男男性行为者安全套使用影响因素分析

有研究表明，在中国，男男性行为对艾滋病／性病知识了解相对较高，但安全套使用率较低，在此人群中存在明显的知、行分离情况。为探求影响男男性行为人群安全套使用的潜在因素，云南省健康教育所对男男性行为人群进行了专题小组讨论、问卷调查，分析归纳了影响男男性行为人群安全套使用的因素，以期对开展针对此人群的艾滋病／性病干预工作有参考和指导意义。     

高档酒吧男男性行为者艾滋病知识知晓及安全套使用情况调查

[目的]了解高档酒吧男男性行为者(MSM)艾滋病知识知晓及安全套使用情况,为艾滋病干预提供科学依据。[方法]2009年4~7月对青岛市某一MSM活动的高级酒吧与男性发生过口交、肛交并自愿接受HIV抗体检测的男性400人,在知情同意的前提下,对MSM进行匿名问卷调查。[结果]调查MSM人群400人,平均年龄27.51±6.49岁,艾滋病知识知晓率为80.00%。最近6个月内与同性发生肛交性行为时每次都使用安全套者占7.25%;最近6个月内与同性发生商业性行为时每次都使用安全套者占8.82%;最近6个月内与异性发生性行为时每次都使用安全套者占5.83%。与同性发生性关系时,艾滋病知识知晓率越高,安全套使用率越高,而与同性发生商业性性行为及与异性发生性行为时,未发现艾滋病知识知晓率与安全套使用率之间的相关性。[结论]艾滋病知识知晓率是促进MSM人群降低危险性行为的有利因素,但存在着知识态度与行为相分离的现象。     

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.     

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.     

广州市海珠区男男性行为人群安全套使用影响因素分析

目的了解广州市男男性行为者(men who have sex with men,MSM)的安全套使用情况及相关影响因素,为针对性开展MSM人群干预工作提供依据。方法 2015—2016年对目标人群进行面对面问卷调查、艾滋病和梅毒血清学检测。结果1 036名MSM的HIV抗体和梅毒阳性检出率分别为7.24%、4.83%。80.60%的MSM最近六个月发生过肛交性行为,8.78%的MSM与异性发生过性行为。最近一次发生同性肛交性行为时安全套使用率从2015年的71.75%上升到2016年的81.49%(P0.05);最近六个月发生同性肛交性行为时每次均用安全套比例从2015年的53.81%上升到2016年的65.04%(P0.05);最近一次发生异性性行为时安全套使用率从2015年的47.83%上升到2016年的66.67%(P0.05);最近六个月发生异性性行为时每次均用安全套比例从2015年的26.09%上升到2016年的60.00%(P0.05)。多因素分析结果显示,文化程度高(OR=1.594,95%CI:1.100～2.308)、最近一年接受过干预服务(OR=1.521,95%CI:1.105～2.093)的MSM更容易坚持使用安全套,最近一年曾被诊断患过性病(OR=0.334,95%CI:0.149～0.745)的MSM坚持每次使用安全套比例低。结论广州市MSM人群安全套使用率低、知行分离,艾滋病、梅毒感染率高,应采取更为有效的综合干预手段,促使MSM人群减少不安全性行为,提高安全套使用率,遏制艾滋病的进一步传播蔓延。     

男男性行为人群安全套使用干预效果评价

目的评价开展男男性行为(MSM)人群预防艾滋病安全套使用干预的近期效果,以进一步探索有效干预方法。方法 2010年9月至2011年3月,利用同性恋组织招募同伴教育志愿者,对青岛市MSM人群进行安全套使用的行为干预,干预前后分别进行问卷调查。结果干预前后分别调查296人和306人,艾滋病相关知识知晓率从干预前的84.12%提高到干预后的89.54%,干预前后差异有统计学意义(P<0.05)。最近6个月与同性发生肛交行为者安全套的每次使用率由干预前的37.64%上升至47.73%,最近一次与同性发生肛交行为时使用安全套的比例由57.93%上升至62.88%,最近6个月与异性发生性行为者安全套的使用比例由18.63%上升至31.63%,最近1年接受过艾滋病预防干预服务的比例由75.68%上升至83.01%,干预前后差异均有统计学意义(P<0.05)。干预前后"艾滋病知识获得途径"除同伴教育、免费宣传资料外,其他途径差异均无统计学意义(P>0.05)。结论对MSM人群采取干预措施对提高安全套使用率有明显效果。     

