北京市男男性行为者安全套使用社会规范与无保护性肛交关系的研究

Objective To understand the prevalence of and factors associated with unprotected anal intercourse(UAI)among men who have sex with men(MSM)in Beijing.Methods Five hundred MSM were recruited for a survey using Respondent Driven Sampling (RDS)method, from September to October in 2009. A computer-assisted, interviewer-administered questionnaire was used to gather information including demographics, sexual behaviors and condom use social norms(a scaled number). Variables were evaluated by using RDSAT and SAS software.Results Mean age of the participants was 30.6 years, with 96.0% of them as Han ethnicity and68.5% having had at least high school or higher education level. 72.8% of them were unmarried, with 61.7% of them identified themselves as homosexual, 61.2% had ＞ 1 male partners in the past six months, and the prevalence of UAI was 42.0%. Significant bivariate predictors of UAI would include condom use social norms score, role for anal sex with male sex partner, number of male sexual partners in the past 6 months and amount of alcohol consumed. In multivariable analysis, UAI was associated with a higher condom use social norms score(AOR= 1.2, 95%CI: 1.1-1.3), receptive anal intercourse(AOR=2.0, 95%CI: 1.3-3.2)and drinking alcohol more than 3 times per month in the past 12 months(AOR=1.6, 95%CI: 1.1-2.5). Conclusion The prevalence of UAI was high in the MSM community in Beijing, suggesting that efforts should be targeting on how to make the condom use a social norm and being promoted.     

北京市男男性行为者安全套使用社会规范与无保护性肛交关系的研究

Objective To understand the prevalence of and factors associated with unprotected anal intercourse(UAI)among men who have sex with men(MSM)in Beijing.Methods Five hundred MSM were recruited for a survey using Respondent Driven Sampling (RDS)method, from September to October in 2009. A computer-assisted, interviewer-administered questionnaire was used to gather information including demographics, sexual behaviors and condom use social norms(a scaled number). Variables were evaluated by using RDSAT and SAS software.Results Mean age of the participants was 30.6 years, with 96.0% of them as Han ethnicity and68.5% having had at least high school or higher education level. 72.8% of them were unmarried, with 61.7% of them identified themselves as homosexual, 61.2% had ＞ 1 male partners in the past six months, and the prevalence of UAI was 42.0%. Significant bivariate predictors of UAI would include condom use social norms score, role for anal sex with male sex partner, number of male sexual partners in the past 6 months and amount of alcohol consumed. In multivariable analysis, UAI was associated with a higher condom use social norms score(AOR= 1.2, 95%CI: 1.1-1.3), receptive anal intercourse(AOR=2.0, 95%CI: 1.3-3.2)and drinking alcohol more than 3 times per month in the past 12 months(AOR=1.6, 95%CI: 1.1-2.5). Conclusion The prevalence of UAI was high in the MSM community in Beijing, suggesting that efforts should be targeting on how to make the condom use a social norm and being promoted.     

北京市男男性行为者安全套使用社会规范与无保护性肛交关系的研究

目的 了解北京市男男性行为者(MSM)无保护性肛交发生情况及其与社区安全套使用社会规范的关系.方法 2009年9-10月采用应答驱动抽样方法(RDS)在北京市MSM中开展调查,问卷采用计算机辅助调查员访谈式,内容包括人口学、性行为学特征及安全套使用社会规范,使用RDSAT和SAS进行统计学分析.结果 500名MSM平均年龄30.6岁,96.0%为汉族,高中及以上文化程度者占68.5%,72.8%未婚.61.2%最近6个月男性性伴数量＞1;42.0%的调查对象最近一次发生过无保护性肛交.多因素统计分析表明,差异有统计学意义的变量包括安全套使用社会规范计分低(AOR=1.2,95%CI:1.1-1.3),肛交中非主动角色(AOR=2.0,95%CI:1.3-3.2)和近12个月饮酒次数＞3次/月(AOR=1.6.95%CI:1.1-2.5).MSM社区安全套使用社会规范量表内部一致性检验克朗巴赫系数为0.93.结论 北京市MSM无保护性肛交行为发生率较高,应充分发挥MSM社区内社会规范的作用,减少无保护性肛交行为的发生.

