论文部分内容阅读
目的了解男男性行为人群(MSM)的相关心理社会因素,对安全性行为的影响,测试适应中国环境下针对MSM的心理社会量表的有效性。方法采用同伴驱动调查的方法,在北京调查了500名MSM,运用Cronbach’s’alpha值确定了量表的信度;通过单变量和多变量Logistic回归,分析了心理社会量表有关得分与安全性行为的关系,检验了量表的效度;探讨了对安全性行为有影响的社会人口学以及心理社会学因素。结果除了耻辱和歧视量表外,单变量分析安全套社会规范和对安全性行为的态度和感知评分量表有很好的信度(Cronbach’s alpha>0.8)和效度。多变量分析显示,对安全性行为的态度和感知评分高者[调整比值比(aOR)=3.64]和有医保者(aOR=1.87)、与临时性伴发生性行为者(aOR=2.43)及从互联网上寻求性伴者,更能坚持使用安全套(aOR=1.69);而已婚者(aOR=0.29)、发生性关系前饮酒者(aOR=0.45)不容易坚持使用安全套。结论安全套使用社会规范量表和对安全性行为的态度和感知评分量表,在中国MSM中有良好的信度和效度,但是耻辱与歧视部分需要根据中国的社会文化进行改进。性关系前饮酒对坚持使用安全套有负面影响,提示今后需要加强预防HIV经性传播干预设计的针对性。
Objective To understand the psychosocial factors of MSM and its impact on safety behaviors and to test the validity of the psychosocial scale for MSM in China. Methods Using peer-driven survey, 500 MSMs were investigated in Beijing and Cronbach’s’alpha values were used to determine the reliability of the scale. Through the univariate and multivariate Logistic regression analysis, scores and safety behaviors of the psychosocial scale The validity of the scale was tested. The socio-demographic and psycho-sociological factors influencing the safety behavior were also discussed. Results In addition to the Stigma and Discrimination Scale, univariate analysis had good reliability (Cronbach’s alpha> 0.8) and validity for the Social Compliance and Safety Attitudes and Perceptions Scale. Multivariate analysis showed that those with higher attitudes and perceived safety scores [adjusted odds ratio (aOR) = 3.64] and those with medical insurance (aOR = 1.87) were significantly associated with those with temporary sexual partners (aOR = 2.43) and Consumers seeking sexual partners on the Internet were more likely to use condoms (aOR = 1.69); those who married (aOR = 0.29) were less likely to consistently use condoms when having pre-sex drinkers (aOR = 0.45). Conclusions The condom use social norms and attitudes toward safety behavior and perceived rating scale have good reliability and validity in Chinese MSM. However, stigma and discrimination need to be improved according to Chinese social culture. Pre-sexual alcohol consumption has a negative impact on the use of condoms, suggesting that the future need to strengthen the prevention of sexual transmission of HIV-targeted design.