CAJ | 학술논문

目的了解在婚男男性行为者(MSM)亚群特征、艾滋病感染状况、性行为和安全套使用情况.方法在北京、哈尔滨、郑州和成都市采用“滚雪球”方法招募调查对象,通过匿名的方式进行问卷调查,包括社会人口学特征、同性和异性性伴种类、同性和异性性行为、安全套使用情况等,并进行HIV抗体检测.结果 4个市共有858名在婚MSM参加调查,平均年龄(38.3±9.1)岁,其中初中及以下文化程度占36.7％；自认为是同性、双性性取向和异性性取向/不确定者所占的比例分别为40.9％、54.3％和4.8％.感染HIV检出率为8.0％,其中成都市最高为13.3％.多因素分析显示,非本市户籍、同性性取向、居住在哈尔滨市、第一次发生插入性行为年龄＜18岁可能增加最近6个月与男性肛交时从不使用安全套的危险性(OR=1.5～2.1).年龄≥46岁、非本市户籍、居住在北京、异性性取向或性取向未确定、近6个月与男性肛交性行为从未使用安全套者可能增加与女性性交时从不使用安全套的危险性(OR=1.7～5.9).结论在婚MSM亚群中HIV感染已处于高流行状态,该亚群存在的高比例无保护同性和异性性行为,加剧HIV在MSM和在婚女性人群间传播.
목적 료해재혼남남성행위자(MSM)아군특정、애자병감염상황、성행위화안전투사용정황.방법 재북경、합이빈、정주화성도시채용“곤설구”방법초모조사대상,통과닉명적방식진행문권조사,포괄사회인구학특정、동성화이성성반충류、동성화이성성행위、안전투사용정황등,병진행HIV항체검측.결과 4개시공유858명재혼MSM삼가조사,평균년령(38.3±9.1)세,기중초중급이하문화정도점36.7％；자인위시동성、쌍성성취향화이성성취향/불학정자소점적비례분별위40.9％、54.3％화4.8％.감염HIV검출솔위8.0％,기중성도시최고위13.3％.다인소분석현시,비본시호적、동성성취향、거주재합이빈시、제일차발생삽입성행위년령＜18세가능증가최근6개월여남성항교시종불사용안전투적위험성(OR=1.5～2.1).년령≥46세、비본시호적、거주재북경、이성성취향혹성취향미학정、근6개월여남성항교성행위종미사용안전투자가능증가여녀성성교시종불사용안전투적위험성(OR=1.7～5.9).결론 재혼MSM아군중HIV감염이처우고류행상태,해아군존재적고비례무보호동성화이성성행위,가극HIV재MSM화재혼녀성인군간전파.
Objective To find out the status of HIV infection,sexual behaviors with both men and women as well as condom use among currently married men who have sex with men (MSM) so as to document for HIV intervention targeting this sub-population,in Beijing,Chengdu,Harbin and Zhengzhou cities.Methods “Snowballing” sampling method was used to recruit subjects in four cities.Participants were investigated by anonymous questionnaire containing demographics,sexual orientation,both homosexual and heterosexual behaviors and condom use during the past 6 months.Blood samples from participants were used to test HIV antibodies.Results Of the 858 participants for four cities,the average age was 38.3 (SD=9.1) years.36.7％ of them had completed the junior high school or under.The percentage of participants who identified themselves as homosexual,bisexual,and heterosexual or undecided were 40.9％,54.3％ and 4.8％,respectively.The overall HIV prevalence was 8.0％,and among four cities the HIV prevalence in Chengdu was the highest ( 13.3％ ).Results from the Multiple logistic regression analysis showed that never used condoms when having anal sex with men during the past 6 months among participants who did not have a city residential card,identifying himself as having homosexual orientation,living in Harbin,having first anal sex experience before 18 years of age the range of OR value was 1.5-2.1.In addition,the faetors associated with never using condoms in vaginal sex with women during the past 6 months were as follows:being over 46 years old,not having a city residential card,living in Beijing,identifying himself as heterosexual orientated or with unknown sexual orientation,never using condoms in anal sex with men during the past 6 months,the range of OR value was 1.7-5.9.Conclusion The prevalence of HIV infection seemed to be quite high among those currently married MSM.High rates of unprotected homosexual and heterosexual behaviors might accelerate the spreading of HIV from currently married MSM to their wives.