Abstract：

Objective To understand the prevalence of and factors associated with unprotected anal intercourse(UAI)among men who have sex with men(MSM)in Beijing.Methods Five hundred MSM were recruited for a survey using Respondent Driven Sampling (RDS)method, from September to October in 2009. A computer-assisted, interviewer-administered questionnaire was used to gather information including demographics, sexual behaviors and condom use social norms(a scaled number). Variables were evaluated by using RDSAT and SAS software.Results Mean age of the participants was 30.6 years, with 96.0% of them as Han ethnicity and68.5% having had at least high school or higher education level. 72.8% of them were unmarried, with 61.7% of them identified themselves as homosexual, 61.2% had ＞ 1 male partners in the past six months, and the prevalence of UAI was 42.0%. Significant bivariate predictors of UAI would include condom use social norms score, role for anal sex with male sex partner, number of male sexual partners in the past 6 months and amount of alcohol consumed. In multivariable analysis, UAI was associated with a higher condom use social norms score(AOR= 1.2, 95%CI: 1.1-1.3), receptive anal intercourse(AOR=2.0, 95%CI: 1.3-3.2)and drinking alcohol more than 3 times per month in the past 12 months(AOR=1.6, 95%CI: 1.1-2.5). Conclusion The prevalence of UAI was high in the MSM community in Beijing, suggesting that efforts should be targeting on how to make the condom use a social norm and being promoted.     

深圳市男男性行为人群相关高危行为干预及其影响因素研究

目的 了解深圳市男男性行为者(MSM)安全套使用及其相关影响因素.方法 2009年8-11月招募深圳市同性恋聚集地的同性接触人群作为访谈对象,采用统一调查表进行问卷调查.对调查的273名MSM进行人口学和行为特征分析;以近6个月发生性行为时不能坚持每次使用安全套的行为为应变量,而各类影响因素为自变量进行logistic回归分析.结果 调查对象来自全国各地,绝大部分为青壮年,平均年龄27.9岁,以未婚居多,文化程度较高,但对艾滋病知识缺乏;安全套使用率低,过去1年每次性行为均使用安全套的比例为20.5%;与同性发生性行为不使用安全套的原因主要是对方为"稳定的性伴和爱人"、"年轻,看起来没病"、"没有滥交".结论 深圳市MSM危险性行为普遍存在,安全套使用情况和影响因素各不相同,艾滋病极有可能在该人群中流行.

Abstract：

Objective To learn the condom-use and it's associated factors among men who have sex with men(MSM)in Shenzhen,so as to provide scientific basis for the development of prevention and control program.Methods Cross-sectional survey was conducted with standardized questionnaire used on individual case.Associated factors with behavior of not persistent condom use were analyzed,using logistic regression method as dependent variable and associated factors with behaviors as independent variables.Results Most of the MSM were young,with average age as 27.9.coming from 26 provinces of China.Only 20.5 percent of the participants were persistently using condoms every time with their sex partners in the past year. The main reasons of not constantly using condom with their male sex partners were having fixed partners,being young,healthy and being faithful.Conclusion High risk sexual behaviors and the low rate of condom-use among MSM might serve as potential risks for HIV epidemics.Data on the rate of condom use and the influencing factors among MSM varied for different sexual partners,suggested that targeted prevention measures should be conducted.     

广西地区650 名男男性行为者对暴露前预防HIV感染接受意愿及其影响因素研究

目的 了解广西地区男男性行为者(MSM)对暴露前预防(PrEP)HIV感染的接受意愿及其影响因素.方法 采用滚雪球法招募650名MSM,利用自行设计的调查问卷一对一面访,了解MSM与艾滋病相关的高危行为、对PrEP的知晓情况及接受意愿.结果 假设PrEP使用的药物安全、有效且免费提供,有91.9%的MSM表示愿意服用药物.自述愿意服药的原因主要为可降低HⅣ感染的风险,不愿意服用药物的原因主要为担心药物的副作用和怀疑药物的效果.logistic回归分析显示,与接受PrEP意愿有关的因素为"是否通过朋友介绍性伴"(OR=6.21,P=0.020)、"是否有能力预防HIV感染"(OR=O.32,P=0.010)、"是否拒绝与不使用安全套的人发生性行为"(OR=0.34,P=0.010)、"是否建议朋友接受PrEP"(OR=39.32,P=0.000).结论 药物的安全性、有效性及费用可能是影响广西地区MSM接受PrEP的主要因素,免费提供安全、有效且副作用小的药物可能是推广PrEP的较好方式;以同伴教育的方式宣传PrEP可能会提高其接受意愿.

