【作者】 修翠珍；

【导师】 薛付忠； 储全胜；

【作者基本信息】 山东大学 ， 流行病与卫生统计学， 2009， 硕士

【摘要】 目的通过一系列宣传教育和行为干预活动,提高男男性行为(MSM)人群的艾滋病防治知识知晓率,预防MSM人群危险行为的发生和减少已经形成的危险行为,提高安全套使用率,为进一步探索对该人群的有效干预措施,遏制HIV的进一步传播提供科学依据。通过调查研究,进一步了解男男性行为(MSM)人群的人口学和与艾滋病相关的行为学特点;掌握并分析我市MSM人群的HIV感染状况,及时掌握该人群的流行趋势和流行特点,为今后制定有效防治措施提供依据。同时,通过课题研究在MSM人群中发展可以长期参与预防艾滋病工作的志愿者,与更多的MSM关键人物建立长期联系,以期为长期的干预活动取得人员关系基础,建立一支稳定的MSM干预志愿者队伍。研究对象与方法成立有艾滋病防治专业人员、同性恋志愿者小组成员、MSM关键知情人员参加的课题执行组,选择在青岛市居住6个月以上经常在青岛市MSM活跃的酒吧、公园、公厕等场所活动的曾经与另一位男性发生过性行为(包括口交、肛交)的18岁及以上的MSM,通过宣传教育、外展服务、同伴教育等对其开展知识宣传和行为干预,覆盖人员800人,分别于干预前后动员其中200人,对他们进行基本人口学特征、艾滋病相关知识知晓率和行为特点调查;于干预前调查的同时对MSM进行HIV感染状况调查。结果采用SPSS分析软件进行统计分析。主要结果1.干预前调查216人,干预后调查199人。干预前后被调查人员的人口学特征基本一致。年龄以21～30岁为主,干预前后分别占68.06%、66.33%;大专以上学历占多数(分别占67.13%和65.83%),性取向以同性恋者较多(分别占56.94%和59.80%),多数人未婚(分别占71.30%和69.85%);第一次性行为多在20岁左右(干预前后平均年龄分别为20.46±4.27岁和20.52±3.05岁),第一次性行为对象以男性者居多(73.15%、79.90%)。2.MSM人群存在多性伴及买性或卖性现象,也有相当比例的MSM同时与女性保持性关系(25.46%、20.10%)。干预前目标人群艾滋病相关知识总的知晓率为60.16%;近6个月肛交安全套使用率为45.27%,近6个月口交安全套使用率为13.40%,与女性发生性行为安全套使用率为32.73%;最近6个月发生性行为的男性人数为4.3±7.6人;性病患病率为8.33%。干预后艾滋病相关知识总的知晓率为87.02%,近6个月肛交安全套使用率为63.83%,近6个月口交安全套使用率为31.58%,与女性发生性行为安全套使用率为57.5%;最近6个月发生性行为的男性人数为3.7±3.2人;性病患病率为6.03%。干预活动取得显著成效,尤其是干预后目标人群的不传播途径、预防措施知识知晓率及肛交安全套使用率有了较大幅度提高。3.被调查的MSM人群的HIV感染率为1.1%。结论与意义男男性行为人群是艾滋病传播主要高危人群之一。首先MSM人群危险行为发生的比例较高,多性伴现象普遍。其次安全套使用比例低,MSM人群数量较大,再有MSM人群中男性同性恋者有相当一部分迫于社会压力最终选择与女性结婚,MSM人群中性交易也较普遍,很多男性卖淫者也同女性发生性关系,综上所述,MSM人群已成为我国艾滋病防控工作的重点。预防MSM人群危险行为的发生和减少已经形成的危险行为,提高安全套使用率,健康教育和行为干预是有效措施。通过在MSM人群活动的场所放置宣传品、安全套及开展联宜活动、知识讲座、外展服务、社区动员等干预活动,容易被MSM人群接受,而让同性恋加入到宣传队伍,作为志愿者进行“同伴教育”,则更受MSM人群欢迎,上述措施对MSM改变危险行为极为有效。通过鼓励MSM参与艾滋病VCT活动,除了能够改变MSM的危险行为,还可以及时掌握该人群艾滋病的流行特点。更多还原

