CAJ | 학술논문

目的了解中国男男性行为兼异性性行为者(MSMW)的HIV感染状况及其与男性和女性的性行为特征.方法采用“滚雪球”方法在广州和成都市各招募300名MSMW为研究对象,进行问卷调查(社会人口学特征、最近6个月男性性伴种类和特征、男男性行为及安全套使用状况、最近12个月异性性伴种类和特征、异性性行为及安全套使用状况)和HIV抗体检测.结果共600名MSMW接受问卷调查和HIV检测,HIV感染率和检出率分别为26.2％和8.5％；最近6个月有28.0％的调查对象拥有≥5名男性性伴,肛交行为时每次使用安全套者占44.2％,最近3次和最近1次男男肛交性行为使用安全套者分别为52.3％和63.0％；最近12个月有86.0％的调查对象与女性发生性行为,其中配偶、婚前女友、婚外情人、女性偶然性伴和女性商业性伴的比例分别为65.0％、27.2％、1.5％、12.7％和4.5％,约1/3的调查对象异性性行为时坚持每次使用安全套,36.5％在最近3次异性性行为时均不使用安全套.最近6、12个月成都市MSMW男男性行为时每次使用安全套分别为55.7％和38.3％,均高于广州市(32.7％和25.3％).HIV阳性者中,与男性发生肛交性行为者为91.1％,最近6个月与男性发生肛交行为时每次使用安全套者为49.7％,最近3次和最近1次男男肛交性行为使用安全套者分别为60.5％和69.4％；最近12个月有82.8％阳性调查者与异性发生过性行为,42.0％每次性行为坚持使用安全套,最近3次性行为使用安全套者占47.8％.最近6、12个月,既往检测HIV阳性MSMW从不使用安全套同性和异性性行为的比例(分别为4.3％和12.9％)均低于本次检测HIV阳性MSMW(22.0％和46.3％).结论 MSMW人群的HIV感染率已经处于较高水平,并存在较高比例的无保护男性肛交性行为和女性阴道性交行为,该人群在HIV跨性别传播中的桥梁作用可能加快HIV在普通人群中的蔓延. 目的瞭解中國男男性行為兼異性性行為者(MSMW)的HIV感染狀況及其與男性和女性的性行為特徵.方法採用“滾雪毬”方法在廣州和成都市各招募300名MSMW為研究對象,進行問捲調查(社會人口學特徵、最近6箇月男性性伴種類和特徵、男男性行為及安全套使用狀況、最近12箇月異性性伴種類和特徵、異性性行為及安全套使用狀況)和HIV抗體檢測.結果共600名MSMW接受問捲調查和HIV檢測,HIV感染率和檢齣率分彆為26.2％和8.5％；最近6箇月有28.0％的調查對象擁有≥5名男性性伴,肛交行為時每次使用安全套者佔44.2％,最近3次和最近1次男男肛交性行為使用安全套者分彆為52.3％和63.0％；最近12箇月有86.0％的調查對象與女性髮生性行為,其中配偶、婚前女友、婚外情人、女性偶然性伴和女性商業性伴的比例分彆為65.0％、27.2％、1.5％、12.7％和4.5％,約1/3的調查對象異性性行為時堅持每次使用安全套,36.5％在最近3次異性性行為時均不使用安全套.最近6、12箇月成都市MSMW男男性行為時每次使用安全套分彆為55.7％和38.3％,均高于廣州市(32.7％和25.3％).HIV暘性者中,與男性髮生肛交性行為者為91.1％,最近6箇月與男性髮生肛交行為時每次使用安全套者為49.7％,最近3次和最近1次男男肛交性行為使用安全套者分彆為60.5％和69.4％；最近12箇月有82.8％暘性調查者與異性髮生過性行為,42.0％每次性行為堅持使用安全套,最近3次性行為使用安全套者佔47.8％.最近6、12箇月,既往檢測HIV暘性MSMW從不使用安全套同性和異性性行為的比例(分彆為4.3％和12.9％)均低于本次檢測HIV暘性MSMW(22.0％和46.3％).結論 MSMW人群的HIV感染率已經處于較高水平,併存在較高比例的無保護男性肛交性行為和女性陰道性交行為,該人群在HIV跨性彆傳播中的橋樑作用可能加快HIV在普通人群中的蔓延.
