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[目的]调查男男性行为者(men who have sex with men,MSM)中双性性行为的发生情况及艾滋病相关的高危行为发生情况,分析MSM发生异性性行为的原因及影响因素,为减少艾滋病由高危人群向一般人群扩散,更好地开展艾滋病高危行为干预工作提供思路。[方法]采用横断面调查研究的方法,于2010年6—12月按年龄段在上海市浦东新区进行分层抽样,对符合入选标准的研究对象进行一对一的问卷调查,收集一般人口学信息、工作生活状况、社交网络与性行为情况、艾滋病相关知识和态度等资料并进行相关的统计描述与分析。[结果]共收集有效问卷158份;66.5%(105/158)的MSM来自上海以外省市;17.7%(28/158)的MSM表示自己是双性恋,27.8%(44/158)的MSM表示过去5年和女性有过性活动,差异有统计学意义(χ2=4.60,P<0.05);和女性有过性活动的MSM人群中最近一次性行为中安全套使用率为80.0%(12/15),最近6个月每次安全套使用率为53.3%(8/15);非条件logistic回归分析结果表明,影响MSM人群与女性发生性行为的因素有婚姻状况(OR=10.53,95%CI:3.07~36.13)和性取向(OR=82.86,95%CI:16.35~419.86)。[结论]MSM人群中的双性恋是将人类免疫缺陷病毒从MSM人群向一般人群扩散的主要人群,一部分男男同性恋由于婚姻原因和女性发生性行为,进一步增加了人类免疫缺陷病毒向一般人群扩散的力度,应从家庭和社会环境的角度加以防治。
[Objective] To investigate the incidence of bisexual behaviors and high-risk AIDS-related behaviors in men who have sex with men (MSM), analyze the causes and influencing factors of heterosexual behaviors in MSM, and to reduce the incidence of AIDS By providing high-risk population to the general population to spread, to better carry out high-risk behavioral interventions AIDS provide ideas. [Methods] By means of cross-sectional survey, stratified sampling was conducted in Pudong New Area, Shanghai from June to December in 2010, and one-to-one questionnaires were conducted on the subjects who met the inclusion criteria to collect general demography Information, work and life conditions, social networking and sexual behavior, AIDS-related knowledge and attitudes and other relevant information and statistical description and analysis. [Results] A total of 158 valid questionnaires were collected; 66.5% (105/158) MSM were from provinces outside Shanghai; 17.7% (28/158) MSM said they were bisexual and 27.8% (44/158) MSM (Χ2 = 4.60, P <0.05). In the most recent sexual intercourse with female MSM, the condom use rate was 80.0% (12 / 15), and the rate of condom use was 53.3% (8/15) in each of the 6 months. The results of unconditional logistic regression showed that the factors affecting the MSM population and their sexual behavior were marital status (OR = 10.53, 95% CI : 3.07 ~ 36.13) and sexual orientation (OR = 82.86,95% CI: 16.35 ~ 419.86). [Conclusions] Bisexuality among MSM population is the main population that spread HIV from MSM population to general population. Some of the gay men and women also have sexual intercourse with women due to marital reasons, which further increases the frequency of transmission of human immunodeficiency virus to the general population The intensity of proliferation should be controlled from the perspective of family and social environment.