2015－2017年绵阳市年轻男男性行为者安全套使用及影响因素

目的 了解年轻男男性行为者(young men who have sex with men, YMSM)安全套使用现状,分析影响因素。 方法 2015年9月－2017年6月,以四川省绵阳市15～24岁YMSM为对象,用滚雪球抽样法招募调查对象,进行安全套使用、社会及性行为等调查和血清学检测。安全套使用影响因素单因素分析用χ²检验,多因素分析用非条件logistic回归。 结果 共回收有效问卷362份,近6个月安全套每次使用率男性肛交55.31%、商业性伴42.11%、固定性伴49.38%、偶然性伴58.10%,异性性伴39.29%。不使用安全套26.83%因自己、46.34%因性伴不愿意,其原因固定性伴29.27%、不舒服23.17%、没必要14.63%。艾滋病病毒抗体阳性率随近6个月肛交安全套使用频率降低呈上升趋势(χ²_趋势=16.82,P=0.000)。多因素分析显示,干部职员(OR=16.058,OR95%CI: 1.95～132.55)、对自己性取向自豪(OR=100.82,OR 95%CI:8.68～1170.39)、近1年接受宣传材料发放(OR=5.37,OR 95%CI: 1.12～25.72)、防治知识来源宣传材料(OR=4.07,OR 95%CI: 1.05～15.81)、性伴不使用安全套采取劝说处理(OR=3.889,OR95%CI: 8.14～293.10)、性伴相处坚持主张(OR=16.058,OR 95%CI: 1.03～14.70)、近6个月肛交每次准备安全套(OR=12.01,OR 95%CI: 3.18～45.43)是安全套使用促进因素。 结论 YMSM安全套使用率不高,性伴制约作用明显,预防服务、身份认同、意愿坚持等与其相关,应针对性开展行为干预。     

天津市使用娱乐性药品的男男性行为者无保护性肛交的影响因素

【目的】探讨天津市使用娱乐性药品的男男性行为者(MSM)的人口学特征与性行为情况,比较使用娱乐性药品者与非使用娱乐性药品者的人口学特征以及性行为的情况。【方法】主要由天津市疾病预防控制中心(CDC)组织在天津开展。2015年7—9月,使用滚雪球抽样方式招募MSM。通过现场问卷调查收集信息,检查MSM的HIV感染情况。对人口学信息以及行为学变量进行统计学分析。【结果】纳入MSM 410名,年龄为17～70岁。297名(72.4%)MSM未婚且单身,194名(47.3%)月均收入在3 000～5 000元,182名(44.4%)受教育程度为高中,366名(89.3%)工作状态为全职。208名MSM自我报告使用过娱乐性药品,其中140名MSM使用过Rush Popper。Rush Popper使用者中无保护性肛交(UAI)的影响因素发现,MSM人群中发生UAI的Rush Popper使用者多集中在30岁以上年龄段、月均收入低于5 000元及与非固定伴侣发生性行为(均P0.05)。【结论】天津市MSM娱乐性药品的使用较为普遍,Rush Popper是使用最普遍的娱乐性药品。应加强对于Rush Popper使用的相关法律法规制定,减少其在MSM人群中的流通。     

