Guo Yan-li, Zhou Jian-bo, Hao Chao, Huan Xi-ping, Shi Tai-ping, Wang Jin-ta, Zhen Sen, Yin Yue-ping
Changzhou Center for Disease Control and Prevention, Changzhou, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2013 Jan;34(1):19-23.
To understand the distribution of marriage status among men who have sex with men (MSM) in the city of Changzhou, and to explore the impact of marriage on AIDS related high risk behaviors and HIV infection in this population.
Target sampling (snowball sampling) was adopted to carry out a cross-sectional study, and structured questionnaire-based interviews were conducted to collect information on social demography, HIV related high risk behaviors. Blood and urine samples were collected to detect HIV, syphilis, gonorrhea and Chlamydia trachomatis infections.
Of the 655 participants, 37.4% were married. Married MSM mostly sought their sexual partners at the public bathing house (61.6%), while unmarried MSM were mainly through bars (33.6%) or internet (31.1%). The proportion of having anal sex with men during the last 6 months was lower in the married group (50.8%) than in the unmarried group (73.3%), (P < 0.001) The percentage of having sex with women in the last 6 months was significantly higher in the married group (68.9%) than that in the unmarried group (33.2%) (P < 0.001), (OR = 4.454, 95%CI: 3.168 - 6.261). The rates of condom use in the last anal sex with men in married and unmarried groups were 71.0% and 77.6%, respectively (P = 0.152). The rate of condom use in the last intercourse with women was significantly lower in the married group (44.0%) than that in the unmarried group (70.4%) (P < 0.001), (OR = 0.331, 95%CI: 0.205 - 0.535). In the sex trade, most of the married MSM would "buy" sex (66.7%), while unmarried MSM would "sell" sex (63.2%) (P < 0.05), (OR = 3.429, 95%CI: 1.255 - 9.366). The percentage of having drugs in the previous year was higher in married group (3.3%) than that in the unmarried group (0.8%) (P < 0.05). In married and unmarried groups, the infection rates of HIV, syphilis, gonorrhea and Chlamydia trachomatis appeared to be (8.6%, 8.6%), (17.1%, 12.3%), (1.6%, 2.4%), and (3.3%, 9.0%), respectively (P > 0.05).
Marriage seemed to have had limited effects on reducing the high risk behaviors of MSM. Different and multiform interventions should be developed according to the different characteristics of married or unmarried MSM population.
了解常州市男男性行为者（MSM）的婚姻状况分布，探讨婚姻对该人群艾滋病相关高危行为及HIV感染的影响。
采用目标抽样（滚雪球抽样）进行横断面研究，通过基于结构化问卷的访谈收集社会人口学、HIV相关高危行为等信息。采集血液和尿液样本检测HIV、梅毒、淋病和沙眼衣原体感染情况。
655名参与者中，37.4%已婚。已婚MSM大多在公共浴室寻找性伴（61.6%），而未婚MSM主要通过酒吧（33.6%）或网络（31.1%）寻找。已婚组在过去6个月与男性发生肛交的比例（50.8%）低于未婚组（73.3%），（P<0.001）。已婚组在过去6个月与女性发生性行为的比例（68.9%）显著高于未婚组（33.2%）（P<0.001），（OR=4.454，95%CI：3.168 - 6.261）。已婚和未婚组在过去与男性最后一次肛交时使用避孕套的比例分别为71.0%和77.6%（P=0.152）。已婚组在过去与女性最后一次性交时使用避孕套的比例（44.0%）显著低于未婚组（70.4%）（P<0.001），（OR=0.331，95%CI：0.205 - 0.535）。在性交易方面，已婚MSM大多“买春”（66.7%），而未婚MSM大多“卖春”（63.2%）（P<0.05），（OR=3.429，95%CI：1.255 - 9.366）。已婚组上一年吸毒比例（3.3%）高于未婚组（0.8%）（P<0.05）。已婚和未婚组中，HIV、梅毒、淋病和沙眼衣原体的感染率分别为（8.6%，8.6%）、（17.1%，12.3%）、（1.6%，2.4%）和（3.3%，9.0%），（P>0.05）。
婚姻对降低MSM高危行为的作用似乎有限。应根据已婚或未婚MSM人群的不同特点制定不同形式的干预措施。