Abstract：

Objective To study the acceptability of pre-exposure prophylaxis (PrEP) to prevent the transmission of HIV among men who have sex with men (MSM) in Guangxi, China.Methods Snow-balling methods were used to recruit 650 MSM in Guangxi. Questionnaires and interview were administrated to these 650 men, using a self-designed questionnaire and face to face interviews to collect information on HIV-related risk behaviors, knowledge and acceptability of PrEP.effective, safe and free of charge', 597 (91.9%) of the 650 MSM claimed that they would accept it,who refused to use it, most of them said that were afraid of the side-effect and doubted on the effectiveness of PrEP. Data from logistic regression analysis showed that those who had found partners through friends (OR=6.21, P=0.020) and those who would advise his friend to use PrEP (OR=39.32, P=0.000) were more likely to accept PrEP. Those who thought they could protect themselves from HIV infection (OR=0.32, P=0.010) or not having sex with the ones who refused to use a condom (OR=0.34, P=0.010) were less likely to accept PrEP. Conclusion Effectiveness, safety and cost seemed to be the main influential factors related to the acceptability of PrEP. Peer education might improve the acceptability of PrEP.     

男男性行为者自我歧视与性行为和心理因素的关系

Objective To understand the self-discrimination experience of MSM and its relationship with sexual behavior and psychological factors.Methods By respondent-driven sampling(RDS) method, a call-for action and anonymous self-administration questionnaire investigation was carried out in Mianyang city on experience of self-discriminations, sexual partners and behaviors and depression symptom, etc.The first 12qualified people were designated as the "root" in the whole investigation from different MSM subgroups.Every "root" would get 3 recruit cards after their own investigation,then cards could be promoted to another 3 qualified people who were willing to accept questionnaires.And this process would go on till the sample size was accomplished.χ2 test,rank correlation and contingency coefficient would be applied for the statistical analysis.Results In total, 201 persons were investigated.Within the past 6 months, 59.2%(119/201) persons felt they did harm to their family or made the family down as gays ,79.6% (160/201)had to disguise their real sexual orientation in avoidance of being discriminated, 39.3% ( 79/201 ) were humiliated for having gay sex.It showed correlation between humiliation or harm to family and frequency to disco balls/night clubs( r = 0.196, χ2 = 7.95, P ＜ 0.05 ), concerts or theaters ( r = 0.201, χ2 = 8.423, P ＜0.05 ) with MSM friends, HIV health consultancy ( r = 0.231, χ2 = 11.329, P ＜ 0.05 ), experiences of one night stands ( rs = 0.183 ,μ = 2.588, P ＜ 0.05 ), detection of depression ( rs = 0.241 ,μ = 15.717, P ＜ 0.05 )and stress-related perception(rs =-0.310,μ= 23.112,P＜0.05) ,the corresponding behavior report rates of who experienced 3 -4 times were 66.7% ( 11/33 ) ,52.9% ( 18/34 ) ,41.2% ( 14/34 ), 17.6% ( 6/34 ),44.1% (15/34) ,44.7% (10/24).Statistical significance was found between the relations of humiliation for gay sex and frequency into concerts or theaters ( r = 0.195, χ2 = 7.933, P ＜ 0.05 ) with MSM friends,experiences of one night stands (rs =0.145,μ=2.051,P＜0.05),man-man anal sex (r=0.165,χ2 =10.823, P ＜ 0.05 ), numbers of female sexual partners ( r = 0.265, χ2 = 11.422, P ＜ 0.05 ), protectiveness of female sexual behavior in the past 6 months ( r =0.513 ,χ2 =7.442 ,P ＜0.05 ) ,detection of depression( rs =0.152 ,μ = 13.034, P ＜ 0.05 ) and stress-related perception ( rs = - 0.259,μ = 21.190, P ＜ 0.05 ), the corresponding behavior report rates of who experienced 3 - 4 times were 22.7% (5/22) ,9.1% (2/22),13.6% ( 3/22 ), 91.6% ( 2/22 ), 66.7% ( 2/3 ), 57.1% ( 4/7 ), 33.3% ( 19/57 ) .It has statistical significance between the relations of disguising their real sexual orientation in avoidance of being of HIV test ( r= 0.232, χ2 = 11.446, P ＜ 0.05 ), and stress-related perception ( rs = - 0.373 ,μ = 28.868,P ＜ 0.05 ).It was found that increasing of discrimination was connected to entrance into gay-welcome places,acceptance of HIV consultancy and tests, posting gay information among MSM friends and hold of many sexual partners.Meanwhile, the pressure was rising when depression was checked out.Conclusion Selfdiscrimination was prevalent among MSM ,which had brought critical influence on the individual behavior,MSM psychological health and prevalence of AIDS.     

