海口市不同性角色MSM青年学生社会接纳和性行为特征

目的了解海南省海口市不同性角色男男性行为(men who have sex with men,MSM)青年学生的社会接纳和高危性行为特征及危险因素,为开展MSM青年学生艾滋病预防干预提供精准化建议。方法在高校中采用同伴推动抽样法(RDS)动员招募MSM青年学生至咨询检测门诊,通过匿名问卷调查,问卷内容包括社会人口学、社会接纳和高危性行为特征,同时采集血样进行HIV和梅毒抗体检测。结果共调查159名MSM青年学生,有效调查问卷150份。调查对象据经常扮演的性角色分三组:被插入方(0号)60人(40.00%),兼有插入和被插入方(0.5号)48人(32.00%),插入方(1号)42人(28.00%)。0号、0.5号和1号组HIV感染率分别为3.33%、0.00%和7.14%,差异无统计学意义(P=0.170);梅毒感染率分别为3.33%、10.42%和19.05%,差异有统计学意义(P=0.034)。觉得生活环境对待同性恋态度友好的39人(26.53%),觉得一般的100人(66.70%),觉得受到歧视的8人(5.30%)。性行为学变量中“首次性行为年龄、首次性行为对象是否为临时性伴、是否使用过兴奋剂、使用兴奋剂后有无发生性行为”有统计学意义(P<0.05);“最近一年每次发生肛交性行为都坚持使用安全套”变量有统计学意义(P<0.01);logistic多因素分析结果显示:0.5号性角色在二~五年级段是一年级的3.143倍(OR=3.143,95%CI:1.893~5.220);不告知他人同性性倾向是0号和1号的8.093倍(OR=8.093,95%CI:2.496~26.243);首次性行为年龄(<18岁)是0号和1号的15.269倍(OR=15.269,95%CI:5.072~45.972),是危险因素。0.5号性角色首次性行为对象相对固定,首次性行为对象为临时性伴是0号和1号的0.238倍(OR=0.238,95%CI:0.092~0.619),是保护因素。结论不同性角色的MSM青年学生社会接纳、高危性行为、安全套使用和梅毒感染率差异有统计学意义,建议分类提供针对性干预,提高该人群预防性传播疾病感染技能。

Social acceptance and sexual behavior characteristics of MSM young students with different sexual roles in Haikou

Objective To understand the characteristics and risk factors of social acceptance and high-risk sexual behavior of young students with different sex roles in MSM (men who have sex with men) in Haikou City, Hainan Province, and to provide refined suggestions for AIDS prevention and intervention among young MSM students. Methods The peer-driven sampling (RDS) method was used to mobilize young MSM students to consulting and testing clinics. Anonymous questionnaires were conducted to investigate the characteristics of social demography, social acceptance and high-risk sexual behaviors. Blood samples were collected for HIV and syphilis antibody detection. Results A total of 159 young MSM students were investigated, and 150 valid questionnaires were used. According to the sex roles often played, there were 60(40.00%) inserted(No. 0) , 48(32.00%) inserts and inserted(No. 0.5) and 42(28.00%) inserts(No. 1) respectively. HIV infection rates of No. 0, No. 0.5 and No. 1 were 3.33%, 0 and 7.14%, respectively, with no significant difference (P= 0.170); syphilis infection rates were 3.33%, 11.63% and 19.05%, respectively, with statistical significance (P= 0.034). Thirty-nine people (26.53%) felt that their living environment was friendly to homosexuals, 100 people (66.70%) felt normal, and 8 people felt they were discriminated against (5.30%). Among the variables of sexual behavior, "age of first sexual act, whether the object of first sexual act is a temporary sexual partner, whether doping has been used, whether sexual act has occurred after using doping" had statistical significance (P<0.05); "condom use persists in every anal intercourse in the last year" had statistical significance (P< 0.01); logistic multivariate analysis showed that: No. 0.5 sexual roles in the second to fifth grade were 3.143 times as high as those in the first grade (OR=3.143, 95% CI:1.893-5.220); not informing others of homosexual sexual orientation was 8.093 times as high as that in the No. 0 and No. 1 (OR=8.093, 95% CI:2.496-26.243); age of first sexual intercourse (<18 years) was 15.269 times as high as that in the No. 0 and No. 1 (OR=15.269, 95% CI:5.072-45.972), which were risk factors. The object of first sexual intercourse of No. 0.5 sex role was relatively fixed, and the object of first sexual intercourse was temporary partner, which was 0.238 times that of No. 0 and No. 1 (OR = 0.238, 95% CI: 0.092-0.619), which was the protective factor. Conclusion There are significant differences in social acceptance, high-risk sexual behaviors, condom use and syphilis infection among young MSM students with different sex roles. It is suggested that targeted interventions be provided to improve their skills in preventing STD infection.