Behavioral characteristics and influencing factors of multiple sexual partners among men who have sex with men in Chongqing
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摘要:
目的 了解重庆地区艾滋病病毒(human immunodeficiency virus, HIV)阴性多性伴肛交(≥5人)男男性行为者(men who have sex with men, MSM)的人口学和性行为特征及其影响因素。 方法 从2018年6月至2019年6月, 招募重庆地区319名HIV阴性MSM, 收集其人口学特征、近半年内安全套使用率、是否感染性病、性角色、药物滥用史、是否服用过暴露后预防(post-exposure prophylaxis, PEP)药物、是否关注HIV知识和是否服用过暴露前预防(pre-exposure prophylaxis, PrEP)药物等信息。采用单因素和多因素Logistic回归分析模型分析MSM人群多性伴肛交的影响因素。 结果 319名HIV阴性MSM中, 34.5%(110/319)近6个月内性伴人数≥5人; 110名多性伴MSM中, 63.6%(70/110)年龄≤28岁, 75.4%(83/110)学历为大学本科或大专; 50名报告情感状况的MSM中, 72.0%(36/50)为单身。多因素Logistic回归分析模型分析显示, 服用过PEP药物和经常关注HIV知识是MSM多性伴肛交的主要影响因素。 结论 重庆地区HIV阴性MSM人群普遍存在多性伴肛交现象。应加大对MSM人群, 尤其是低龄MSM人群, HIV防治知识的宣教力度。在推广PrEP和PEP在MSM人群中的使用时, 应警惕其相关风险补偿。 Abstract:Objective To understand the demographic and sexual behavioral characteristics and factors associated with multiple anal sexual partners(5 or more) among human immunodeficiency virus(HIV) negative men who have sex with men(MSM) in Chongqing. Methods From June 2018 to June 2019, eligible HIV negative MSM were recruited in our analysis. Based on questionnaire, we collected demographic characteristics, the percentage of condoms using, the status of sexually transmitted diseases, sex role, history of drug abuse, history of post-exposure prophylaxis(PEP), concerning about HIV knowledge and history of pre-exposure prophylaxis(PrEP) in the past 6 months. Univariate and multivariate Logistic regression models were used to analyze the factors associated with multiple anal sexual partners(5 or more) among HIV negative MSM. Results Among 319 HIV negative MSM, 34.5%(110/319) of them had sex with 5 or more in the past 6 months. Among 110 MSM who have anal sex with 5 or more, 63.6%(70/110) of them were 28-year-old or younger, and 75.4%(83/110) of them had bachelor or college degree. 50 MSM reported emotional status, of which 72.0%(36/50) were single. The results of multivariate Logistic analysis showed that having a history of PEP and always concerning about HIV knowledge were primary influencing factors of multiple anal sexual partners(5 or more) among HIV negative MSM. Conclusions Having multiple anal sexual partners is a common phenomenon among HIV negative MSM in Chongqing. It is necessary to increase the awareness of HIV prevention and education among MSM populations, especially among younger MSM populations. While promoting the use of PrEP and PEP in MSM populations, we should be vigilant about the risk compensation of them. -
Key words:
- HIV /
- MSM /
- Multiple sexual partners /
- PrEP /
- PEP
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表 1 重庆地区HIV阴性MSM人口学特征及高危性行为特征构成
Table 1. Demographic characteristics and high-risk sexual behavior characteristics of HIV-negative MSM in Chongqing
