四川、重庆地区男男性接触者婚姻状况及其对艾滋病相关行为的影响

目的 了解四川、重庆地区男男性接触者（men who have sex with men，MSM）婚姻分布状况，分析婚姻对该人群艾滋病相关知识、态度及健康服务接受情况，艾滋病高危行为及HIV和STD感染率的影响。方法 采用非随机抽样的方法共招募重庆及四川地区1240名男男性接触者，采用匿名问卷调查的方法了解其婚姻及艾滋病相关知识、态度及健康服务接受情况，艾滋病相关高危性行为状况等。采用金标准快速诊断法和酶联免疫吸附试验进行HIV抗体检测。采用检验进行组间率的比较。年龄及艾滋病相关知识了解情况采用秩和检验进行组间比较。结果 在婚组与非在婚组的年龄、户口类型、文化程度、就业情况和个人平均月收入的差异均有统计学意义（P<0.05）。非在婚组及在婚组艾滋病相关知识得分分别为9±4和8±5（中位数±四分位间距），两组间差异具有统计学意义（P<0.05）。在婚组MSM仅有53.8%的人认为本地区男男性接触者艾滋病感染比率高，非在婚组58.0%的人认为本地区男男性接触者艾滋病感染比率高；在婚组中绝大部分认为艾滋病对自己及家人威胁很大，比例远高于非在婚组，差异有统计学意义（P<0.05）。在婚组MSM人群有40.5%没有做过艾滋病检测，未检测率远高于非在婚组中的34.3%（P<0.05）。艾滋病高危性行为方面，统计学差异无意义。HIV检测方面，在婚组MSM感染率为30.9%，远高于非在婚组感染率的21.1%，两者有统计学差异（P<0.05）。结论 婚姻并不能降低MSM人群艾滋病高危性行为的频率，而在婚组MSM艾滋病感染率的过高，提示艾滋病由MSM人群向一般人群传播的风险更大。

Marital status and its influence on AIDS-related behaviors among men who have sex with men in Sichuan and Chongqing area

Objective To know about the marital status of men who have sex with men (MSM) in Chongqing and Sichuan area, and to explore the impact of marital status on acquired immune deficiency syndrome (AIDS)-related knowledge and attitude, acceptance of health service, AIDS-related high-risk behavior and human immunodeficiency virus (HIV)/sexually transmited disease (STD) infection. Methods A total of 1 240 MSM participants were recruited from Sichuan and Chongqing area using the nonrandom sampling method, and they were surveyed through an anonymous questionnaire, and their AIDS-related knowledge and attitude, acceptance of health service, AIDS-related high-risk behavior were investigated. The HIV antibody was detected by gold standard rapid diagnosis method and enzyme-linked immunosorbent assay. Chi-square test was adopted for rate comparison among groups. The age and AIDS-related knowledge were compared between groups by rank sum test. Results Significant differences were detected in age, residence registration type, education level, employment status, and personal average monthly income between married group and unmarried group (P<0.05). The median AIDS related knowledge score for the unmarried group was 9 (inter-quartile range 4), which was significantly higher than that of the married group (8[inter-quartile range 5], P<0.05). It was found that 53.8% of the participants in the married group deemed that MSM population had a high HIV infection rate in their area, while the number was 58.0% in the unmarried group. The proportion of participants in the married group who thought AIDS was a great threat to their family was significantly higher than that in the unmarried group (P<0.05). We found that 40.5% MSM in the married group never had the HIV testing, which was significantly higher than that in the unmarried group (34.3%, P<0.05). AIDS-related high-risk sexual behaviors were similar in the two groups. The HIV-infection rate in the married group was 30.9%, being significantly higher than that in the unmarried group (21.1%, P<0.05). Conclusion Marriage does not reduce the frequency of AIDS-related high-risk sexual behavior among MSM population. The high HIV-infection rate in MSM people in the married group indicates a higher risk for HIV transmission from MSM population to normal people.