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目的了解男男性行为者(MSM)艾滋病感染危险认知现状,分析影响因素。方法 2011年9月-2012年3月在四川省绵阳市结合滚雪球采样法,采用自行设计的调查表,由专门人员面对面进行行为学和血清学调查。结果共调查405名,自认艾滋病感染风险很大0.8%、较大9.5%、较小82.5%、无风险7.3%,相应危险认知艾滋病病毒(HIV)感染率分别依次为66.7%、5.3%、4.9%、6.9%(χ2似然比=8.267,P=0.041)。多因素分析,危险认知独立影响因素为:年龄、近1年接受HIV咨询或检测、近6月肛交数、近6月无保护性主动肛交、有/有过固定男友(BF),年龄≤25岁、近1年未接受过HIV咨询或检测、近6月肛交人数≥2、近6月有无保护性主动肛交、没有/没有过BF艾滋病感染风险认知的概率较高。结论 MSM艾滋病危险认知普遍缺乏,高危行为与危险认知呈正相关,揭示MSM艾滋病防治面临的困惑和挑战。如何解决危险认知缺失和将危险认知有效向行为改变转化是防治工作的难点和重点。
Objective To understand the status quo of MSM HIV status and analyze the influencing factors. Methods From September 2011 to March 2012, a snowball sampling method was adopted in Mianyang City, Sichuan Province. Self-designed questionnaires were used to conduct behavioral and serological investigations face-to-face by specialists. Results A total of 405 people were investigated. The risk of HIV infection was 0.8%, 9.5%, 82.5% and 7.3% respectively. The corresponding HIV prevalence rates were 66.7%, 5.3% , 4.9%, 6.9% (χ2 likelihood ratio = 8.267, P = 0.041). Multivariate analysis and hazard cognition independent factors were as follows: age, HIV counseling or testing in the past 1 year, anal sex in the past 6 months, unprotected active anal intercourse in the recent 6 months, BF with / without fixation, age ≤ 25 years old, nearly 1 year did not receive HIV counseling or testing, nearly 6 months anal number ≥ 2, nearly 6 months without protective active anal sex, no / have a higher risk of BF infection risk awareness. Conclusions There is a general lack of awareness of AIDS risk in MSM. High-risk behavior is positively correlated with risk perception, revealing confusion and challenges in MSM’s AIDS prevention and treatment. How to solve the problem of lack of knowledge of danger and how to change the cognition of danger effectively to the change of behavior are the difficulties and focuses of prevention and cure.