山东省男男性行为者安全套使用及影响因素分析

目的分析山东省男男性行为者(MSM)人群性行为安全套使用情况及影响因素,为制定针对性的防治措施提供依据。方法于2010年4—7月采用面对面的匿名问卷调查方法,在MSM人群中收集有效问卷3 086份,采集血液标本3 073份,采用酶联免疫吸附法和免疫印迹法对血清样本进行艾滋病病毒(HIV)抗体、梅毒抗体检测。结果2 254名MSM最近6个月与同性发生过肛交性行为,占73.0%(2 254/3 086),731人坚持每次都使用安全套,占32.4%;704名MSM最近半年与异性发生过性行为,占22.8%(701/3 086),161人坚持每次都使用安全套,占22.9%(161/704);多因素logistic回归分析结果表明,低档场所(浴池/桑拿/足疗/按摩、公园/公厕/草地)、年龄较大、在本地居住时间较长是MSM发生同性肛交性行为时不坚持使用安全套的独立影响因素,而学历较高是MSM发生同性肛交性行为时坚持使用安全套的独立影响因素;低档场所、网络招募、年龄较大、在本地居住时间较长、外省户籍是MSM发生异性性行为时不坚持使用安全套的独立影响因素,而未婚是MSM发生异性性行为时坚持使用安全套的独立影响因素。结论山东省MSM安全套使用率较低;场所、年龄、婚姻状况、学历、在本地居住时间、户籍等是山东省MSM安全套使用的主要影响因素。     

First Anal Intercourse and Condom Use Among Men Who Have Sex with Men in Switzerland

The aim of this study was to analyze the circumstances of first anal intercourse (FAI) among men who have sex with men (MSM) and to identify factors associated with condom use at this event. We conducted a cross-sectional survey among a convenience sample of MSM living in Switzerland (N = 2,200). Anonymous questionnaires were distributed using Swiss gay communication channels (newspapers, associations, websites) and gay bathhouses. We gathered data on age at FAI, age of the partner, degree of familiarity with him, place of first meeting, and sociodemographic indicators. We did not ask whether FAI was insertive, receptive, or both. Data were stratified by birth year classes (birth cohorts). The median age at FAI fell from 24.5 years among men born before 1965 to 20.0 years among those born between 1975 and 1984 (p < .001). In each birth cohort, between 20 and 30% reported a partner 10 years older or more. Of eight variables examined in multivariate analysis, two were positively associated with condom use: age of participants at FAI and low degree of familiarity between partners. Conversely, large age discrepancy between partners was negatively associated with condom use. In conclusion, our data showed that early initiation of anal intercourse and large age discrepancy were associated with risk taking: a pattern of initiation that may facilitate HIV transmission from older to younger cohorts of MSM. Since age at FAI is on the decrease, there is an urgent need to heighten awareness of prevention actions regarding sexual debut of MSM.     

玉溪市男男性接触者安全套使用及影响因素分析

目的掌握玉溪市男男性接触者（MSM）人群安全套使用情况及其相关影响因素,为制定有针对性的干预措施提供依据。方法采用横断面调查和追踪调查相结合的方式,对105名MSM人群进行问卷调查。结果共调查MSM105人,其中未婚54．3％、在婚36．2％、离异或丧偶9．5％;最近1次肛交用安全套比例66．7％,其中未婚达78．9％、在婚55．3％、离异或丧偶40．0％,差异有统计学意义（P〈0．05）;MSM人群最近1次与异性发生性行为用安全套比例32．4％,其中在婚47．4％、未婚26．3％、离异或丧偶10．0％,差异有统计学意义（P〈0．05）;通过多因素Logistic回归分析,发现促进MSM使用安全套的影响因素包括高文化程度（OR=0．616）,在婚、离异或丧偶的婚姻状态（OR=0．161、0．488）,高艾滋病知识知晓（OR=0．444）,接受过艾滋病咨询检测（OR=0．198）,以及接受过同伴教育（OR=0．182）。结论玉溪市MSM人群安全套使用率偏低,影响因素较多。应进一步推广艾滋病咨询检测及同伴教育活动,注重完善MSM不同人群的干预措施。     