男男性行为者自我歧视与性行为和心理因素的关系

Objective To understand the self-discrimination experience of MSM and its relationship with sexual behavior and psychological factors.Methods By respondent-driven sampling(RDS) method, a call-for action and anonymous self-administration questionnaire investigation was carried out in Mianyang city on experience of self-discriminations, sexual partners and behaviors and depression symptom, etc.The first 12qualified people were designated as the "root" in the whole investigation from different MSM subgroups.Every "root" would get 3 recruit cards after their own investigation,then cards could be promoted to another 3 qualified people who were willing to accept questionnaires.And this process would go on till the sample size was accomplished.χ2 test,rank correlation and contingency coefficient would be applied for the statistical analysis.Results In total, 201 persons were investigated.Within the past 6 months, 59.2%(119/201) persons felt they did harm to their family or made the family down as gays ,79.6% (160/201)had to disguise their real sexual orientation in avoidance of being discriminated, 39.3% ( 79/201 ) were humiliated for having gay sex.It showed correlation between humiliation or harm to family and frequency to disco balls/night clubs( r = 0.196, χ2 = 7.95, P ＜ 0.05 ), concerts or theaters ( r = 0.201, χ2 = 8.423, P ＜0.05 ) with MSM friends, HIV health consultancy ( r = 0.231, χ2 = 11.329, P ＜ 0.05 ), experiences of one night stands ( rs = 0.183 ,μ = 2.588, P ＜ 0.05 ), detection of depression ( rs = 0.241 ,μ = 15.717, P ＜ 0.05 )and stress-related perception(rs =-0.310,μ= 23.112,P＜0.05) ,the corresponding behavior report rates of who experienced 3 -4 times were 66.7% ( 11/33 ) ,52.9% ( 18/34 ) ,41.2% ( 14/34 ), 17.6% ( 6/34 ),44.1% (15/34) ,44.7% (10/24).Statistical significance was found between the relations of humiliation for gay sex and frequency into concerts or theaters ( r = 0.195, χ2 = 7.933, P ＜ 0.05 ) with MSM friends,experiences of one night stands (rs =0.145,μ=2.051,P＜0.05),man-man anal sex (r=0.165,χ2 =10.823, P ＜ 0.05 ), numbers of female sexual partners ( r = 0.265, χ2 = 11.422, P ＜ 0.05 ), protectiveness of female sexual behavior in the past 6 months ( r =0.513 ,χ2 =7.442 ,P ＜0.05 ) ,detection of depression( rs =0.152 ,μ = 13.034, P ＜ 0.05 ) and stress-related perception ( rs = - 0.259,μ = 21.190, P ＜ 0.05 ), the corresponding behavior report rates of who experienced 3 - 4 times were 22.7% (5/22) ,9.1% (2/22),13.6% ( 3/22 ), 91.6% ( 2/22 ), 66.7% ( 2/3 ), 57.1% ( 4/7 ), 33.3% ( 19/57 ) .It has statistical significance between the relations of disguising their real sexual orientation in avoidance of being of HIV test ( r= 0.232, χ2 = 11.446, P ＜ 0.05 ), and stress-related perception ( rs = - 0.373 ,μ = 28.868,P ＜ 0.05 ).It was found that increasing of discrimination was connected to entrance into gay-welcome places,acceptance of HIV consultancy and tests, posting gay information among MSM friends and hold of many sexual partners.Meanwhile, the pressure was rising when depression was checked out.Conclusion Selfdiscrimination was prevalent among MSM ,which had brought critical influence on the individual behavior,MSM psychological health and prevalence of AIDS.     

中国18省市大学生首次性行为年龄的人群分布特征及其影响因素

目的 了解中国大学生首次性行为年龄的人群分布特征,为制定适宜的性教育提供依据.方法 采取无记名自填问卷方式,按照分层整群抽样方法,对18个省(市、区)33 653名大学生进行中国青少年健康危险行为问卷调查.结果 中国大学生14岁前发生性行为的报告率为1.9%,男、女生分别为2.8%和1.1%(P＜0.01);15～18岁发生性行为的报告率男、女生分别为6.4%和2.1%;19岁后发生性行为的报告率男、女生分别为6.9%和2.6%.大学生首次性行为的发生年龄与父母学历、所在地区和家庭结构密切相关.来自大家庭和核心家庭、居住在东中部地区、父母文化程度较低的大学低年级学生,首次性行为发生年龄较晚.结论 应加强对两部地区、父母文化程度较高以及家庭结构不完整的青少年的性教育.

