A study on group sex behavior and HIV testing related factors among men who have sex with men in Shandong Province
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摘要:
目的 了解山东省男男性行为者(men who have sex with men, MSM)群交行为和人类免疫缺陷病毒(human immunodeficiency virus, HIV)检测的相关影响因素，为制订艾滋病防控措施提供参考依据。 方法 2022年4―7月在山东省6个监测哨点城市招募MSM进行问卷调查，每个哨点样本量为400人。收集MSM社会人口学、性行为等信息，并采集血样进行HIV和梅毒检测。采用单因素和多因素logistic回归分析模型分析最近6个月群交行为及最近1年HIV检测情况的相关影响因素。 结果 共纳入MSM2 415人。最近6个月发生群交行为的比例为19.7%，最近1年进行HIV检测的比例为89.7%。多因素logistic回归分析模型分析结果显示，年龄≤30岁(aOR=1.83, 95% CI: 1.02~3.26)、肛交主要性伴为商业性伴(aOR=3.34, 95% CI: 2.14~5.22)或临时性伴(aOR=1.55, 95% CI: 1.21~1.99)、最近6个月发生无保护肛交(aOR=2.89, 95% CI: 2.27~3.67)、使用过新型毒品(aOR=1.79, 95% CI: 1.37~2.34)、最近1年患过性病(aOR=2.23, 95% CI: 1.55~3.21)、HIV抗体阳性(aOR=1.70, 95% CI: 1.03~2.80)的MSM最近6个月发生过群交行为的可能性更高。大专及以上文化程度(aOR=1.81, 95% CI: 1.28~2.57)、肛交主要性伴为临时性伴(aOR=1.94, 95% CI: 1.37~2.76)、最近6个月未发生无保护肛交(aOR=1.84, 95% CI: 1.31~2.58)、梅毒抗体阳性(aOR=1.96, 95% CI: 1.07~3.62)、HIV抗体阳性(aOR=4.45, 95% CI: 2.40~8.24)的MSM最近1年未进行HIV检测的可能性更高。 结论 山东省MSM最近6个月发生群交行为的比例较高，需要加强对MSM的宣传干预，并关注MSM获取HIV预防保健服务情况。 -
关键词:
- 艾滋病 /
- 男男性行为者 /
- 高危性行为 /
- 人类免疫缺陷病毒检测
Abstract:Objective To understand the related factors of group sex behavior and human immunodeficiency virus (HIV) testing among men who have sex with men (MSM) in Shandong Province, to explore its related factors, and to provide a reference for formulating targeted strategies for HIV/AIDS prevention and control. Methods From April to July in 2022, MSM were recruited in six sentinel surveillance sites in Shandong, with a sample size of 400 in each sentinel. A face-to-face questionnaire was conducted to collect sociodemographic characteristics, sexual behaviors, etc. Blood samples were collected from them for HIV and syphilis antibodies testing. Univariate and multivariate logistic regression models were used to analyze the related factors of group sex behavior in the last 6 months and HIV testing in the last year. Results A total of 2 415 MSM were investigated. Of all participants, 19.7% had group sex behavior in the last 6 months and 89.7% ever had HIV testing in the last year. Multivariate logistic regression showed that MSM who were aged ≤30 years (aOR =1.83, 95% aOR: 1.02-3.26), ever had anal sex with commercial (aOR =3.34, 95% aOR: 2.14-5.22) or casual partners (aOR=1.55, 95% aOR: 1.21-1.99), had unprotected anal sex in the last 6 months (aOR=2.89, 95% aOR: 2.27-3.67), used new-type drug (aOR=1.79, 95% aOR: 1.37-2.34), diagnosed with STD in the last year (aOR=2.23, 95% aOR: 1.55-3.21), and HIV antibody positive (aOR = 1.70, 95% aOR: 1.03-2.80) were more likely to have group sex in the last 6 months. In contrast, MSM who had education level of college or above (aOR=1.81, 95% aOR: 1.28-2.57), had anal sex with casual partner (aOR=1.94, 95% aOR: 1.37-2.76), had no unprotected anal sex in the last 6 months (aOR=1.84, 95% aOR: 1.31-2.58), syphilis antibody positive (aOR =1.96, 95% aOR: 1.07-3.62), and HIV antibody positive (aOR = 4.45, 95% aOR: 2.40-8.24) were more likely to have no HIV testing in the last year. Conclusions High prevalence of group sex behavior in the last 6 months were noticed among MSM in Shandong Province. It is important to strengthen publicity and education measures, and focus on accessibility to HIV preventive health care services in MSM. -