목적 료해중국남남성행위겸이성성행위자(MSMW)적HIV감염상황급기여남성화녀성적성행위특정.방법 채용“곤설구”방법재엄주화성도시각초모300명MSMW위연구대상,진행문권조사(사회인구학특정、최근6개월남성성반충류화특정、남남성행위급안전투사용상황、최근12개월이성성반충류화특정、이성성행위급안전투사용상황)화HIV항체검측.결과 공600명MSMW접수문권조사화HIV검측,HIV감염솔화검출솔분별위26.2％화8.5％；최근6개월유28.0％적조사대상옹유≥5명남성성반,항교행위시매차사용안전투자점44.2％,최근3차화최근1차남남항교성행위사용안전투자분별위52.3％화63.0％；최근12개월유86.0％적조사대상여녀성발생성행위,기중배우、혼전녀우、혼외정인、녀성우연성반화녀성상업성반적비례분별위65.0％、27.2％、1.5％、12.7％화4.5％,약1/3적조사대상이성성행위시견지매차사용안전투,36.5％재최근3차이성성행위시균불사용안전투.최근6、12개월성도시MSMW남남성행위시매차사용안전투분별위55.7％화38.3％,균고우엄주시(32.7％화25.3％).HIV양성자중,여남성발생항교성행위자위91.1％,최근6개월여남성발생항교행위시매차사용안전투자위49.7％,최근3차화최근1차남남항교성행위사용안전투자분별위60.5％화69.4％；최근12개월유82.8％양성조사자여이성발생과성행위,42.0％매차성행위견지사용안전투,최근3차성행위사용안전투자점47.8％.최근6、12개월,기왕검측HIV양성MSMW종불사용안전투동성화이성성행위적비례(분별위4.3％화12.9％)균저우본차검측HIV양성MSMW(22.0％화46.3％).결론 MSMW인군적HIV감염솔이경처우교고수평,병존재교고비례적무보호남성항교성행위화녀성음도성교행위,해인군재HIV과성별전파중적교량작용가능가쾌HIV재보통인군중적만연.
Objective To understand the status of HIV infection and sexual behaviors with men and women among men who have sex with men and women (MSMW) and documented for HIV epidemic among men who have sex with men to the general population.Methods 300 participants were recruited by using "snowballing" sampling in Chengdu and Guangzhou,respectively.Participants completed the questionnaire and HIV test.The questionnaire included social demographic characteristics,number of male sexual partners,sexual behaviors and condom use in the past 6 months.Relations with female sexual partners,vaginal intercourse and condom use in the past 12 months were also studied.Results Of the 600 oarticioants,the overall prevalence of HIV infectionwas 26.2％ and the detection rate of HIV-positives in this survey was 8.5％.In the past 6 months 28.0％ of the participants had 5 or more male sexual partners and the percentage of MSMW who had used condoms consistently during anal sex intercourse with men,was 44.2％.Of the participants,52.3％ had used condoms in the last three anal sex events and 63.0％ in the last event.In the past 12 months,86.0％ of the participants who had vaginal sex with female partners and the proportions of MSMW who had wife,girlfriend,lover,female casual partner and female commercial partner were 65.0％,27.2％,1.5％,12.7％,4.5％,respectively.About a third of the MSMW had always used condoms when having vaginal sex in the past 12 month.In the last three vaginal sex events,the proportion of participants who had never used condoms was 36.5％.In the past 6 months,55.7％ of the MSMWs had used condoms consistently during anal sex with men in Chengdu,which was higher than those MSMW in Guangzhou (32.7％).In the past 12 months,the proportion of MSMW who had used condoms consistently during vaginal sex was 38.3％,which was higher than MSMW of Guangzhou (25.3％).Among those HIV-positive MSMWs,91.1％ had anal sex with men in the past 6 months and 49.7％ HIV-positive MSMW had used condoms consistently during anal sex with men.The number of HIV-positive MSMW who had used condoms in the last or last three anal sex events with men,accounted for 60.5％ and 69.4％,respectively.In the past 12 months,82.8％ of the HIV-positive participants had vaginal sex with women.Of the HIV-positive participants,42.0％ used condoms consistently and the percentage of HIV-positive MSMWs who used condom during last three vaginal sexes was 47.8％.In the past 6 months,the percentage (4.3％) of MSMW who were HIV-positive prior to the survey and never used condoms during anal sex with men was lower than the percentage (22.0％) of MSMW who were HIV-positive found in this survey.In the past 12 months 12.9％ of the MSMW who were HIV positive prior to the survey never used condoms when having vaginal sex event,which was lower than MSMW (46.3％) who were HIV positive in this survey.Conclusion The prevalence of HIV infection had reached a quite high level and with high rates of unprotected anal sex with men and vaginal sex with women among MSMWs,indicating that the inherent bridging aspect of MSMW might accelerate the spreading of HIV infection to the general population.