广西男男性行为者艾滋病传播与社会环境因素的关系研究

HIV/AIDS has been a public health issue facing the globe.Sexual transmission route has been a main way replacing traditional injection drug transimission.MSM(men who have sex with men) has been one of important factors contributing to HIV/AIDS epidemic in China. Studies on the relationship between social environment factors such as social network and social culture environment and HIV/AIDS spread among MSM are lacking in China.In this proposal, we focus on the influence of social network characteristics, social culture environmental factors on HIV/AIDS epidemic among MSM with 1840 total samples in Guangxi Zhuang Autonomous Region through RDS(respondent-driven sampling).Outcome variables in this study are the prevalence of HIV and high risk sexual behaviour.The determinants include the after-mentioned explanatory variables of interest and other confounding variables. Our objectives are as follows: ⑴To understand the level and the distribution of two outcome variables among MSM in Guangxi; ⑵ To explore the correlation of two outcome variables with individual level including social demographic, knowledge-Attitude-Belief-Practice of HIV，the quality of life and mental disorders;⑶To examine the association of two outcome variables and the social network characteristics including network size and network density; ⑷To explore whether two outcome variables are related to the social environment factors such as social support, social influence, attitude towards homosexuality, and whether or not receiving current intervention measures. In this study, both qualitative and quantitative research will be used. Information will be collected by face to face interview with structured questionnaires and semi-structured interview guidelines. Multilevel modeling analysis will be used to ananlyze data.According to previous resutls, the prevention and control measures of HIV for MSM will be made out and its effect will be assessed qualitatively and quantitatively. Our research will provide evidence for policy-maker to make measures and strategies of prevention and control HIV/AIDS spread among MSM.

艾滋病(HIV/AIDS)是全球面临的重要公共卫生问题，男男性行为者(MSM)是艾滋病流行的一个重要因素，社会环境因素与MSM高危性行为的关系已成为国外研究的热点，而国内相关的研究甚少。本项目拟对广西四城市MSM艾滋病传播的影响因素进行基于反应者驱动抽样方法( RDS)的调查，采用深入访谈与多水平模型等定性定量研究方法，了解MSM艾滋病传播水平和高危性行为的状况及分布规律，探索社会环境因素与MSM艾滋病传播水平及高危性行为的关系，阐明它们之间的机制，初步制定出针对MSM艾滋病防控措施和策略，并对其效果进行定性定量评价，为政府及有关部门制订有效的防控MSM艾滋病传播措施与策略提供理论与实际依据。

广西MSM 人群HIV感染率处于上升趋势。这次研究目的是了解广西四城市MSM人群 HIV感染状况及影响因素。采用自制的问卷收集研究对象的资料，内容包括：社会人口学特征、性行为、吸毒史、最近一次发生肛交性行为前是否服用过精神类药物(K 粉、摇头丸、冰毒、麻古等)、最近12月内的性病史、社会网络规模与密度、HIV相关耻辱得分及社会支持得分。结果表明在1550例MSM中，HIV阳性率为9.0%(139/1550),梅毒检测阳性率是11.7%(181/1550)。单因素分析结果显示民族、近一年的性病史如梅毒和淋病、近六个月同性性行为时安全套的使用频率、HIV相关耻辱得分、梅毒感染、寻找性伴的场所、最近6月同性性行为时性角色、最近一次同性性行为前精神类药物的服用均对MSM感染HIV有影响(p≤0.05)。多因素Logistic回归分析表明目前感染梅毒的MSM感染HIV的可能性是未感染梅毒者的3.79倍(95%CI=2.51-5.73，P=0.000≤0.05)，最近一次肛交性行为前服用过精神类药物的研究对象感染HIV的风险是未服用4.83倍(95%CI=1.49-15.59, P=0.009)。今后对MSM的干预可注重年轻的，尤其是非汉民族、喜服精神类药物的及有过性传播疾病的人群。