表 1 2415名MSM人口学特征
Table 1. Demographic characteristics of 2 415 MSM
变量Variable MSM① (n=2 415) 变量Variable MSM① (n=2 415) 年龄/岁Age/years 文化程度Educational level ≤30 1 364(56.5) 高中及以下High school or below 899(37.2) ＞30~＜50 888(36.8) 大专及以上College or above 1 516(62.8) ≥50 163(6.7) 性取向Sexual orientation 婚姻状况Marital status 同性恋Homosexuality 2 056(85.1) 已婚/同居Married/cohabitation 574(23.8) 双性恋/异性恋/不确定Bisexual/heterosexuality/not sure 359(14.9) 未婚/离异/丧偶Not married/divorce/widowhood 1 841(76.2) 最主要寻找男伴的场所The main place to find sexual partner 户籍Household registration 酒吧/歌舞厅等Bar/singing and dancing hall, etc 170(7.0) 山东省Shangdong Province 2 173(90.1) 互联网/交友软件Internet/dating software 2 245(93.0) 外省Non-local provinces 240(9.9) 注：MSM，男男性行为者。
①以人数(占比/%)表示。
Note:MSM, men who have sex with men.
① Number of people (proportion/%).
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表 2 MSM性行为及HIV、梅毒感染情况
Table 2. The situation of sexual behavior, HIV and syphilis infection of MSM
变量Variable MSM① (n=2 415) 变量Variable MSM① (n=2 415) AIDS知识知晓情况AIDS awareness 新型毒品使用Novel drug abuse 不知晓Unaware 57(2.4) 否No 2 037(84.3) 知晓Aware 2 358(97.6) 是Yes 378(15.7) 肛交主要性伴Anal sex dominant partner 最近1年患过性病Diagnosed with sexually transmitted disease in the last year 商业性伴Commercial sexual partner 117(5.0) 否No 2 233(92.5) 临时性伴Non-regular sexual partner 1 395(59.8) 是Yes 182(7.5) 固定性伴Regular sexual partner 822(35.2) HIV抗体检测结果HIV antibody test result 最近6个月无保护肛交Unprotected anal sex in the last 6 months 阴性Negative 2 335(96.7) 否No 1 196(51.2) 阳性Positive 80(3.3) 是Yes 1 138(48.8) 梅毒抗体检测结果Syphilis antibody test result 阴性Negative 2 310(95.7) 阳性Positive 105(4.3) 注：MSM，男男性行为者；HIV，人类免疫缺陷病毒; AIDS, 艾滋病。
①以人数(占比/%)表示。
Note: MSM, men who have sex with men; HIV, human immunodeficiency virus; AIDS, acquired immunodeficiency syndrome.
① Number of people (proportion/%).
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表 3 MSM最近6个月群交行为多因素logistic回归分析变量赋值情况
Table 3. Variable assignments for multivariate logistic regression analysis of group sex behavior among MSM in the past 6 months
变量Variable 赋值Assignment 因变量Dependent variable 最近1年HIV检测The HIV testing in the last year 0=是；1=否0=Yes; 1=No 自变量Independent variable 年龄/岁Age/years 1=≤30；2=＞30~＜50；3=≥50 婚姻状况Marital status 1=未婚/离异/丧偶；2=在婚/同居1=Not married/divorce/widowhood; 2=Married/cohabitation 户籍Household registration 1=山东省；2=外省1=Shangdong Province; 2=Non-local provinces 文化程度Educational level 1=高中及以下；2=大专及以上1=High school or below; 2=College or above 性取向Sexual orientation 1=同性恋；2=双性恋/异性恋/不确定1=Homosexuality; 2=Bisexual/heterosexuality/not sure AIDS知识知晓情况AIDS awareness 0=不知晓；1=知晓0=unaware; 1=aware 肛交最主要性伴Anal sex dominant partner 1=商业性伴；2=临时性伴；3=固定性伴1=Commercial sexual partner; 2=Non-regular sexual partner; 3=Regular sexual partner 最近6个月无保护肛交Unprotected anal sex in the last 6 months 0=否；1=是0=No; 1=Yes 新型毒品使用Novel drug abuse 0=否；1=是0=No; 1=Yes HIV抗体检测结果HIV antibody test result 0=阴性；1=阳性0=Negative; 1=Positive 注：MSM，男男性行为者；AIDS，艾滋病；HIV，人类免疫缺陷病毒。
Note: MSM, men who have sex with men; AIDS, acquired immunodeficiency syndrome; HIV, human immunodeficiency virus.
