(4.2) 3(1.2) 47(5.0) 12~ 138(11.5) 16(6.4) 122(12.9) ≥24 943(78.6) 217(86.5) 726(76.5) 文化程度 27.489 < 0.001 初中及以下 182(15.2) 50(19.9) 132(13.9) 高中或中专 416(34.7) 112(44.6) 304(32.0) 大专及以上 602(50.2) 89(35.5) 513(54.1) 样本来源 1.237 0.266 网络招募 692(57.7) 137(54.6) 555(58.5) 滚雪球抽样 508(42.3) 114(45.4) 394(41.5) 最近6个月有同性商业性行为 35.816 < 0.001 是 63(6.7) 32(16.2) 31(4.2) 否 876(93.3) 166(83.8) 710(95.8) 知晓艾滋病知识 0.460 0.497 是 1 156(96.3) 240(95.6) 916(96.5) 否 44(3.7) 11(4.4) 33(3.5) 
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表 2 最近6个月与男性性伴和女性性伴的性行为状况[n(%)]
Table 2. Sexual behavior with male partners and female partners in the last 6 months among MSM[n(%)]
变量 同性性行为 同性商业性行为 异性性行为 人数 人数 人数 最近6个月发生性行为 939(78.3) 63(5.3) 251(20.9) 最近6个月性行为时坚持每次使用安全套 498(53.0) 33(52.4) 75(29.9) 最近一次性行为时使用安全套 747(79.6) 49(77.8) 131(52.2)
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表 3 有同性性行为和异性性行为MSM的性病感染/HIV检测状况[n(%)]
Table 3. Status of STD or HIV testing among MSM who had homosexual behavior and heterosexual behavior[n(%)]
变量 最近6个月有异性性行为 χ2值 P值 最近6个月有同性性行为 χ2值 P值 是(n=251) 否(n=949) 是(N=939) 否(N=261) 最近一年曾患有性病 0.007 0.934 0.187 0.666 是 9(3.6) 33(3.5) 34(3.6) 8(3.1) 否 242(96.4) 916(96.5) 905(96.4) 253(96.9) 最近一年做过HIV检测 1.786 0.181 7.138 0.008 是 159(63.3) 557(58.7) 579(61.7) 137(52.5) 否 92(36.7) 392(41.3) 360(38.3) 124(47.5) 最近一年接受过安全套/宣传材料发放 0.004 0.951 21.964 < 0.001 是 188(74.9) 709(74.7) 731(77.8) 166(63.6) 否 63(25.1) 240(25.3) 208(22.2) 95(36.4) 最近一年接受过同伴教育 3.582 0.058 1.282 0.257 是 148(59.0) 496(52.3) 512(54.5) 132(50.6) 否 103(41.0) 453(47.7) 427(45.5) 129(49.4)
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表 4 最近6个月发生异性性行为的多因素分析
Table 4. Multivariate analysis of factors associated with having sex with women in the last 6 months among MSM
变量 β OR(95% CI)值 P值 年龄(岁) 0.924 18~ 1.000 25~ 0.085 1.089(0.611~1.940) 0.773 ≥35 0.016 1.016(0.525~1.967) 0.963 与异性的婚姻状况 未婚 1.000 已婚(包括在婚/同居/离异/丧偶) 2.020 7.538(4.773~11.905) < 0.001 在调查城市居住时间(月) 0.032 < 6 -0.017 0.983(0.452~2.137) 0.965 7~ -1.081 0.339(0.093~1.243) 0.103 12~ -0.846 0.429(0.224~0.824) 0.011 ≥24 1.000 文化程度 0.079 初中及以下 1.000 高中或中专 0.451 1.570(0.944~2.609) 0.082 大专及以上 0.052 1.053(0.614~1.806) 0.850 最近6个月发生同性商业性行为 是 1.510 4.528(2.435~8.423) < 0.001 否 1.000 知晓艾滋病知识 是 -0.317 0.729(0.278~1.908) 0.519 否 1.000 注：95% CI表示95%可信区间。
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