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目的探讨影响男男性行为人群(简称MSM)艾滋病流行的影响因素,为下一步制定更有效和有针对性的防治策略提供信息支持。方法采用半结构式访谈提纲,通过社会组织和疾控中心招募的MSM感染者及非感染者共40名进行个人深入访谈。结果只有7.5%的访谈者不认同自己的性取向,而80%的访谈者在20岁前就意识到自我性取向。30%访谈者首次同性性行为发生在18岁及以下,网络成为其交友的主要方式,感染者和非感染者首次性行为用套比例均不高于30%,是否使用安全套几乎取决于性伴。大部分人较迷茫消极,圈内信任度低,性伴更换频繁。感染者和非感染者中,从无固定性伴的分别有25%和15%,从未和异性发生过性行为的比例分别为45%和50%,和同性发生肛交安全套坚持使用率分别为5%和40%,口交几乎都不用套,存侥幸心理现象严重;75%的非感染者意识到重庆HIV感染率高但仍未引起重视;部分MSM谈到故意传播艾滋病的现象,但不知应对。四分之一的访谈者认为MSM曲解了艾防宣传的内容。一些社会需求如保密的自愿咨询服务和无歧视的求医环境被需要。结论艾滋病传播受社会、心理和行为多方面影响,建立积极健康的同志文化氛围,调整艾滋病宣传内容和方向,开展网络宣传,加强学校教育以及健全法律体系是下一步重要的干预措施。
Objective To explore the influencing factors of AIDS prevalence in men who have sex with men (MSM), and to provide information support for the development of more effective and targeted prevention and control strategies. METHODS: Semi-structured interviews were conducted with 40 in-person interviews with MSM and non-infected patients recruited by social organizations and CDCs. As a result, only 7.5% of interviewers disagreed with their sexual orientation, while 80% of interviewers were aware of their self-orientation before age 20. Thirty percent of interviewees first occurred at the age of 18 with same-sex behavior, and the Internet became the main mode of making friends. The proportion of first-time infected and non-infected patients was no higher than 30%. The use of condoms depends almost on sexual partners . Most people are more confused negative, inner circle of trust is low, frequent replacement of partners. Of those infected and non-infected, 25% and 15% of those with no fixed partners, 45% and 50% of those who had never had heterosexual and sexual intercourse, respectively 75% of non-infected people are aware of the high prevalence of HIV infection in Chongqing but no attention has been paid to it; some of the MSM talked about intentional transmission of AIDS but did not know how to deal with it . One-quarter of interviewers think MSM misinterprets the contents of AI defense. Some social needs, such as confidential voluntary counseling services and a non-discriminatory medical treatment environment, are needed. Conclusion The spread of AIDS is affected by many social, psychological and behavioral factors. Establishing a positive and healthy gay culture, adjusting the content and direction of AIDS publicity, conducting online publicity, strengthening school education and improving the legal system are the next important intervention measures.