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目的了解广州市男男性行为者(MSM)无保护肛交性行为(UAI)的相关影响因素,为开展有针对性的艾滋病高危行为干预提供依据。方法于2008年5—8月在广州市采用同伴推动抽样法招募MSM完成面对面的艾滋病相关知识和行为问卷调查,并进行HIV和梅毒的抗体检测。运用RDSAT软件计算各指标人群校正值,结合SPSS统计软件进行2检验单因素分析和logis-tic多因素分析。结果共招募379名MSM(其中13名MSM作为种子),校正后UAI发生率为60.3%(粗发生率为61.5%,233/379);校正HIV感染率为5.2%(粗感染率为4.5%,17/379),现症梅毒感染率为17.5%(粗感染率为17.4%,66/379)。发生UAI主要集中在20～29岁、未婚、文化程度大专及以上、职业为服务类的人群,校正构成比分别为50.3%、47.8%、44.3%、39.4%。发生UAI的MSM人群HIV感染率达7.2%,高于安全性行为人群的1.5%(P<0.05);UAI有性病相关症状者占23.0%,高于性行为安全者(15.2%)(P<0.05);最近6个月与女性发生过性行为在UAI中的构成比为24.4%,低于发生安全性行为者的35.4%(P<0.05)。多因素分析显示该人群中低层工作者(工人、民工、农民)、近6个月未与女性发生性行为者、有性病相关症状报告者以及HIV阳性者的UAI发生率显著高于其他亚人群,OR值分别为3.534、1.733、1.832、5.128。结论广州市MSM的UAI发生率较高,应针对不同亚人群特别是低层工作者开展有效干预,提高HIV抗体检测率和对HIV及性病的发现力度,进而加强对UAI的干预,并扩大性病转介与诊疗服务的覆盖面,有效促进安全性行为。
Objective To understand the influencing factors of unprotected anal intercourse (UAI) among MSM in Guangzhou and provide the basis for targeted HIV / AIDS risk behavior intervention. METHODS: From May to August 2008, MSM was recruited by companion-driven sampling in Guangzhou to conduct face-to-face HIV / AIDS related knowledge and behavioral questionnaire surveys, and HIV and syphilis antibody testing. Using RDSAT software to calculate the correction value of each index population, combined with SPSS statistical software 2 test univariate analysis and logis-tic multivariate analysis. Results A total of 379 MSM were recruited (including 13 MSM as seeds). The corrected UAI rate was 60.3% (crude rate was 61.5%, 233/379), corrected HIV prevalence rate was 5.2% (crude infection rate was 4.5% , 17/379). The prevalence of syphilis was 17.5% (crude infection rate was 17.4%, 66/379). The occurrence of UAI mainly concentrated in people aged 20-29, unmarried, college graduates with tertiary education or above, occupation as service category. The corrected constituent ratios were 50.3%, 47.8%, 44.3% and 39.4% respectively. The prevalence of HIV infection in UAI MSM population was 7.2%, which was 1.5% (P <0.05) higher than that in safety behavior group. The incidence of UAI with STD-related symptoms was 23.0%, higher than that of sexual behavior safety (15.2%) (P < 0.05). The incidence of sexual behaviors in women with UAI in the last 6 months was 24.4%, which was lower than 35.4% (P <0.05) in those who took safe sex. Multivariate analysis showed that the incidence of UAI in lower middle-class workers (workers, migrant workers and peasants), those who did not have sexual intercourse with women in the recent 6 months, those who had sexually transmitted disease-related symptoms and HIV positive were significantly higher than those in other sub-populations , OR values were 3.534,1.733,1.832,5.128 respectively. Conclusion The incidence of UAI in MSM in Guangzhou is relatively high. Effective intervention should be aimed at different sub-populations, especially lower-level workers, so as to improve the detection rate of HIV antibody and the detection of HIV and sexually transmitted diseases, thus further intervene with UAI and expand the transmission of venereal diseases The coverage of referral and treatment services effectively promotes safe sex.