Abstract：

Objective To describe the characteristics of sexual debut among college students in China to provide appropriate sex education in that population. Methods An anonymous questionnaire survey was conducted among 33 653 college students selected by multi-stage stratified cluster sampling method in 18 provinces and cities of China. Results The percentage of students who had initiated sexual intercourse before age 14 was 1.9%. Overall, male students (2.8%) were significantly more likely to have initiated sexual intercourse before age 14, than female students (1.1%). The percentage of students who had initiated sexual intercourse from age 15 to 18 was 6.4% in males versus 2.1% in females. while the rates of students who had initiated sexual intercourse after age 19 were 6.9% in males and 2.6% in females. The first sexual intercourse was significantly associated with parental educational attainment, geographic location and family structure. Students whose parents were relatively well educated, living in the western areas of the country China, or with nucleus/extensive families were more likely to have early sex in their puberties. Conclusion Sexual education should be strengthened especially in the western areas, and targeted on the students whose parents with relatively higher educational background or who were from extensive families.     

北京市男男性行为者HIV和梅毒螺旋体血清抗体阳转率及影响因素

目的 了解北京市男男性行为者(MSM)的HIV和梅毒螺旋体血清抗体阳转情况及其影响因素. 方法 在北京市以社区为基础招募HIV阴性的MSM共525名,以一对一的方式进行问卷调查,收集人口学和行为学情况资料,在第6、12个月进行随访,并采集血样进行HIV和梅毒螺旋体抗体检测,初筛均采用ELISA法,确证分别采用蛋白印迹(WB)和凝集法. 结果 基线共调查550名,HIV和梅毒螺旋体血清抗体阳性率分别为4.5%(25/550)和29.3%(161/550),HIV血清抗体阴性队列525名,随访12个月,队列保持率为87.0%(457/525),HIV和梅毒螺旋体血清抗体阳转率分别为3.37/100人年和9.32/100人年.近3个月同性性行为后冲洗直肠者阳转率为7.11/100人年,未冲洗者为0.76/100人年,冲洗与HIV血清抗体阳转相关(HR=9.23,95%CI=2.08～40.88).近3个月在公园、公厕或浴池寻找男性性伴者阳转率为41.77/100人年,无该行为者阳转率为7.97/100人年;近3个月同性性行为后冲洗直肠者阳转率为16.17/100人年,无该行为者阳转率为4.92/100人年;近3个月在公园、公厕或浴池寻找男性性伴(HR=4.67,95%CI=1.77～12.34)和近3个月同性性行为后冲洗直肠(HR=3.09,95%CI=1.40～6.83)与梅毒螺旋体血清抗体阳转相关. 结论 北京市MSM的HIV和梅毒螺旋体血清抗体阳转情况十分严重,主要影响因素为同性性行为后冲洗直肠、到公园等场所寻找男性性伴.

Abstract：

Objective To study the incidence and risk factors of HIV and syphilis seroconversion among men who have sex with men(MSM) in Beijing. Methods A total of 550 MSM were recruited on the basis of community and followed up after 6 and 12 months in Beijing.Each subject was investigated by only one investigator at one time to collect information on demographics and behaviors.Blood samples were collected to test HIV and syphilis seroconversion.ELISA was used for screening test,west blotting(WB) and Particle agglutination were used for confirmatory test. Results A total of 550 MSM investigated,among which 4.5% (25/550) were HIV-positive and 29.3% (161/550) were syphilis-positive.For 525 HIVnegative MSM,87.0% (457/525) retained during the 12-month investigation.Seroincidences for HIV and syphilis were 3.37/100 person-years (95% CI = 1.66-5.08) and 9.32/100 person-years (95% CI =5.87-12.77) respectively.HIV seroconversions for those who performed and did not perform rectal douching after homosexual anal intercourse in the past 3 months were 7.11/100 and 0.76/100 person-years respectively.Multivariate Cox regression analysis revealed that rectal douching after homosexual anal intercourse in the past 3 months(HR=9.23,95%CI =2.08-40.88) was significantly associated with HIV seroconversion.Syphilis seroconversions for those who met male sex partners in parks,public washrooms or bathhouses in the past 3 months were 41.77/100 and 7.97/100 person-years respectively.Syphilis seroconversions for those who performed and did not perform rectal douching after homosexual anal intercourse in the past 3 months were 16.17/100 and 4.92/100 person-years respectively.In the past 3 months,meeting male sex partners in parks,public washrooms or bathhouses (HR=4.67,95% CI = 1.77-12.34) and performing rectal douching after homosexual anal intercourse (HR = 3.09,95% CI=1.40-6.83) were significantly associated with syphilis seroconversion. Conclusion The seroconversions of HIV and syphilis during the follow-up visits in this MSM cohort study in Beijing were very serious,and that the associated factors for seroconversions were rectal douching after homosexual anal intercourse and meeting male sex partners in parks,public washrooms or bathhouses.     

