基于IMB模型的年轻MSM安全套使用及其影响因素

目的 探索年轻男男性行为者（young men who have sex with men，YMSM）安全套使用的正负向影响因素，并评价艾滋病干预服务的预防效果。方法 于2017年6月~2018年2月通过滚雪球抽样方式，对中国西部的重庆市、四川省、广西省726名15~29岁的YMSM进行现况调查，问卷内容来源于信息-行为-技巧模型（information motivation behavioral skills model，IMB），并利用Amos 17.0软件构建扩展的IMB模型。结果 在过去的半年，59.64%的年轻MSM每次肛交性行为均用安全套，57.71%的YMSM整个性行为过程一直使用安全套。扩展IMB模型拟合程度良好。YMSM使用安全套的影响因素包括行为技巧、预防行为代价、接受艾滋病干预服务、预防信息、预防动机、文化程度、月可支配收入，总效应系数分别为0.417、-0.366、0.258、0.141、0.159、0.053、0.020。结论 艾滋病干预服务促进YMSM使用安全套，而预防行为代价抑制预防行为。今后干预工作应对YMSM开展风险教育，重视预防行为代价以及预防知识掌握不全情况，并适当增加干预服务力度和范围。

Study on factors influencing condoms use among young men who have sex with men based on the information-motivation-behavioral skills model

Objective To explore the positive and negative influencing factors of condoms use among young men who have sex with men (YMSM), and to evaluate the effect of HIV/AIDS intervention service. Methods A status survey of 726 YMSM(15-29 age) was conducted by Snowball sampling method in Chongqing, Sichuan and Guangxi provinces,the western of China. The questionnaire was based on the Information-Motivation-Behavior Skills (IMB) Model. Amos 17.0 software was used to build the extend IMB model. Result In the last six months, 59.64% YMSM used condoms every time when they had anal sex, and 57.71% YMSM used condoms during the whole sex process. The extend IMB fit the data well. The influencing factors of condoms use among YMSM were behavioral skills, preventive behavior costs, HIV/AIDS intervention service, preventive knowledge, preventive motivation, degree of education, monthly disposable income, and the total effect coefficient of influencing factors were 0.417,-0.366,0.258,0.141,0.159,0.053, 0.020, respectively. Conclusions HIV/AIDS intervention service have a positive influencing factor to condoms use, but preventive behavior costs inhibit condoms use among YMSM. In the future, the intervention service should carry out risk education, focusing on preventive behavior costs and the fact inadequate knowledge of prevention information, and appropriately strengthen the intensity and the scope of HIV/AIDS intervention service among YMSM.