【作者】 邢建民；

【导师】 张孔来；

【作者基本信息】 中国协和医科大学 ， 流行病与卫生统计学， 2007， 博士

【摘要】 研究目的探讨男男性行为(MSM)人群对中国艾滋病流行的影响,为MSM人群的艾滋病防治提供参考建议。研究方法本研究是以网络为平台进行的MSM人群性行为现状及其影响因素的现况调查,通过方便抽样招募研究对象,通过定量和定性方法相结合收集资料。研究对象及招募通过网络、大众媒体等各种途径招募中国大陆地区、接受调查前三年内有过男男性行为的男性。结果5710位研究对象来自全国除西藏之外的30个省(直辖市、自治区),77.7%居住在中心城区,97.2%年龄在18～44岁,汉族占94.6%,82.8%具有大学及以上文化程度,71.7%自我认定为同性恋者,79.5%未婚者中25.7%将选择异性婚姻,30岁以上48.2%已婚,64.5%每月可支配收入高于1600元;艾滋病知识回答正确率在58.5%～99.6%;63.3%认为自己有感染HIV的可能;88.7%知道艾滋病咨询热线但只有8.1%拨打;59.8%知道HIV检测地点,有40.1%做过HIV检测,检测人数呈逐年增加趋势;90.3%通过网络寻找同性朋友;87.3%最近六个月有同性性行为,21.5%有异性性行为,18.1%既有同性又有异性性行为;1.8%使用过精神类药品;12.8%出现过性病相关症状;66.5%接受过性病艾滋病相关的干预。有同性性行为者的4916人中67.2%有1个以上的同性伴侣。最近一次肛交、口交安全套使用率分别为60.2%、15.0%。与固定伴侣、偶然伴侣、MB、同性性顾客肛交安全套每次都用的比例分别为:30.0%、42.7%、66.7%、57.9%;口交:7.0%、8.8%、6.2%、4.4%;水性润滑剂每次使用率为45.8%;10.6%有过群P,最近一次安全套全程使用率为68.4%;与妻子或女友、一夜情女性、CSW、异性性顾客阴道交安全套每次都用的比例分别为20.3%、56.3%、81.0%、57.1%。多因素逐步Logistic回归的结果显示:已婚者倾向于在最近一次肛交不使用安全套;进城务工人员、一般文艺工作者、做过HIV检测、性伴数6个以上者易患性病。结论MSM人群中艾滋病相关危险行为普遍存在,随着MSM人群HIV感染率的增加,将对中国艾滋病的流行产生巨大的影响。更多还原

【Abstract】 Objective: To explore MSM population’s contribution to HIV epidemic in China.Methods: A web-based cross-sectional study on MSM population, recruiting participants by convenient sampling and collecting data by quantitative and qualitative methods.Object and Recruitment: Men who had sex with men in the previous 3 years in China’s mainland recruited through a variety of available ways, such as Internet, mass media etc..Results: A total of 5710 eligible participants from 30 provinces (municipalities and autonomous regions) except Tibet, 77.7% living in the cities, and 97.2% aged between 18 and 44 yrs, and 94.6% the Han nationality, and 82.8% graduated from colleges and above, and 71.7% self-identified homosexual, and 79.5% unmarried with 25.7% that would marry with women, and 48.2% married that aged above 30 yrs, and 64.5% salary per month above 1600 RMB, and the correct rates answering to HIV-related issues ranged from 58.5% to 99.6%, 63.3% thinking that they are likely to be infected by HIV, and 88.7% knowing counseling hotline on HIV whereas only 8.1% of them dialed, and 59.8% knowing at least one site for HIV test whereas only 40.1% of them did, and the number increasing year by year, and 90.3% dating male partners via Internet, and 87.3% having sex with men and 21.5% with women in the past 6 months, 1.8% using drugs and 12.8% reporting STD-related symptoms in the past 6 months, and 66.5% having received HIV/STD-related interventions. Among 4916 participants who had sex with men, 67.2% had more than one male partner. The proportions of 100% condom use when having anal sex with fixed partners, occasional partners, MBs and customers in the past 6 months were 30.0%, 42.7%, 66.7%, 57.9%, respectively; when having oral sex were 7.0%, 8.8%, 6.2%, 4.4%, respectively. The proportion of 100% using water-based lubricants was 45.8%. About 10.6% of participants had group sex in the past 6 months and the proportion of condom use in the last sex was 68.4%. The proportions of 100% condom use when having vaginal sex with wives or girlfriends, occasional women, CSW and women customer were 20.3%, 56.3%, 81.0%, 57.1%. The participants that had married were likely not to use condom in the last anal sex with men. The participants that were immigrant workers and engaged in show business, did HIV test, had more than 6 male partners were likely to have STDs.Conclusions: Most of MSM are at risk for HIV/STD infection. With increasing HIV prevelance in MSM population, MSM population would make a strong impact on HIV epidemic in China.更多还原