【Abstract】 objectiveThrough a series of educational and behavioral interventions to improve men who have sex with men (MSM) of knowledge about AIDS , prevention the high risk behavior of MSM and reduce the high risk behavior , raise the utilization rate of condoms , provide a scientific basis for reducing the spread of HIV. Through this investigation to learn more about demographic characteristics and high risk behaviors related HIV/AIDS; grasp HIV infection status of MSM, and to provide scientific basis for developing intervention strategies.At the same time, cultivate volunteers who can participate the AIDS prevention work, make a long-term contract with more key men. Establish a stable intervention teams.Subjects and methodsSet up a task implementation group including professionals on AIDS, volunteers , key men . Choose the MSM who have been in Qingdao for 6 months or more and have had sex with men (including oral sex, anal sex) and 18-years-old or above. Through education, outreach services, peer education to advocacy safe behavior , covering 800 persons in all. Chose 200 people respectively before and after the intervention, and investigate their basic demographic characteristics, knowledge of HIV/AIDS-related awareness and behavior characteristics; investigate HIV infection status of MSM before intervention. The data is statisticed with SPSS 8.0.The main results 1. Investigate 216 and 199 persons respectively before and after intervention. Their demographic characteristics essentially the same. A majority of them at age 21 to 30-year-old(accounted for 68.06% and 66.33% respectively before and after the intervention), college education or above(67. 13% , 65.83%), and homosexual (56.94%, 59.80%) , unmarried (69. 85%,71.30 %); A majority of them had their first sexual act at about 20-year-old. (before and after the intervention the average age is 20. 46±4. 27 years and 20. 52±3. 05 years), most of them have sex with men at their first sexual(73.15 %, 79.90%).2. There is multiple partners and to buy or sell sex among them, a considerable proportion of MSM keep sexual relations with women (25. 46%, 20.10%). The total awareness rate of AIDS-related knowledge is 60. 16% before intervention. The percentage of condom use in making anal sex is 45. 27% in the previous 6 months, the percentage of condom use in making oral sex is 13.40% in the previous 6 months, the percentage of condom use in making sex with women is 32. 73%; the averag number of MSM who having sex in the previous 6 months is 4. 3±7.6; and the infection rate of sexual transmitted diseases is 8.33% before intervention. The total awareness rate of AIDS-related knowledge is 87.02% after intervention. The percentage of condom use in making anal sex is 63. 83% in the previous 6 months, the percentage of condom use in making oral sex is 31. 58% in the previous 6 months, the percentage of condom use in making sex with women is 57. 5%; the average number of MSM who having sex in the previous 6 months is 3.7±3.2; and the infection rate of sexual transmitted diseases is 6.03% after intervention. The interventions is sucessful, especially the awareness rate of prevention knowledge and the rate of condom use in making anal sex have increased in a large degree after the intervention.3. HIV infection rate of the MSM is 1.1 %.Conclusion MSM is one of the three population with AIDS high-risk behavior . First of all, the percentage of high risk behavior of MSM is high, a major of them have multiple partners. This was followed by a low rate of condom use, MSM is a large number of people, and a considerable number of them choose to marry with women under social pressure, furthermore buy and sell sex is also common in MSM. In a word MSM has become the focus population of AIDS prevention and control work in China. So prevent and reduce high risk behavior , increase the rate of condom use ,health education and behavioral intervention is effective.Through the intervention activities of putting IEC material and condom, outreach service, lectures and other interventions, to make MSM easy to accept, MSM are able to carry out " Peer education " as volunteers, the above-mentioned measures is effective to change high risk behavior of MSM. Encouraging MSM to participate in VCT, in addition to reducing the high risk behavior of MSM, you can grasp HIV infection characteristics in time.更多还原