Serostatus disclosure and associated factors among people living with HIV/AIDS （PLWHA） in Liuzhou City,China

Introduction HIV serostatus disclosure has become an entry criterion for prevention of sexual partners spread, so we aimed to examine the prevalence of disclosure and associated factors among people living with HIV/ AIDS （PLWHA） in Liuzhou City, Guangxi Zhuang Autonomous Region, southern China. Methods The PLWHA with marital or regular sexual relationship were eligible for our study, and a self-de- signed questionnaire was assigned to all the convenient- ly sampled participants. Determinants of disclosure were analyzed using chi-square test and binary Logistic regression. Results A total of 425 PLWHA were included in the present study. Two hundred and forty-five （57.6%） disclosed their HIV-positive status to their spouses/reg- ular sexual partners, while 180（42.4% ） did not. A- mong the 245 informed spouses/regular sexual part- ners, 236 （96. 3 % ） had received the HIV testing and the positive rate was 50.4%. While among the non-informed spouses/regular sexual partners, 63 （35.0%） had received the HIV testing and the positive rate was 3.2%. Binary Logistic regression analysis indicated that age, area, monthly income, HIV/AIDS related knowledge and antiretroviral therapy （ART） were in- dependently associated with HIV serostatus disclosure. Conclusions The disclosure rate was low in this study. As to its influencing factors, it is necessary to provide comprehensive disclosure consulting among PLWHA living in urban, the elderly or high monthly income and emphasize the propaganda on HIV/AIDS related knowledge, expand coverage for antiretroviral therapy, so as to provide scientific reference for promoting HIV disclosure and reducing the HIV incidence of spouses/ regular sexual partners among PLWHA.     

泰安市男男性行为大学生艾滋病感染及相关行为状况

了解泰安市大中专院校大学生男男性行为者(men sho have sex with men,MSM)的艾滋病病毒(HIV)感染状况及其相关危险行为,为制定适宜的健康干预措施提供依据.方法 采用横断面调查研究,对泰安市大中专院校在校MSM人群通过自愿咨询检测(VCT)的方式获得方便样本,采用自填式问卷调查收集人口学特征和行为学信息,并采集血液样本进行HIV、梅毒和单纯疱疹病毒Ⅱ型(HSV-Ⅱ)的血清学检测.结果 共有127例男男性行为者参与研究.性行为角色以“肛交性行为的被插入方”为主的占42.5%.最常用的寻找性伴的方式是网络(89.0%),其中69人通过男同交友软件Blued,占54.3%.有79.4%的被试存在多性伴,近6个月与固定性伴、临时性伴发生无保护肛交的比例分别为60.4%(55/91),50.7%(37/73).最近一次肛交的安全套使用率仅为61.4%,未使用安全套的原因主要是认为和性伴彼此忠诚(18.4%)、身边没有(18.4%)、认为自己不会感染HIV(16.3%).大学生艾滋病知识知晓率为96.1%,但8题全部答对的比例仅为58.3%.大学生HIV感染率为3.1%,4.7%曾感染过梅毒,HSV-Ⅱ血清阳性率为3.1%.单因素分析显示,主要性行为方式以“肛交性行为的插入方”角色为主、使用Blued软件作为寻找性伴的主要方式、与固定性伴发生无保护性行为是HIV感染的危险因素,但Logistic回归分析均无统计学意义.结论 泰安市大中专院校学生MSM艾滋病流行已经显现.急需采取针对性措施提高感染风险意识,改变普遍存在的高危性行为.     

男男性行为人群无保护性肛交行为及其影响因素研究进展

近年来,我国MSM人群HIV感染率呈逐年上升趋势,该人群具有多性伴、无保护性肛交等高危行为。本文对无保护性肛交行为的流行情况以及年龄、文化程度、性伴数量与类型、新型毒品滥用、歧视等影响因素的研究进展进行综述,为开展该人群的靶向干预,预防和控制HIV在MSM人群中的蔓延提供参考。     