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表 4 MSM最近6个月群交行为logistic回归分析
Table 4. The logistic regression analysis of group sex behavior in the last 6 months of MSM
变量Variable 群交行为Group sex behavior ① 单因素logistic回归Univariate logistic regression 多因素logistic回归Multivariate logistic regression OR值value (95% CI) P值value aOR值value (95% CI) P值value 年龄/岁Age/years ≤30 1 364(56.5) 2.14(1.29~3.57) 0.003 1.83(1.02~3.26) 0.042 ＞30~＜50 888(36.8) 1.59(0.94~2.68) 0.081 1.51(0.86~2.64) 0.152 ≥50 163(6.7) 1.00 1.00 婚姻状况Marital status 已婚/同居Married/cohabitation 574(23.8) 1.00 1.00 未婚/离异/丧偶Not married/divorced /widowed 1 841(76.2) 1.28(1.00~1.65) 0.050 1.32(0.96~1.80) 0.086 户籍Household registration 山东省Shangdong Province 2 173(90.1) 1.00 1.00 外省Non-local provinces 240(9.9) 1.50(1.10~2.04) 0.011 1.38(0.99~1.92) 0.054 最主要寻找男伴的场所The most important place to find sexual partner 酒吧/歌舞厅等Bar/singing and dancing hall, etc 170(7.0) 1.45(1.01~2.08) 0.046 1.35(0.89~2.03) 0.156 互联网/交友软件Internet/dating software 2 245(93.0) 1.00 1.00 肛交主要性伴Anal sex dominant partner 商业性伴Commercial sexual partner 117(5.0) 4.80(3.17~7.27) < 0.001 3.34(2.14~5.22) < 0.001 临时性伴Non-regular sexual partner 1 395(59.8) 1.66(1.31~2.10) < 0.001 1.55(1.21~1.99) < 0.001 固定性伴Regular sexual partner 822(35.2) 1.00 1.00 最近6个月无保护肛交Unprotected anal sex in the last 6 months 否No 1 196(51.2) 1.00 1.00 是Yes 1 138(48.8) 3.66(2.92~4.58) < 0.001 2.89(2.27~3.67) < 0.001 新型毒品使用Novel drug abuse 否No 2 037(84.3) 1.00 1.00 是Yes 378(15.7) 2.61(2.05~3.34) < 0.001 1.79(1.37~2.34) < 0.001 最近1年患过性病Diagnosed with STD in the last year 否No 2 233(92.5) 1.00 1.00 是Yes 182(7.5) 3.13(2.28~4.29) < 0.001 2.23(1.55~3.21) < 0.001 HIV抗体检测结果HIV antibody test result 阴性Negative 2 335(96.7) 1.00 1.00 阳性Positive 80(3.3) 2.70(1.70~4.28) < 0.001 1.70(1.03~2.80) 0.036 梅毒抗体检测结果Syphilis antibody test result 阴性Negative 2 310(95.7) 1.00 1.00 阳性Positive 105(4.3) 1.90(1.24~2.93) 0.003 1.04(0.63~1.73) 0.870 注：MSM，男男性行为者；HIV，人类免疫缺陷病毒。
①以人数(占比/%)表示。
Note: MSM, men who have sex with men; HIV, human immunodeficiency virus.
① Number of people (proportion/%).
