Song Dan-dan, Zhang Hong-bo, Wang Jun, Wang Xiao-dong, Liu Qi, Han De-lin, Dai Li-ping, She Min, Wang Min, Dong Zhen-xin
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2012 Apr;33(4):368-73.
To understand the status of HIV infection and sexual behaviors with men and women among men who have sex with men and women (MSMW) and documented for HIV epidemic among men who have sex with men to the general population.
300 participants were recruited by using "snowballing" sampling in Chengdu and Guangzhou, respectively. Participants completed the questionnaire and HIV test. The questionnaire included social demographic characteristics, number of male sexual partners, sexual behaviors and condom use in the past 6 months. Relations with female sexual partners, vaginal intercourse and condom use in the past 12 months were also studied.
Of the 600 participants, the overall prevalence of HIV infection was 26.2% and the detection rate of HIV-positives in this survey was 8.5%. In the past 6 months 28.0% of the participants had 5 or more male sexual partners and the percentage of MSMW who had used condoms consistently during anal sex intercourse with men, was 44.2%. Of the participants, 52.3% had used condoms in the last three anal sex events and 63.0% in the last event. In the past 12 months, 86.0% of the participants who had vaginal sex with female partners and the proportions of MSMW who had wife, girlfriend, lover, female casual partner and female commercial partner were 65.0%, 27.2%, 1.5%, 12.7%, 4.5%, respectively. About a third of the MSMW had always used condoms when having vaginal sex in the past 12 month. In the last three vaginal sex events, the proportion of participants who had never used condoms was 36.5%. In the past 6 months, 55.7% of the MSMWs had used condoms consistently during anal sex with men in Chengdu, which was higher than those MSMW in Guangzhou (32.7%). In the past 12 months, the proportion of MSMW who had used condoms consistently during vaginal sex was 38.3%, which was higher than MSMW of Guangzhou (25.3%). Among those HIV-positive MSMWs, 91.1% had anal sex with men in the past 6 months and 49.7% HIV-positive MSMW had used condoms consistently during anal sex with men. The number of HIV-positive MSMW who had used condoms in the last or last three anal sex events with men, accounted for 60.5% and 69.4%, respectively. In the past 12 months, 82.8% of the HIV-positive participants had vaginal sex with women. Of the HIV-positive participants, 42.0% used condoms consistently and the percentage of HIV-positive MSMWs who used condom during last three vaginal sexes was 47.8%. In the past 6 months, the percentage (4.3%) of MSMW who were HIV-positive prior to the survey and never used condoms during anal sex with men was lower than the percentage (22.0%) of MSMW who were HIV-positive found in this survey. In the past 12 months 12.9% of the MSMW who were HIV positive prior to the survey never used condoms when having vaginal sex event, which was lower than MSMW (46.3%) who were HIV positive in this survey.
The prevalence of HIV infection had reached a quite high level and with high rates of unprotected anal sex with men and vaginal sex with women among MSMWs, indicating that the inherent bridging aspect of MSMW might accelerate the spreading of HIV infection to the general population.
了解男男性行为者与女性发生性行为者（MSMW）中艾滋病毒感染状况及性行为情况，并记录男男性行为者中艾滋病毒流行情况对普通人群的影响。
分别在成都和广州采用“滚雪球”抽样法招募300名参与者。参与者完成问卷调查并进行艾滋病毒检测。问卷包括社会人口学特征、男性性伴侣数量、过去6个月的性行为及避孕套使用情况。还研究了与女性性伴侣的关系、过去12个月的阴道性交及避孕套使用情况。
在600名参与者中，艾滋病毒感染总体患病率为26.2%，本次调查中艾滋病毒阳性检出率为8.5%。在过去6个月里，28.0%的参与者有5个或更多男性性伴侣，在与男性进行肛交时始终使用避孕套的MSMW比例为44.2%。在参与者中，52.3%在最近三次肛交事件中使用了避孕套，最后一次事件中这一比例为63.0%。在过去12个月里，86.0%的参与者与女性伴侣有过阴道性交，有妻子、女朋友、情人、女性性伴侣和女性商业性伴侣的MSMW比例分别为65.0%、27.2%、1.5%、12.7%、4.5%。在过去12个月里，约三分之一的MSMW在进行阴道性交时始终使用避孕套。在最近三次阴道性交事件中，从未使用避孕套的参与者比例为36.5%。在过去6个月里，成都55.7%的MSMW在与男性进行肛交时始终使用避孕套，高于广州的MSMW（32.7%）。在过去12个月里，在阴道性交时始终使用避孕套的MSMW比例为38.3%，高于广州的MSMW（25.3%）。在艾滋病毒阳性的MSMW中，91.1%在过去6个月里与男性进行过肛交，49.7%的艾滋病毒阳性MSMW在与男性进行肛交时始终使用避孕套。在与男性的最后一次或最后三次肛交事件中使用避孕套的艾滋病毒阳性MSMW数量分别占60.5%和69.4%。在过去12个月里，82.8%的艾滋病毒阳性参与者与女性有过阴道性交。在艾滋病毒阳性参与者中，42.0%始终使用避孕套，在最近三次阴道性交中使用避孕套的艾滋病毒阳性MSMW比例为47.8%。在过去6个月里，调查前艾滋病毒阳性且在与男性进行肛交时从未使用避孕套的MSMW比例（4.3%）低于本次调查中发现的艾滋病毒阳性MSMW比例（22.0%）。在过去12个月里，调查前艾滋病毒阳性的MSMW在进行阴道性交时从未使用避孕套的比例为12.9%，低于本次调查中艾滋病毒阳性的MSMW（46.3%）。
艾滋病毒感染患病率已达到相当高的水平，MSMW中与男性无保护肛交和与女性阴道性交的比例很高，表明MSMW固有的桥梁作用可能会加速艾滋病毒感染向普通人群的传播。