成都市男男性行为人群口交时安全套使用影响因素分析

目的探索成都市男男性行为人群口交行为时安全套使用的影响因素。方法采用滚雪球抽样选取成都市465名男男性行为者作为调查对象,通过问卷调查的方式收集人口学特征、艾滋病知晓率、高危行为等信息,用累积logistic模型分析成都市MSM人群发生口交行为时安全套使用的影响因素。结果共调查成都市465名MSM者,其中79.7%的调查对象最近6个月与性伴发生口交行为时从未使用安全套;最近6个月发生口交行为时安全套使用的影响因素有文化程度、寻找性伴最常去的场所、是否知道性伴的健康状况。结论成都市MSM人群口交行为时安全套使用率低,需通过多种途径对其进行健康教育,以提高安全套使用率。     

Gender Matters: Condom Use and Nonuse Among Behaviorally Bisexual Men

Although frequently cited as being at high risk for HIV/STI transmission, little is known about behaviorally bisexual men’s patterns and experiences of condom use and nonuse with male and female sexual partners. Using a variety of recruitment techniques informed by a Community Advisory Committee, a total of 77 behaviorally bisexual men were recruited from Indianapolis, Indiana to participate in semi-structured interviews focused on sexual health. Qualitative data were collected containing detailed information on their patterns and experiences of condom use and nonuse with both male and female partners. Participants described numerous commonly reported barriers for consistent condom use, as well as distinct bisexual-specific barriers. The majority reported consistent condom use with male and female casual partners, but many who did not use condoms described doing so in the context of ongoing relationships. In addition, participants provided reasons for condom use and nonuse that varied based on the gender of the partner and the type of relationship with the partner. Future interventions focused on increasing condom use among behaviorally bisexual men should take into account the unique complexities of gender and relationship configurations in this distinct population.     

Factors Associated with Event Level Anal Sex and Condom Use During Anal Sex Among Adolescent Women

PurposeTo examine the distribution of and factors associated with event-level heterosexual anal sex and of event-level condom use during anal sex among adolescent women.MethodsAdolescent women (N = 387; age 14–17 years at enrollment) were recruited from primary care clinics for a longitudinal cohort study of sexually transmitted infections and sexual behavior. Data were taken from daily sexual diaries; generalized estimating equation logistic regression assessed the likelihood of anal sex or condom use during anal sex on a given day.ResultsHeterosexual anal intercourse is a small but nonrandom event-level component in adolescent women's sexual behavior. About 30% of anal sex events were condom protected. Mood, partner, and situational factors predicted anal sex, but not condom use during anal sex; within-day and recent behavior factors were the strongest influences on both outcomes.ConclusionsOur findings suggest the importance of providers' screening adolescent women patients during office visits about anal sex and about condom use during anal sex, as well as asking questions about the context of these behaviors to appropriately tailor risk reduction counseling.     

Sexual Practices and Psychosocial Correlates of Current Condom Use Among Chinese Gay Men in Hong Kong

This study examined sexual practices, condom use, and psychosocial correlates of condom use in a convenience sample of 187 Chinese gay men in Hong Kong. Among those who were sexually active and answered the item on condom use (n = 164), 22% never used condoms, 39% were inconsistent condom users, and 39% used condoms every time they engaged in sexual activities in the past 6 months. Compared to inconsistent and noncondom users, consistent condom users had more positive feelings toward condom use, perceived greater vulnerability to STD/AIDS infections, showed greater self-acceptance and disclosure of their homosexual sexual orientation, were more involved with local gay communities, endorsed more favorable attitudes toward coming out, and had a lower level of perceived discrimination because of their homosexual sexual orientation. The two groups did not differ significantly on perceived partner reaction to condom use. Results of a logistic regression analysis showed that positive feelings toward condom use were the most salient correlate of consistent condom use.     

性爱安全全副武装

数字是枯燥的,却最有说服力。中国人安全套的 年均使用量不到两只,而欧美国家人均达12只。国家 药具发展中心透露的数字,让人无法相信自己的眼 睛:安全套质量令人担忧,合格率仅为56%到70%,进 口安全套也不例外。