有导致出血的性施虐一受虐行为的男男性行为者行为特征研究

目的 探讨有导致出血的性施虐-受虐行为的男男性行为者(MSM)的行为特征,并分析与HIV/AIDS高危行为等之间关系.方法 采用改良型"滚雪球"抽样法(定向抽样法)进行横断面调查.从MSM有效问卷中获取有导致出血的性施虐-受虐行为者,并在无此行为者中选取比较组进行研究,采用SPSS 13.0软件进行统计分析.结果 有导致出血的性施虐-受虐行为组累计同性性伴数(M=20)、肛交(M=10)、口交(M=10)、手交(M=15)同性性伴数及近6个月同性性伴数(M=4)、肛交(M=3)、手交(M=3)同性性伴数均高于或显著高于比较组.有导致出血的性施虐-受虐行为组近6个月性交中安全套曾破裂或滑脱(22.6%)、曾罹患性传播感染(28.0%)、曾参与群交(34.8%)、近6个月曾在MSM活动场所与陌生同性性交(62.2%)、有过主动或被动的吻肛(64.0%)、拳交(18.9%)、指交行为(66.7%)、性交过程中曾出血(58.3%)、首次性交对象为未成年人(33.8%)、曾有过强烈自杀念头(33.3%)及自杀未遂行为(23.6%)的百分率,均高于或显著高于比较组.结论 有导致出血的性施虐-受虐行为的MSM与HW/AIDS相关的高危行为,显著多于无此行为者,该人群是在健康干预工作中需特殊关注的亚人群.     

HIV Infection and Sexual Behaviors Among Non-Commercial Men Who Have Sex with Men at Different Venues

The prevalence of HIV infection among men who have sex with men (MSM) has increased rapidly in China. Previous studies suggested that some venue-specific characteristics could significantly affect MSM’s sexual behaviors that were related to HIV transmission. Thus, to compare the HIV infection rates and related risky sexual behaviors among MSM at different venues, we conducted a cross-sectional study with time-location sampling in Shenzhen, China. Among the 801 MSM recruited in the study, 7.0 % (n = 56) were found to be HIV positive, with 0.9 % of MSM at bars (BMSM), 3.5 % of MSM at suburban recreational centers (RMSM), 8.1 % of MSM at saunas (SMSM), 9.3 % of MSM at parks (PMSM), and 10.1 % of MSM at dorm-based venues (DMSM). HIV infection was significantly more prevalent in MSM in dorm-based venues, parks, and saunas than in other venues. Compared to MSM in other venues, BMSM were more likely to be single, drug and alcohol users, but less likely to be HIV and syphilis positive. More PMSM reported having unprotected anal intercourse with other men while more SMSM reported having multiple male sex partners and more RMSM had a low level of HIV-related knowledge. The results indicated that MSM frequenting different venues were inconsistent with regards to demographic characteristics, HIV and syphilis infection rates, and risky sexual behaviors. Greater efforts are needed to develop intervention strategies that target specific venues and risky behaviors.     

A Comparative Analysis of Behaviors and Sexual Affiliation Networks among Men Who Have Sex With Men in Hong Kong

In Hong Kong, men who have sex with men (MSM) account for a significant proportion of HIV infections. While perceived as a hidden population, they constitute a distinct social network shaped by their differential use of unique channels for sex partnership. To characterize their pattern of connectivity and association with high-risk sexual behaviors, 311 MSM were recruited via saunas and the internet to participate in a questionnaire survey. Internet recruits were younger, and many (31/43) were solely reliant on the internet to seek sex partners, while visiting a similar number of venues as the sauna recruits (p = 0.98). Internet users generally had a high frequency of unprotected anal intercourse (UAI). MSM who had visited only a single venue reported more UAI with their regular partners (adjusted OR 6.86, 1.88–24.96) and sought fewer casual partners than those frequenting multiple venues (adjusted OR 0.33, 0.19–0.60). This study provides evidence for the heterogeneity of the sexual affiliation networks of MSM in Hong Kong. High HIV risk of UAI could be offset by fewer casual partners in certain venues, the implications of which would need to be explored in longitudinal studies. Methodologically, internet sampling was very efficient in identifying sex networking venues, while internet recruits gave a high retention rate for updating profiles. However, sampling at high centrality saunas did not necessarily identify the MSM-affiliating venues in the networks efficiently. The sampling strategy of MSM survey should therefore be objective-driven, which may differ for health message dissemination and social marketing, versus HIV surveillance or risk assessment.     

