广州市男男性行为者无保护肛交情况及相关因素分析

目的了解广州市男男性行为者（MSM）无保护肛交性行为（UAI）的相关影响因素，为开展有针对性的艾滋病高危行为干预提供依据。方法于2008年5-8月在广州市采用同伴推动抽样法招募MSM完成面对面的艾滋病相关知识和行为问卷调查，并进行HIV和梅毒的抗体检测。运用RDSAT软件计算各指标人群校正值，结合SPSS统计软件进行x2检验单因素分析和logistic多因素分析。结果共招募379名MSM（其中13名MSM作为种子），校正后UAI发生率为60．3％（粗发生率为61．5％，233／379）；校正HIV感染率为5．2％（粗感染率为4．5％，17／379），现症梅毒感染率为17．5％（粗感染率为17．4％，66／379）。发生UAI主要集中在20—29岁、未婚、文化程度大专及以上、职业为服务类的人群，校正构成比分别为50．3％、47．8％、44．3％、39．4％。发生UAI的MSM人群HIV感染率达7．2％，高于安全性行为人群的1．5％（P〈0．05）；UAI有性病相关症状者占23．0％，高于性行为安全者（15．2％）（P〈0．05）；最近6个月与女性发生过性行为在UAI中的构成比为24．4％，低于发生安全性行为者的35．4％（P〈0．05）。多因素分析显示该人群中低层工作者（工人、民工、农民）、近6个月未与女性发生性行为者、有性病相关症状报告者以及HIV阳性者的UAI发生率显著高于其他亚人群，OR值分别为3．534、1．733、1．832、5．128。结论广州市MSM的UAI发生率较高，应针对不同亚人群特别是低层工作者开展有效干预，提高HIV抗体检测率和对HIV及性病的发现力度，进而加强对UAI的干预，并扩大性病转介与诊疗服务的覆盖面，有效促进安全性行为。

Unprotected anal intercourse and related factors among men who have sex with men in Guangzhou City

Objective To examine the prevalence of unprotected anal intercourse （UAI） and relat- ed factors among men who have sex with men （MSM） in Guangzhou and to provide evidences for targeted behavior intervention. Methods Participantes were recruited using Respondent-Driven Sampling （ RDS ） method in Guangzhou from May to August 2008. Each participant was provided with an anonymous face to face questionnaire interview, and HIV and syphilis antibody tests. Respondent-Driven Sampling Analysis Tool and SPSS were used to generate adjusted estimates and explore associated factors. Results A total of 379 participants were recruited and 13 of them were seeds. The adjusted prevalence of UAI, HIV, and syphilis were 60.3% , 5.2% , and 17.5% , respectively. The participants at 20 - 29 years old, single, college educated or higher, and engaged in service jobs had higher prevalence of UAI; and the adjusted prevalences were 50.3% , 47.8% , 44.3% , and 39.4% , respectively. The prevalence of HIV among MSM with UAI was higher than those who without UAI （7.2% vs 1.5% , P 〈0.05）. The prevalence of symptoms of sex transmitted diseases （STD） among MSM with UAI was higher than those without UAI （23.0% vs 15.2% ,P 〈 0.05 ）. The prevalence of having sex with female in last 6 months among MSM with UAI was lower than those without UAI （ 24.4% vs 35.4% , P 〈 0.05 ）. Multivariate analysis showed that those who were in lower social groups （workers, migrant laborers, and farmers ） （OR = 3. 534 ）, having no sex with female in the last six months （ OR = 1. 733）, with STD symptoms （ OR = I. 832）, or infected with HIV antibody positive （ OR = 5. 128 ） had a significantly higher prevalence of UAI than other subgroups. Conclusion The findings indicated a high prevalence of UAI among MSM in Guangzhou. Targeted behavioral interventions with voluntary counseling and testing （VCT） and STD services are needed to address to the subgroups at lower social status.