男男性行为者公开性取向与艾滋病相关行为的关系研究

目的了解男男性行为者（MSM）公开性取向与艾滋病相关行为的关系。方法从MSM不同年龄、活动场所等“亚群”特征中招募符合条件的“种子”共8人，结合滚雪球抽样法招募调查对象，进行相关行为匿名调查和血清学检测，应用Y。检验、非条件logistic回归分析进行数据分析。结果合格调查401例，公开性取向11．0％（44／401）。公开性取向／未公开性取向艾滋病病毒（HIV）确证感染率6．8％（3／44）／6．4％（23／357），梅毒累计感染率15．9％（7／44）／22．1％（79／357），现症感染率6．8％（3／44）／9．5％（34／357）（X2=0．107、0．900、0．096，P均〉0．05）。单因素分析：年龄、职业、婚姻状况、性取向、收入、近1年接受HIV检测、自认感染风险、阳性结果的态度、认识当地MSM朋友数、家庭关系、固定性伴侣（BF）间感情付出、更多寻找一夜情性伴的原因、近6月男性肛交数、商业性行为，女性性行为、有BF性伴、无保护性口交、累计BF数、有过异性性行为、商业性行为与公开性取向相关（X2=6．921、3．927、6．678、4．767、7．565、5．083、4．104、6．165、12．455、13．257、14．315、6．471、12．062、10．432、4．951、4．692、7．205、5．019、8．568、7．233，P均〈0．05）。多因素分析，公开性取向的独立影响因素：收入（OR=3．745，95％CI：1．446～9．687）、BF间感情付出（OR=5．863，95％CI：2．257～14．256）、近6月男性商业性行为（OR=8．000，95％CI：1．468～43．478）、近6月男性肛交数（OR=3．706，95％CI：1．324～10．367），收入较高，BF间感情付出很多，近6月男性肛交数≥5、有男性商业性行为者公开性取向的比例较高。结论MSM公开性取向很少，其公开性取向与否对社会及社群健康的影响极具双面性，在艾滋病防治中应针对各自特征开展健康教育和行为干预。

Study on the relationship between sexual orientation of MSM and their AIDS related behavior

Objective To understand the relationship between sexual orientation of MSM who made their sexu-alities public and AIDS related behavior. Methods 8 qualified ＂ seed＂ MSM were recruited and were later used to recruit other subjects using snowball sampling method. An anonymous survey regarding AIDS related behavior was conducted and blood samples were collected for serological test. X2 test and non-conditional logis- tic regression analysis were used for data statistical analysis. Results A total of 401 MSM were recruited in the study. 44 of them （11.00%） made their sexualities public. The HIV infection rates among MSM who made their sexual orientation public and those who did not were 6.8% （3/44） and 6.4% （23/357）, while the ac- cumulative infection rates of syphilis were 15.9% （7/44） and 22.1% （79/357）, and the current infection rates were 6.8% （3/44） and 9.5% （34/357） （X2 analysis showed that age, occupation, marital status 0. 107, 0. 900, 0. 096, P〉0.05） . The single factor sexual orientation, income, HIV testing in recent 1 year, risk of infection, attitude toward positive result, number of friends of local MSM, family relationship, affection of permanent boyfriend （BF）, causes of looking for more sexual partners, anal sex in recent six months , commercial sexual behavior, sexual behavior with females, BF partners, casual sexual partners, oral sex without protection, cumulative number of BF, heterosexual behavior, commercial sexual behaviors were all associated with sexual orientation out of closet （？（2_6. 921, 3. 927, 6. 678, 4. 767, 7. 565, 5. 083, 4.104, 6.165, 12.455, 13.257, 14.315, 6.471, 12.062, 10.432, 4.951, 4.692, 7.205, 5.019, 8. 568, 7. 233, P〈0.05） . Multiple factors analysis indicated that independent factors affecting sexual orien- tation were income （OR = 3. 745 95% CI： 1. 446-9. 687）, affection of BF （OR = 5. 863 950/oo CI： 2. 257 14. 256）, commercial sexual behavior and number of anal sex in recent six months （OR= 8. 000 95~CI： 1. 468-43. 478） （OR=3. 706 95%CI： 1. 324-10. 367） . MSM with higher income, or in stable relationship or having anal sex at least 5 times in recent 6 months or having commercial sex behavior were more likely to make their sexuality public. Conclusions Only a few MSM makes sexual orientation public now a days which has a double-sided effect on social and community health. Therefore, health education and behavior intervention need to be carried out based on the specific traits.