变量 多性伴例数(n) 构成比(%) 年龄(岁) 110 ≤28 70 63.6 > 28 40 36.4 文化程度 110 高中及以下 9 8.2 大学本科或大专 83 75.4 硕士及以上 18 16.4 民族 110 汉族 106 96.4 其他 4 3.6 收入(元) 110 无收入 15 13.6 < 6 000 46 41.8 ≥6 000 49 44.6 情感状况 50 单身a 36 72.0 有亲密关系b 14 28.0 重庆地区 110 否 42 38.2 是 68 61.8 安全套使用率(%) 60 < 50 10 16.7 ≥50 50 83.3 是否感染性病c 110 否 90 81.8 是 20 18.2 性取向 47 同性恋 40 85.1 双性恋 7 14.9 性角色 50 “1”d 13 26.0 “0.5”e 19 38.0 “0”f 18 36.0 性伴类型(种)g 50 < 2 21 42.0 ≥2 29 58.0 注:a单身包括离异或分居; b有亲密关系包括有男友或与男友同居; c人免疫缺陷病毒感染者除外; d“1”指男男性行为中的插入方; e“0.5”指男男性行为中, 既可以做插入方也可以做被插入方; f“0”指男男性行为中的被插入方; g性伴类型包括临时男性性伴、固定男性性伴和商业男性性伴3种。 
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表 2 重庆HIV阴性MSM性伴≥5人的单因素Logistics回归分析模型
Table 2. Univariate Logistic regression analysis of HIV-negative MSM who have sex with 5 or more people in Chongqing
变量 例数(n) OR(95% CI)值 P值 年龄(岁) ≤28 216 1.000 > 28 103 0.755(0.464~1.230) 0.259 文化程度 高中及以下 35 1.000 大学本科或大专 233 0.635(0.245~1.643) 0.349 硕士及以上 51 1.014(0.538~1.912) 0.965 民族 汉族 118 1.000 其他 12 1.508(0.428~5.316) 0.523 收入(元) 无收入 70 1.000 < 6 000 136 0.364(0.184~0.720) 0.004 ≥6 000 112 0.681(0.407~1.142) 0.145 情感状况 单身 85 1.000 非单身 45 1.555(0.708~3.413) 0.271 重庆地区 否 102 1.000 是 217 1.534(0.942~2.498) 0.086 安全套使用率(%) < 50 26 1.000 ≥50 163 1.412(0.599~3.329) 0.430 是否感染性病a 否 266 1.000 是 64 1.098(0.607~1.987) 0.757 性取向 同性恋 105 1.000 双性恋 25 0.936(0.360~2.429) 0.891 性角色 “1”b 35 1.000 “0.5”c 39 1.633(0.624~4.276) 0.318 “0”d 56 0.822(0.330~2.046) 0.674 药物滥用史 否 87 1.000 是 46 0.525(0.243~1.134) 0.101 是否公开性取向 否 28 1.000 是 102 0.849(0.348~2.072) 0.720 是否服用过PEP药物e 否 105 1.000 是 25 0.358(0.129~0.987) 0.047 自认HIV感染的风险程度 较低 60 1.000 中等 46 0.428(0.156~1.173) 0.099 较高 26 0.426(0.149~1.222) 0.112 是否关注HIV知识 偶尔关注 57 1.000 经常关注 75 0.371(0.172~0.799) 0.011 是否了解PrEPf 否 43 1.000 是 275 1.287(0.665~2.490) 0.454 是否服用过PrEP药物 否 282 1.000 是 34 0.323(0.156~0.669) 0.002 注:a人免疫缺陷病毒感染者除外; b“1”指男男性行为中的插入方; c“0.5”指男男性行为中, 既可以做插入方也可以做被插入方; d“0”指男男性行为中的被插入方; e暴露后预防(post-exposure prophylaxi, PEP); f暴露前预防(pre-exposure prophylaxis, PrEP)。
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表 3 重庆HIV阴性MSM性伴≥5人的多因素Logistics回归分析模型
Table 3. 3 Multivariate Logistic regression analysis of HIV-negative MSM who have sex with 5 or more people in Chongqing
变量 β值 Sx值 Wald值 OR值 P值 收入(元) 无收入 1.000 < 6 000 -0.562 0.646 0.756 0.570 0.385 ≥6 000 -0.050 0.650 0.006 0.952 0.939 重庆地区 否 1.000 是 0.191 0.656 0.085 1.211 0.771 是否服用过PEP药物 否 1.000 是 1.074 0.536 4.016 2.926 0.045 自认HIV感染的风险程度 较低 1.000 中等 -0.358 0.463 0.597 0.699 0.440 较高 0.442 0.576 0.589 1.556 0.443 是否关注HIV知识 偶尔关注 1.000 经常关注 1.019 0.400 6.480 2.772 0.011 文化程度 高中及以下 1.000 大学本科或大专 -0.244 0.683 0.128 0.784 0.721 硕士及以上 -0.870 0.851 1.047 0.419 0.306 情感状况 单身 1.000 非单身 -0.612 0.426 2.069 0.542 0.150 药物滥用史 否 1.000 是 0.677 0.422 2.579 1.968 0.108
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