Situation on rectal douching and associated factors among men who have sex with men
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摘要:
目的 了解男男性行为人群(men who have sex with men, MSM)直肠冲洗行为状况及相关因素,为制定针对性干预措施提供依据。 方法 2020年5月1日―2020年7月10日,在江苏省无锡市采用滚雪球抽样的方法,选取KTV、浴室、公园、酒吧等场所招募400名MSM研究对象,开展横断面调查。通过调查问卷收集研究对象的社会人口学信息、行为学信息、物质滥用史、性病史和直肠冲洗行为等内容,并采集调查对象静脉血进行HIV抗体检测。采用χ2检验和多因素Logistic回归分析模型分析MSM直肠冲洗行为的相关因素。 结果 共调查MSM400人,最近6个月发生性行为时进行直肠冲洗的占比51.3%,其中只在性行为前进行直肠冲洗的占比57.6%,只在性行为后进行直肠冲洗的占比14.6%,性行为前后均进行直肠冲洗的占比27.8%。多因素分析结果显示,月均收入>5 000元(OR=2.18, 95% CI: 1.36~3.51, P=0.001)、同性恋(OR=19.35, 95% CI: 4.01~93.38, P<0.001)、双性恋(OR=10.31, 95% CI: 2.12~50.14, P=0.004)、最近6个月肛交时为被插入方(OR=8.96, 95% CI: 4.14~19.40, P<0.001)、最近6个月肛交时为插入方和被插入方均有(OR=10.71, 95% CI: 4.80~23.89, P<0.001)、物质滥用史(OR=3.20, 95% CI: 1.60~6.42, P=0.001)、性病史(OR=2.17, 95% CI: 1.30~3.63, P=0.003)、HIV检测阳性(OR=3.60, 95% CI: 1.14~11.36, P=0.029)是影响MSM直肠冲洗的相关因素。 结论 MSM发生性行为时进行直肠冲洗较普遍,且与HIV感染有关,迫切需要加强对该人群的健康教育和行为干预,以降低该人群感染HIV的风险。 Abstract:Objective This study aimed to explore the prevalence of associated with rectal douching among men who have sex with men (MSM) and related factors, in order to provide targeted interventions. Methods In this observational study, snowball sampling was used to recruit 400 MSM in KTV, bathroom, bar and so on in Wuxi, Jiangsu Province from May 1, 2020 to July 10, 2020. A questionnaire was used to collect socio-demographic characteristics, behaviors, substances abuse, history of diagnosed sexually transmitted diseases (STDs) and rectal douching. Blood sample was collected and tested for HIV. Chi-square test and Logistic regression analysis model were performed to determine factors associated with rectal douching among MSM. Results A total of 400 MSM were recruited, among whom 51.3% practiced rectal douching in the past 6 months, 57.6% before anal sex only, 14.6% after anal sex only and 27.8% (57/205) before and after anal sex. Monthly income > 5 000 RMB (OR=2.18, 95% CI: 1.36-3.51, P=0.001), homosexual (OR=19.35, 95% CI: 4.01-93.38, P < 0.001), bisexual (OR=10.31, 95% CI: 2.12-50.14, P=0.004), engaging in receptive anal sex exclusively in the past 6 months (OR=8.96, 95% CI: 4.14-19.40, P < 0.001), engaging in both insertive and receptive anal sex in the past 6 months (OR=10.71, 95% CI: 4.80-23.89, P < 0.001), substances use (OR=3.20, 95% CI: 1.60-6.42, P=0.001), history of diagnosed STDs (OR=2.17, 95% CI: 1.30-3.63, P=0.003) and positive HIV status (OR=3.60, 95% CI: 1.14-11.36, P=0.029) were associated with rectal douching in MSM. Conclusions Rectal douching is common in MSM, which is a significant factor associated with HIV transmission. Health education and behavioral interventions related to rectal douching should be enhanced among MSM in order to reduce the risk of HIV transmission. -
Key words:
- Men who have sex with men /
- Rectal douching /
- HIV /
- Risk factors
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表 1 不同特征的MSM与同性发生性行为时进行直肠冲洗的差异分析[n(%)]
Table 1. Analysis on differences in rectal douching among MSM with various characteristics in same-sex sexual behaviors [n(%)]
特征 调查人数 直肠冲洗人数 χ2值 P值 年龄组(岁) 0.001 0.974 ≤30 213(53.3) 109(51.2) >30 187(46.7) 96(51.3) 婚姻状况 8.968 0.011 未婚 319(79.8) 175(54.9) 已婚/同居 51(12.8) 17(33.3) 离异/丧偶 30(7.5) 13(43.3) 文化程度 3.559 0.059 高中或以下 194(48.5) 90(46.4) 大专或以上 206(51.5) 115(55.8) 月均收入(元) 10.565 0.001 ≤5 000 164(41.0) 68(41.5) >5 000 236(59.0) 137(58.1) 本地居住时间 1.015 0.314 ≤6个月 150(37.5) 72(48.0) >6个月 250(62.5) 133(53.2) 性取向 31.799 < 0.001 异性 24(6.0) 2(8.3) 同性 263(65.8) 158(60.1) 双性 113(28.2) 45(39.8) 固定性伴 0.781 0.377 有 142(35.5) 77(54.2) 无 258(64.5) 128(49.6) 最近6个月同性性伴数 2.167 0.141 < 2 250(62.5) 121(48.4) ≥2 150(37.5) 84(56.0) 最近6个月肛交时性角色 47.946 < 0.001 插入方 69(25.9) 13(18.8) 被插入方 113(42.5) 77(68.1) 均有 84(31.6) 55(65.5) 最近6个月肛交时坚持使用安全套 0.431 0.512 是 177(66.5) 99(55.9) 否 89(33.5) 46(51.7) 物质滥用史 17.603 < 0.001 否 333(83.3) 155(46.5) 是 67(16.7) 50(74.6) 性病史 4.309 0.038 无 265(66.3) 126(47.5) 有 135(33.7) 79(58.5) HIV检测阳性 4.753 0.029 否 380(95.0) 190(50.0) 是 20(5.0) 15(75.0) 表 2 MSM与同性发生性行为时进行直肠冲洗的多因素分析
Table 2. Multivariate analysis on rectal douching among MSM in homosexual behaviors
特征 β值 sx Wald值 OR(95% CI)值 P值 婚姻状况 未婚 1.00 已婚/同居 -0.466 0.415 1.259 0.63(0.28~1.42) 0.262 离异/丧偶 -0.481 0.443 1.176 0.62(0.26~1.47) 0.278 月均收入(元) ≤5 000 1.00 >5 000 0.780 0.243 10.229 2.18(1.36~3.51) 0.001 性取向 异性 1.00 同性 2.962 0.803 13.604 19.35(4.01~93.38) < 0.001 双性 2.333 0.807 8.357 10.31(2.12~50.14) 0.004 最近6个月肛交时性角色 插入方 1.00 被插入方 2.193 0.394 30.992 8.96(4.14~19.40) < 0.001 均有 2.371 0.409 33.556 10.71(4.80~23.89) < 0.001 物质滥用史 否 1.00 是 1.163 0.355 10.718 3.20(1.60~6.42) 0.001 性病史 无 1.00 有 0.776 0.262 8.754 2.17(1.30~3.63) 0.003 HIV检测阳性 否 1.00 是 1.281 0.587 4.766 3.60(1.14~11.36) 0.029 -
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