Characteristics and influencing factors of heterosexual behavior among young men who have sex with men in Taizhou City from 2015 to 2018
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摘要:
目的 了解台州市年轻男男性行为者(young men who have sex with men,YMSM)异性性行为特征及其影响因素,为开展艾滋病(acquired immune deficiency syndrome,AIDS)干预措施提供参考依据。 方法 于2015年1-7月、2016年2-9月、2017年1-8月和2018年1-8月对台州市YMSM进行人口学与行为学特征、AIDS相关认知等问卷调查以及人类免疫缺陷病毒(human immunodeficiency virus,HIV)、梅毒和丙型肝炎病毒(hepatitis C virus,HCV)检测。 结果 共调查YMSM 432人,56人有过异性性行为,其中14.3%异性性行为时从未使用安全套,26.8%最近一次异性性行为时未使用安全套,HIV和梅毒检出率均为5.4%,未发现HCV阳性者,AIDS知识知晓率为91.1%。多因素Logistic回归分析模型分析结果显示婚姻状况、在本地居住时间是YMSM异性性行为的影响因素。 结论 台州市YMSM异性性行为者有传播HIV、梅毒的风险,AIDS知晓率较好,但仍存在商业性行为等高危行为和不用安全套等知行分离情况。应针对已婚或本地居住时间<2年者中采取安全性行为干预措施。 Abstract:Objective To investigate characteristics and influencing factors of heterosexual behavior among young men who have sex with men (YMSM) in Taizhou, and to provide evidence for conducting intervention on acquired immune deficiency syndrome (AIDS). Methods The demographic characteristics, behavioral characteristics and AIDS related knowledge of YMSM in Taizhou were investigated by the method of questionnaire survey from January to July in 2015, February to September in 2016, January to August in 2017, and January to August in 2018. Human immunodeficiency virus (HIV), syphilis and hepatitis C virus (HCV) were tested in everyone. Results A total of 432 YMSM were recruited, including 56 YMSM who had heterosexual behavior. 14.3% of YMSM who had heterosexual behavior never used condoms when having heterosexual behavior. 26.8% did not use condoms when having the last heterosexual behavior. The detection rates of HIV and syphilis were both 5.4%. No HCV positive person was found. The awareness rate of AIDS related knowledge was 91.1%. In multivariate logistic regression, marital status and local residence time were influencing factors of heterosexual behavior among YMSM. Conclusions YMSM in Taizhou are at risk of spreading HIV and syphilis. Although the awareness rate of AIDS related knowledge is better, there are still high-risk behavior such as commercial sex behavior and knowledge-practice separation such as not using condoms. It is necessary to promote intervention activities for safe sexual behavior, especially among YMSM who are married and live in the local areas for less than 2 years. -
Key words:
- AIDS /
- Young men who have sex with men /
- Heterosexual behavior /
- Influencing factors
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表 1 台州市YMSM一般人口学特征和异性性行为发生情况分析[n (%)]
Table 1. Analysis on general demographic characteristics and heterosexual behavior of YMSM in Taizhou [n (%)]
变量 例(%) 异性性行为 单因素分析 多因素分析 χ2值 P值 aOR(95% CI)值 P值 年龄(岁) 0.842 0.359 <20 81(18.8) 13(16.0) ≥20 351(81.3) 43(12.3) 民族a 0.006 0.938 汉 406(94.4) 53(13.1) 少数民族 24(5.6) 3(12.5) 文化程度 6.300 0.043 小学/初中 88(20.3) 16(18.2) 1.64(0.73~3.70) 0.233 高中/中专 164(38.0) 25(15.2) 1.57(0.76~3.22) 0.221 大专及以上 180(41.7) 15(8.3) 1.00 婚姻状况 42.929 < 0.001 未婚/离异/丧偶 419(97.0) 46(11.0) 1.00 已婚 13(3.0) 10(76.9) 32.17(8.22~125.98) < 0.001 户籍所在地 1.596 0.206 本省 272(63.0) 31(11.4) 外省 160(37.0) 25(15.6) 在本地居住时间(年) 5.771 0.056 < 1 70(16.2) 13(18.6) 2.43(1.15~5.10) 0.020 1~ 31(7.2) 7(22.6) 3.09(1.20~7.93) 0.019 >2 331(76.6) 36(10.9) 1.00 样本来源 1.152 0.562 酒吧/浴池/公园/大学 190(44.0) 25(13.2) 网络 131(30.3) 14(10.7) VCT 111(25.7) 17(15.3) AIDS知晓 0.001 0.978 是 393(91.0) 51(91.1) 否 39(9.0) 5(8.9) 注:a表示数据有缺失。 表 2 台州市YMSM异性性行为者的行为学特征
Table 2. Behavioral characteristics of YMSM who had heterosexual behavior in Taizhou
变量 例(%) 异性性行为(%) χ2值 P值 最近半年与异性发生过性行为 0 1.000 是 56(13.0) 56(13.0) 否 376(87.0) 376(87.0) 最近半年与异性发生性行为时使用安全套的频率a 0 1.000 从未使用 8(14.3) 8(14.3) 有时使用 15(26.8) 15(26.8) 每次都用 33(58.9) 33(58.9) 最近一次与异性发生性行为时使用安全套a 0 1.000 是 41(73.2) 41(73.2) 否 15(26.8) 15(26.8) 最近半年与同性发生过肛交性行为 0.750 0.386 是 378(87.5) 47(83.9) 否 54(12.5) 9(16.1) 最近半年与同性肛交时使用安全套的频率a 3.176 0.204 从未使用 28(7.4) 3(6.4) 有时使用 146(38.6) 13 (27.6) 每次都用 204(54.0) 31 (66.0) 最近一次与同性肛交时使用安全套a 1.561 0.212 是 286(75.7) 39(83.0) 否 92(24.3) 8(17.0) 最近半年与同性发生过商业性行为a 0.107 0.743 是 20(5.3) 3(6.3) 否 360(94.7) 45(93.7) 最近半年与同性发生商业性
行为时使用安全套的频率a1.342 0.601 从未使用 1(5.0) 0(0.0) 有时使用 4(20.0) 1(33.3) 每次都用 15(75.0) 2(66.7) 最近一次与同性发生商业性行为时使用安全套a 4.804 0.028 是 16(80.0) 1(33.3) 否 4(20.0) 2(66.7) 注:a数据有缺失。 表 3 台州市YMSM异性性行为者HIV、梅毒、HCV检测情况
Table 3. Detection of HIV, syphilis and HCV of YMSM who had heterosexual behavior in Taizhou
变量 例(%) 异性性行为 χ2值 P值 HIV 0.233 0.629 阳性 34 (7.9) 3 (5.4) 阴性 398 (92.1) 53 (94.6) 梅毒 0.014 0.905 阳性 18 (4.2) 3 (5.4) 阴性 414 (95.8) 53 (94.6) -
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