CAJ | 학술논문

目的了解常州市男男性行为者(MSM)婚姻分布状况,分析婚姻对该人群艾滋病高危行为及HIV感染率的影响.方法采用定向抽样(“滚雪球”)法进行横断面调查,通过问卷调查收集社会人口学、HIV感染高危行为等信息,并采集血液和尿液样本进行HIV、梅毒、淋球菌和生殖道沙眼衣原体检测.结果有效调查的655名MSM中,在婚比例为37.4％.在婚组(245人)通常在浴池、桑拿等场所寻找性伴(61.6％),非在婚组(410人)主要通过酒吧/茶吧(33.6％)和互联网(31.1％)寻找性伴.最近6个月发生同性肛交性行为者,在婚组(50.8％)低于非在婚组(73.3％)(P＜0.001)；最近6个月与异性发生性关系者,在婚组(68.9％)明显高于和非在婚组(33.2％)(P＜0.001),OR=4.454(95％CI:3.168～6.261).最近一次同性肛交性行为安全套使用率,在婚组和非在婚组分别为71.0％和77.6％(P=0.152)；最近一次与异性性行为安全套使用率,在婚组(44.0％)明显低于非在婚组(70.4％)(P＜0.001),OR=0.331 (95％CI:0.205～0.535).性交易中,在婚组主要是“买”性(66.7％),而非在婚组主要是“卖”性(63.2％)(P＜0.05),OR=3.429(95％CI:1.255～9.366).最近一年吸食过毒品的比例,非在婚组(3.3％)高于在婚组(0.8％)(P＜0.05).在婚组和非在婚组HIV感染率均为8.6％,梅毒感染率分别为17.1％、12.3％,淋球菌阳性率分别为1.6％、2.4％,生殖道沙眼衣原体阳性率分别为3.3％、9.0％(P值均＞0.05).结论婚姻对MSM高危行为的制约作用有限,应根据MSM婚姻状况的特点,制定多种形式的干预措施.
목적 료해상주시남남성행위자(MSM)혼인분포상황,분석혼인대해인군애자병고위행위급HIV감염솔적영향.방법 채용정향추양(“곤설구”)법진행횡단면조사,통과문권조사수집사회인구학、HIV감염고위행위등신식,병채집혈액화뇨액양본진행HIV、매독、림구균화생식도사안의원체검측.결과 유효조사적655명MSM중,재혼비례위37.4％.재혼조(245인)통상재욕지、상나등장소심조성반(61.6％),비재혼조(410인)주요통과주파/다파(33.6％)화호련망(31.1％)심조성반.최근6개월발생동성항교성행위자,재혼조(50.8％)저우비재혼조(73.3％)(P＜0.001)；최근6개월여이성발생성관계자,재혼조(68.9％)명현고우화비재혼조(33.2％)(P＜0.001),OR=4.454(95％CI:3.168～6.261).최근일차동성항교성행위안전투사용솔,재혼조화비재혼조분별위71.0％화77.6％(P=0.152)；최근일차여이성성행위안전투사용솔,재혼조(44.0％)명현저우비재혼조(70.4％)(P＜0.001),OR=0.331 (95％CI:0.205～0.535).성교역중,재혼조주요시“매”성(66.7％),이비재혼조주요시“매”성(63.2％)(P＜0.05),OR=3.429(95％CI:1.255～9.366).최근일년흡식과독품적비례,비재혼조(3.3％)고우재혼조(0.8％)(P＜0.05).재혼조화비재혼조HIV감염솔균위8.6％,매독감염솔분별위17.1％、12.3％,림구균양성솔분별위1.6％、2.4％,생식도사안의원체양성솔분별위3.3％、9.0％(P치균＞0.05).결론 혼인대MSM고위행위적제약작용유한,응근거MSM혼인상황적특점,제정다충형식적간예조시.
Objective To understand the distribution of marriage status among men who have sex with men (MSM) in the city of Changzhou,and to explore the impact of marriage on AIDS related high risk behaviors and HIV infection in this population.Methods Target sampling (snowball sampling) was adopted to carry out a cross-sectional study,and structured questionnairebased interviews were conducted to collect information on social demography,HIV related high risk behaviors.Blood and urine samples were colleted to detect HIV,syphilis,gonorrhea and Chlamydia trachomatis infections.Results Of the 655 participants,37.4％ were married.Married MSM mostly sought their sexual partners at the public bathing house (61.6％),while unmarried MSM were mainly through bars (33.6％) or intemet (31.1％).The proportion of having anal sex with men during the last 6 months was lower in the married group (50.8％) than in the unmarried group(73.3％)(P＜0.001).The percentage of having sex with women in the last 6 months was significantly higher in the married group (68.9％) than that in the unmarried group (33.2％) (P＜0.001),(OR=4.454,95％ CI:3.168-6.261).The rates of condom use in the last anal sex with men in married and unmarried groups were 71.0％ and 77.6％,respectively (P=0.152).The rate of condom use in the last intercourse with women was significantly lower in the married group (44.0％) than that in the unmarried group (70.4％) (P＜0.001),(OR=0.331,95％CI:0.205-0.535).In the sex trade,most of the married MSM would "buy" sex (66.7％),while unmarried MSM would "sell" sex (63.2％) (P＜ 0.05),(OR =3.429,95％ CI:1.255-9.366).The percentage of having drugs in the previous year was higher in married group(3.3％) than that in the unmarried group (0.8％)(P＜0.05).In married and unmarried groups,the infection rates of HIV,syphilis,gonorrhea and Chlamydia trachomatis appeared to be (8.6％,8.6％),(17.1％,12.3％),(1.6％,2.4％),and (3.3％,9.0％),respectively (P＞0.05).Conclusion Marriage seemed to have had limited effects on reducing the high risk behaviors of MSM.Different and multiform interventions should be developed according to the different characteristics of married or unmarried MSM population.