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目的了解男男性行为者(MSM)发生无保护性行为的性伴(SPUSC)相关行为特征。方法采用应答推动方法(RDS),在MSM活动场所对MSM人群进行招募和寻问式匿名调查400人。结果近1次SPUSC年龄20~39岁占76.8%,41.7%为高中及中专文化,男性固定性伴(BF)占56.2%、偶然性伴(419)占35.1%、商业性伴(MB)占3.4%、异性固定性伴占5.4%,网络结识为55.7%、家庭聚会等18.6%、酒吧/舞厅等13.0%、公园/公厕等11.7%、浴室/桑拿等1.0%,42.0%仅是性关系,58.0%有情感/经济关系。不同寻找性伴类型的MSM其SPUSC的年龄、文化、性伴类型、结识场所、与性伴关系的构成差异有统计学意义(P<0.01),聚会型21.1%年龄≤19岁,公园型16.3%年龄≥40岁、初中及以下文化为27.9%、419为45.2%,酒吧型、浴室型分别有11.9%、11.1%的商业性伴,22.3%的浴室型有异性固定性伴。60.5%公园型的SPUSC仅是性关系,其余除酒吧型外均超过60%有情感/经济关系。调查对象对SPUSC的艾滋病感染等相关高危行为普遍缺乏了解,不同类型MSM知晓其SPUSC的静脉吸毒、419、MB、群交、安全套携带、安全套使用情况差异有统计学意义(P<0.05),不知道其相关高危行为多以公园型最高。调查对象与SPUSC性行为安全套每次使用率主动肛交为14.5%、口交为6.9%,阴道交为27.1%。结论 MSM的SPUSC与性伴人口学特征、性行为特征及场所类型有关,普遍对自身艾滋病感染风险认识不足,广泛存在以BF情结和419的性满足为基础的艾滋病传播危险,应针对性开展行为干预。
Objective To understand the behavioral characteristics of sexual partners (SPUSC) with unprotected sex in men who have sex with men (MSM). Methods Using response-driven approach (RDS), 400 MSM were recruited and asked anonymously at MSM sites. Results One time of SPUSC was 76.8% in age from 20 to 39 years, 41.7% of them were in high school and technical secondary school, 56.2% were male fixed partners (BF), 35.1% were occasional sexual partners (419), and MB 3.4% of the total sex, 5.4% of the sex partners, 55.7% of the people of the Internet, 18.6% of family gatherings, 13.0% of bars / dance halls, 11.7% of parks / public toilets, 1.0% of bathrooms / saunas, 42.0% , 58.0% have emotional / economic relations. There were significant differences in the age, culture, partner type, meeting place, and sexual partners between the SPMU and the MSM who did not find the partner type (P <0.01). The gathering type was 21.1%, the age was less than 19 years, and the park type was 16.3 % Age ≥ 40 years old, junior middle school and below culture 27.9%, 419 45.2%, bar type, bathroom type were 11.9%, 11.1% of business partners, 22.3% of the bathroom with the opposite sex fixed partners. 60.5% of park-type SPUSC are only sexual relationships, and the rest have more than 60% emotional / economic relationship except bar type. There was a general lack of understanding about the high-risk behaviors related to HIV / AIDS in SPUSC. Different types of MSM were aware of the intravenous drug use of SPUSC. The difference was statistically significant (P <0.05) between 419 MB, group delivery, condom carrying and condom use The high-risk behavior associated with the highest park-type. Subjects and SPUSC sex condom use rate of active anal 14.5%, oral sex was 6.9%, vaginal delivery was 27.1%. Conclusion The MSM SPUSC is related to the characteristics of sexual partners, sexual behaviors and types of places, and generally there is not enough knowledge about the risk of HIV infection. There is a wide range of HIV / AIDS transmission risks based on the BF complex and 419 sexual satisfaction, and the behaviors should be targeted Intervention.