男男性行为人群同性恋身份自我认同与艾滋病危险因素的相关性

目的]探索男男性接触者（MSM）对自己同性恋身份的认同及其与艾滋病相关危险因素的关系。方法]使用统一设计的调查问卷,对利用＂滚雪球＂、＂网络动员＂等途径招募的151名MSM采用匿名面对面询问方式调查其自我认同、性行为、性伴网络、吸毒史和健康相关行为。结果]消极自我认同的比例为56.29%（85/151）。文化程度与自我认同有关联性（χ2=8.022,P〈0.05）。自认性取向为同性恋的积极自我认同比例高于自认性取向为双性恋和异性恋者（χ2=5.108,P〈0.05）。不同自我认同和与男性首次性行为年龄、与异性结婚可能性、人类免疫缺陷病毒（HIV）抗体检测率、过去6个月有异性性伴/固定男性伴/多次男性伴等因素的关联有统计学意义（P值均〈0.05）,其中积极自我认同的MSM与男性首次性行为更多发生在20岁以前、与异性结婚可能性小、更易接受HIV检测服务、拥有固定男性伴比例高、拥有异性性伴和多次男性伴的比例小。结论]MSM人群消极自我认同的比例较高,其无保护性交和多性伴较广泛地存在,主动求医进行HIV抗体检测率较低,感染HIV危险性和传播桥梁作用也更大。应广泛开展社会反歧视宣传,促进MSM积极自我认同,增进艾滋病预防服务利用,有效降低艾滋病传播的风险。

Correlation between Self-Identification as Homosexual and Human Immunodeficiency Virus Risk Factors among Men Who Have Sex with Men

Objective ] To explore homosexual self-identification among men who have sex with men （MSM）, and study its correlation with the risk of human immunodeficiency virus （HIV） infection. Methods ] Altogether 151 MSM were recruited by snowball and network sampling methods. Face-to-face interview was conducted to collect information about self-identification, sexual behaviors, sexual networks, drug-abuse history and health-related behaviors with uniform questionnaires. Results ] Negative self-identification accounted for 85 （56.29%）. Education level was positively correlated with the proportion of positive selfidentification （χ2=8.022, P 〈 0.05）. The proportion of positive self-identification was significantly higher in those self-identified as homosexual than in those self-identified as heterosexual （χ2=5.108, P 〈 0.05）. There were significant differences in the age at first sexual intercourse with male, the possibility of marrying a female, HIV test, and having heterosexual partners/boyfriend/occasional partner over past 6 months between different self-identification groups （P〈 0.05）. A higher proportion of first sexual intercourse with male was found in the MSM with positive self-identification who were less than 20 years, less likely to marry a female, more likely to accept HIV testing, had boyfriend and less heterosexual partners and occasional partners. Conclusion ] MSM have a high proportion of negative self-identification. Unprotected intercourses and multiple sexual partners are common, but HIV antibody testing is rare among them, which lead to a high risk of HIV infection and a more influencing bridge role of HIV transmission. Extensive anti-discrimination propaganda and increased services for AIDS prevention will help to promote the positive self- identification among MSM and reduce the risk of AIDS transmission.