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表 5 MSM最近1年HIV检测变量赋值情况
Table 5. Variable assignment for HIV testing among MSM in the past year
变量Variable 赋值Assignment 因变量Dependent variable 最近6个月群交行为Group sex behavior in the last six months 0=否；1=是0=No; 1=Yes 自变量Independent variable 年龄/岁Age/years 1=≤30；2=＞30~＜50；3=≥50 婚姻状况Marital status 1=未婚/离异/丧偶；2=在婚/同居1=Not married/divorce/widowhood; 2=Married/cohabitation 户籍Household registration 1=山东省；2=外省1=Shangdong Province; 2=Non-local provinces 最主要寻找男伴的场所The most important place to find sexual partner 1=酒吧/歌舞厅等；2=互联网/交友软件1=Bar/singing and dancing hall, etc; 2=Internet/dating software 肛交最主要性伴Anal sex dominant partner 1=商业性伴；2=临时性伴；3=固定性伴1=Commercial sexual partner; 2=Non-regular sexual partner; 3=Regular sexual partner 最近6个月无保护肛交Unprotected anal sex in the last 6 months 0=否；1=是0=No; 1=Yes 新型毒品使用Novel drug abuse 0=否；1=是0=No; 1=Yes 最近1年患过性病Diagnosed with sexually transmitted disease in the last year 0=否; 1=是0=No; 1=Yes HIV抗体检测结果HIV antibody test result 0=阴性; 1=阳性0=Negative; 1=Positive 梅毒抗体检测结果Syphilis antibody test result 0=阴性; 1=阳性0=Negative; 1=Positive 注：MSM，男男性行为者；HIV，人类免疫缺陷病毒。
Note: MSM, men who have sex with men; HIV, human immunodeficiency virus.
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表 6 MSM最近1年HIV检测logistic回归分析
Table 6. The logistic regression analysis of HIV testing in MSM over the past year
变量Variable HIV检测人数Number of people tested for HIV① 单因素logistic回归Univariate logistic regression 多因素logistic回归Multivariate logistic regression OR值value (95% CI) P值value aOR值value (95% CI) P值value 年龄/岁Age/years ≤30 160(11.7) 2.03(1.05~3.94) 0.035 1.25(0.57~2.71) 0.579 ＞30~＜50 79(8.9) 1.49(0.76~2.95) 0.247 1.26(0.59~2.67) 0.549 ≥50 10(6.1) 1.00 1.00 婚姻状况Marital status 已婚/同居Married/cohabitation 33(5.7) 1.00 1.00 未婚/离异/丧偶Not married/divorced /widowed 216(11.7) 2.18(1.49~3.18) < 0.001 1.45(0.90~2.33) 0.124 户籍Household registration 山东省Shangdong Province 235(10.8) 2.30(1.27~4.18) 0.006 1.88(1.00~3.55) 0.052 外省Non-local provinces 12(5.0) 1.00 1.00 文化程度Educational level 高中及以下High school or below 54(6.0) 1.00 1.00 大专及以上College or above 195(12.9) 2.31(1.69~3.16) < 0.001 1.81(1.28~2.57) 0.001 性取向Sexual orientation 同性恋Homosexuality 227(11.0) 1.90(1.21~2.99) 0.005 1.53(0.91~2.58) 0.110 双性恋/异性恋/不确定Bisexual/heterosexuality/not sure 22(6.1) 1.00 1.00 AIDS知识知晓情况AIDS awareness 不知晓Unaware 10(17.5) 1.89(0.94~3.78) 0.074 1.68(0.75~3.75) 0.204 知晓Aware 239(10.1) 1.00 1.00 肛交主要性伴Anal sex dominant partner 商业性伴Commercial sexual partner 7(6.0) 1.03(0.45~2.33) 0.951 1.36(0.59~3.15) 0.474 临时性伴Non-regular sexual partner 143(10.3) 1.84(1.31~2.59) < 0.001 1.94(1.37~2.76) < 0.001 固定性伴Regular sexual partner 48(5.8) 1.00 1.00 近6个月无保护肛交Unprotected anal sex in the last six months 否No 123(10.3) 1.63(1.20~2.19) 0.001 1.84(1.31~2.58) 0.001 是Yes 75(6.6) 1.00 1.00 新型毒品使用Novel drug abuse 否No 227(11.1) 2.03(1.29~3.19) 0.002 1.42(0.88~2.28) 0.153 是Yes 22(5.8) 1.00 1.00 HIV抗体检测结果HIV antibody test result 阴性Negative 231(9.9) 1.00 1.00 阳性Positive 18(22.5) 2.64(1.54~4.55) < 0.001 4.45(2.40~8.24) < 0.001 梅毒抗体检测结果Syphilis antibody test result 阴性Negative 232(10.0) 1.00 1.00 阳性Positive 17(16.2) 1.73(1.01~2.96) 0.045 1.96(1.07~3.62) 0.030 注：MSM，男男性行为者；AIDS，艾滋病；HIV，人类免疫缺陷病毒。
①以人数(占比/%)表示。
Note: MSM, men who have sex with men; AIDS, acquired immunodeficiency syndrome; HIV, human immunodeficiency virus.
① Number of people (proportion/%).
下载: 导出CSV
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