广州市男男性行为者儿童期性虐待经历对成年后高危性行为的影响

  目的  了解广州市男男性行为者（men who have sex with men,MSM）的儿童期性虐待（childhood sexual abuse,CSA）情况,分析CSA对成年后高危性行为的影响。  方法  采用非概率抽样方法招募广州市≥ 18周岁的MSM,通过电子问卷收集调查对象的社会人口学资料、CSA经历和近6个月高危性行为情况。采用χ2检验比较不同社会人口学特征的MSM的CSA经历和近6个月的高危性行为情况,用Logistic回归分析模型分析探讨CSA对高危性行为的影响。  结果  调查对象的平均年龄为（28.35±6.83）岁。26.95%（263/976）的MSM遭受过CSA,近6个月多性伴（multiple sexual partners,MSP）率和无保护肛交（unprotected anal intercourse,UAI）率分别为61.68%（602/976）和47.95%（468/976）。调整了年龄、民族、户籍、本地居住时间、婚姻状况、文化程度、工作状况、个人月收入和性取向之后,有CSA者近6个月发生MSP的风险高于无CSA者（aOR=1.62,95% CI:1.19~2.22）,但近6个月UAI与CSA关联的差异无统计学意义。  结论  广州市MSM经历CSA的比例较高,CSA可增加成年后的高危性行为的风险,因此,制定MSM高危性行为干预措施可能需要考虑CSA的影响。     

淮南市男男性行为者艾滋病相关高危行为及影响因素分析

目的了解男男性行为者(MSM)高危行为特征及其影响因素,为制定艾滋病防治措施提供参考依据。方法采用"滚雪球"方法在淮南市招募279名MSM为研究对象,通过问卷收集人口学、艾滋病知识、高危行为及干预服务接受情况等,对数据进行单因素及多因素logistic回归分析。结果 279名调查对象绝大部分为青壮年,平均年龄28岁,未婚居多、文化程度以高中及以上为主,AIDS知识知晓率为89.90%。最近6个月,应答者中100%的调查对象发生过同性肛交,7.72%发生过同性商业性行为,31.05%MSM曾经和异性发生性接触;过去6个月同性非商业性无保护肛交的发生率为62.36%,同性无保护商业性性行为发生率为38.10%,与异性发生无保护性行为发生率为83.53%。多因素logistic回归分析发现,来自县城的招募对象、最近一周同性肛交多于1次、最近六个月有异性性行为、最近一年患过性病、高艾滋病知识得分、最近一年检测过HIV与MSM最近6个月同性肛交安全套坚持使用率的关系有统计学意义。结论淮南市MSM人群艾滋病相关的高危行为普遍存在,亟需采取针对性的干预措施。     

中国大陆男男性接触者艾滋病性病高危险行为情况调查

目的 调查中国大陆男男性接触者（men who have sex with men,MSM)的艾滋病（acpuired immunodeficiency syndrome,AIDS）和性病（sexually transmitted diseases,STD）高危险行为及相关情况。方法 采用不同记名邮寄问卷形式调查。结果 发放调查问卷1800份,回收有效问卷729份,应答率40.5%。调查对象平均31.0岁。首次男男性交平均18.6岁。累计男性伴平均数39.2人,75.7%有过肛交行为。近一年内,63.6%有过陌生男性伴,39.8%曾群交,9.3%“买”过性,３.8％“卖”过性。约半数与女性性交过。　133人自述患过性病（18.2%）。62人检测过人类免疫缺陷病毒（human immune deficiency virus,HIV）抗体,11人阳性（17.7%）。约2/3使用过避孕套。结论 被调查的MSM在性方面相当活跃,HIV感染率在这一人群中巳达较高水平,而且流行全直接蔓延到异性恋人群。     

Sexual Partnering and HIV Risk among Black Men Who Have Sex with Men: New York City

Black men who have sex with men (MSM) are disproportionately affected with HIV in the US. Limited event-specific data have been reported in Black MSM to help understand factors associated with increased risk of infection. Cross-sectional National HIV Behavioral Surveillance Study data from 503 MSM who reported ≥1 male sexual partner in the past year in New York City (NYC) were analyzed. Case-crossover analysis compared last protected and last unprotected anal intercourse (UAI). A total of 503 MSM were enrolled. Among 349 tested for HIV, 18% were positive. Black MSM (N = 117) were more likely to test HIV positive and not know their HIV-positive status than other racial/ethnic groups. Case-crossover analysis of 208 MSM found that men were more likely to engage in protected anal intercourse with a first time partner and with a partner of unknown HIV status. Although Black MSM were more likely to have Black male partners, they were not more likely to have UAI with those partners or to have a partner aged >40 years. In conclusion, HIV prevalence was high among Black MSM in NYC, as was lack of awareness of HIV-positive status. Having a sexual partner of same race/ethnicity or older age was not associated with having UAI among Black MSM.