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目的了解长沙市男男性行为人群(MSM)艾滋病相关高危行为及其影响因素。方法采用同伴推动法和分类滚雪球法招募MSM,对符合条件的MSM进行问卷调查、标本采集和HIV抗体检测。以高危性行为为应变量,以人口学特征、艾滋病知识知晓、干预服务覆盖等因素为自变量,进行二分类Logistic回归分析。结果共调查957名MSM,HIV感染率为3.5%(33/957)。最近6个月,89.4%(856/957)的MSM与同性发生过肛交性行为,无保护率为60.5%(511/845);6.0%(51/855)的MSM通过付钱的方式与男性发生过性行为,无保护率为30.0%(15/50);12.7%(108/852)的MSM为了得到钱与男性发生过性行为,无保护率为26.2%(28/107);最近6个月平均男性性伴数为4.79个,66.8%(534/799)的MSM有2个及以上男性性伴。最近1年,艾滋病干预服务覆盖率为71.9%(687/956),艾滋病相关知识知晓率为89.6%(857/956)。与男性首次性行为年龄<20岁、月收入高于2 000元、文化程度低、去浴室/酒吧/场所寻找性伙伴是发生多男性性伴的危险因素;与男性首次性行为年龄<20岁、文化程度高、在婚、干预服务未覆盖、艾滋病知识不知晓是发生无保护性肛交行为的危险因素。结论要继续提高MSM干预服务的覆盖率,针对性地强化浴室、酒吧会所等高危场所MSM的干预服务。
Objective To understand the HIV / AIDS-related high-risk behaviors and its influencing factors in MSM in Changsha. Methods Companion-driven method and classified snowball method were used to recruit MSM. Questionnaires, specimen collection and HIV antibody test were performed on eligible MSM. Using high-risk sexual behaviors as the dependent variable, two-class Logistic regression analysis was conducted based on demographic characteristics, knowledge of HIV / AIDS, coverage of intervention services and other factors. Results A total of 957 MSM were investigated and the HIV infection rate was 3.5% (33/957). In the last 6 months, 89.4% (856/957) of MSM and homosexual men had anal sex, with no protection rate of 60.5% (511/845); 6.0% (51/855) of MSM were paid with men The unprotected rate was 30.0% (15/50); 12.7% (108/852) of MSM had 26.2% (28/107) unprotected rate in order to get money and men; the most recent 6 The monthly average number of male partners was 4.79 and 66.8% (534/799) of MSM had 2 or more male partners. In the recent one year, coverage of HIV / AIDS intervention services was 71.9% (687/956) and awareness of HIV / AIDS related knowledge was 89.6% (857/956). The first sexual activity with men <20 years of age, monthly income of more than 2,000 yuan, a low level of education, go to the bathroom / bar / place to find sexual partners are more risk factors for male partners; , A high degree of education, marriage, intervention services are not covered, AIDS knowledge is unknown risk of unprotected anal sex. Conclusion It is necessary to continue to improve the coverage of MSM intervention services and specifically strengthen MSM intervention services in high-risk areas such as bathrooms and clubs.