云南省MSM人群成瘾性物质使用情况及影响因素

目的  了解云南省男男性行为者(men who have sex with men, MSM)人群成瘾性物质的使用情况，分析影响MSM人群使用成瘾性物质的相关因素。 方法  以云南省MSM社会组织为基础，招募年龄≥18岁、MSM或性取向为男性的调查对象。通过问卷调查收集人口学信息、性行为特征、成瘾性物质使用情况及HIV相关知识和检测情况等信息。采用多因素logistic回归分析模型分析影响MSM人群成瘾性物质使用情况及影响因素。 结果  共调查2 411名MSM，成瘾性物质的终生使用率为15.06%(363/2 411)，最近半年的使用率为10.24%(247/2 411)，其中85.02%(210/247)的调查对象以使用亚硝酸酯类吸入剂(rush poppers)为主。多因素logistic回归分析模型分析结果显示：边境州(市)(OR=1.79，95% CI：1.33~2.44)、18~＜25岁组[与18~＜25岁组相比，25~35岁组(OR=0.49，95% CI：0.34~0.72)；＞35岁组(OR=0.47，95% CI：0.34~0.64)]、文化程度为高中以上(OR=1.65，95% CI：1.29~2.11)、主要性角色为被插入(OR=1.65，95% CI：1.24~2.21)、最近半年有多性伴(OR=2.29，95% CI：1.72~3.06)、不坚持使用安全套[与不坚持使用安全套相比，使用安全套(OR=0.59，95% CI：0.46~0.75)]和HIV/AIDS知识知晓情况差[与HIV/AIDS知识知晓情况差相比，HIV/AIDS知识知晓情况好(OR=0.52，95% CI：0.35~0.76)]的MSM人群使用成瘾性物质的比例更高。 结论  应加强对云南省MSM人群，尤其是边境州(市)MSM人群成瘾性物质和HIV/AIDS相关知识的宣传教育。此外，还需加强MSM人群中以rush poppers为代表的成瘾性物质使用情况的监测和监管及HIV等性传播疾病患病情况的监测，从而减少成瘾性物质的使用及性传播疾病的危害。

Analysis on the use of addictive substances and its influencing factors among men who have sex with men in Yunnan

Objective To investigateand analyze the use of addictive substances and its influencing factors in men who have sex with men (MSM) in Yunnan. Methods The MSM in Yunnan were recruited from social organization of MSM. The inclusion criteria were male, age aboved 18 years, having had sex with men or male homosexuality. Demographic information, sexual behavior, use of addictive substances, HIV related knowledge and detection status were collected, analyzed and compared. Multiple logistic regression was used to analyze the factors correlated with addictive substances in MSM. Results A total of 2 411 MSM were investigated in the study. The overall prevalence rates of addictive substances use were 15.06% (363/2 411) in the lifetime and 10.24%(247/2 411) in the last six months, of whom 85.02%(210/247) were rush poppers users. Factors associated with addictive substances use included: border states (cities) (OR=1.79, 95% CI: 1.33-2.44), 18~25 years old group [compared to 18~25 years old group, 25-35 years old group (OR=0.49, 95% CI: 0.34-0.72); aboved 35 years old group (OR=0.47, 95% CI: 0.34-0.64)], educated above high school (OR=1.65, 95% CI: 1.29-2.11), the primary sex role is inserted(OR=1.65, 95% CI: 1.24 - 2.21), having multiple sexual parters in the past six months (OR=2.29, 95% CI: 1.72-3.06), low condom use [compared to low condom use, high condom use (OR=0.59, 95% CI: 0.46-0.75)] and poor knowledge about AIDS [compared to poor knowledge about AIDS, high knowledge about AIDS (OR=0.52, 95% CI: 0.35-0.76)]. Conclusions Publicity and education on addictive substances and HIV/AIDS among MSM population in Yunnan should be strengthened, especially in border states and cities. In addition, it is necessary to strengthen the monitoring and supervision of addictive substance use represented by Rush poppers in this population and the monitoring of the prevalence of sexually transmitted diseases such as HIV, so as to reduce the use of addictive substances and the harm of sexually transmitted diseases.