Guo Yanli, Wang Dongli, Zhou Jianbo, Chen Shulei, Wang Jinta, Zhen Sen, Huan Xiping, Yin Yueping
Department of STI and AIDS Prevention and Control, Changzhou Center for Disease Prevention and Control, Changzhou 213022, China. Email:
Zhonghua Yu Fang Yi Xue Za Zhi. 2014 Apr;48(4):307-11.
To study the effects of educational background of men who have sex with men (MSM) on their high risk sexual behaviors and the HIV/STI infection rates.
During July to November of 2009 and March to October of 2010, snowball and convenience sampling methods were adopted to recruit MSM from MSM venues and via the internet in Changzhou city of Jiangsu province, and finally 659 MSM were conducted a questionnaire survey and serological testing. According to the educational background of MSM, they were divided into 3 groups, that is, junior high school group (206 cases), high school group (254 cases), and university group (199 cases). The questionnaire mainly includes information on social demography, sexual behaviors, condom use, etc. Blood samples were collected for HIV and syphilis spirochete detection, and urine samples were also collected in 291 MSM who were recruited during July to November of 2009 for neisseria gonorrhoeae and chlamydia trachomatis nucleic acid detection. χ(2) test and other statistical analysis methods were used to compare the characteristics of sexual behaviors and HIV/STI infections in 3 groups.
Of the 659 valid questionnaires returned, junior high school group, high school group, and university group accounted for 31.3% (206 cases), 38.5% (254 cases) and 30.2% (199 cases). Places where MSM of different education levels most often to seek sexual partners, were significantly different. Junior high school group and high school group mostly went to bath house/sauna club (56.3%, 116 cases) and bar (34.8%, 88 cases) for partners, respectively, while the university group sought partners mainly through the internet (41.1%, 81 cases) (χ(2) = 99.35, P < 0.05). 53.4% (109/204) of the junior high school group had anal sex with men in the last 6 months, which was higher than that of high school group (67.7%, 172/254) (χ(2) = 9.74, P < 0.05) and university group (72.7%, 144/198) (χ(2) = 16.04, P < 0.05) . A total of 54.4% (111/204) of the junior high school group had sex with women in the last 6 months, which was higher than that of university group (38.6%, 76/197) (χ(2) = 10.10, P < 0.05) , but was not statistically significantly different from that of high school group (46.9%, 119/254) (χ(2) = 2.59, P = 0.11) . The rates of condom use with men at the last anal sex in junior high school group (73.4%, 80/109) , high school group (78.0%, 131/168) and university group (73.9%, 105/142) were similar. The rates of condom use with women in the last intercourse in junior high school group, high school group and university group were 51.8% (57/110), 54.6% (65/119) and 61.8% (47/76), respectively(χ(2) = 1.88, P = 0.39) . In junior high school group, high school group and university group, the infection rates of HIV were 9.2% (19/206), 10.6% (27/254) and 5.6% (11/197) (χ(2) = 3.68, P = 0.16), the positive rates of neisseria gonorrhoeae were 3.8% (3/79), 3.4% (4/117) and 0.0% (0/95) (χ(2) = 3.85, P = 0.14), the positive rates of chlamydia trachomatis were 5.1% (4/79), 9.4% (11/117) and 4.2% (4/95) (χ(2) = 2.70, P = 0.26). The infection rate of syphilis in junior high school group was 19.9% (41/206), which was higher than high school group (12.2%, 31/254) (χ(2) = 5.11, P < 0.05) and university group (10.2%, 20/197) (χ(2) = 7.45, P < 0.05 ).
There was no obvious correlation between education level and high risk sexual behaviors;MSM with lower education level were at higher risk of infection of syphilis.
研究男男性行为者（MSM）的教育背景对其高危性行为及HIV/性传播感染（STI）感染率的影响。
于2009年7月至11月及2010年3月至10月，采用雪球抽样和便利抽样方法，从江苏省常州市的男男性行为场所及通过互联网招募男男性行为者，最终对659名男男性行为者进行问卷调查和血清学检测。根据男男性行为者的教育背景，将其分为3组，即初中组（206例）、高中组（254例）和大学组（199例）。问卷主要包括社会人口学信息、性行为、避孕套使用等方面。采集血液样本进行HIV和梅毒螺旋体检测，对2009年7月至11月招募的291名男男性行为者还采集尿液样本进行淋病奈瑟菌和沙眼衣原体核酸检测。采用χ²检验等统计分析方法比较3组性行为特征及HIV/STI感染情况。
共回收有效问卷659份，初中组、高中组和大学组分别占31.3%（206例）、38.5%（254例）和30.2%（199例）。不同教育程度的男男性行为者寻找性伴的场所存在显著差异。初中组和高中组寻找性伴主要场所分别为浴室/桑拿俱乐部（56.3%，116例）和酒吧（34.8%，88例），而大学组主要通过互联网寻找性伴（41.1%，81例）（χ² = 99.35，P < 0.05）。初中组在过去6个月中有53.4%（109/204）与男性发生肛交，高于高中组（67.7%，172/254）（χ² = 9.74，P < 0.05）和大学组（72.7%，144/198）（χ² = 16.04，P < 0.05）。初中组在过去6个月中有54.4%（111/204）与女性发生性行为，高于大学组（38.6%，76/197）（χ² = 10.10，P < 0.05），但与高中组（46.9%，119/254）差异无统计学意义（χ² = 那么，χ² = 2.59，P = 0.11）。初中组、高中组和大学组在最近一次肛交时与男性使用避孕套的比例分别为73.4%（80/109）、78.0%（131/168）和73.9%（105/142），差异无统计学意义。初中组、高中组和大学组在最近一次性交时与女性使用避孕套的比例分别为51.8%（57/110）、54.6%（65/119）和61.8%（47/76）（χ² = 1.88，P = 0.39）。初中组、高中组和大学组的HIV感染率分别为9.2%（19/206）、10.6%（27/254）和5.6%（11/197）（χ² = 3.68，P = 0.16），淋病奈瑟菌阳性率分别为3.8%（3/79））、3.4%（4/117）和0.0%（0/95）（χ² = 3.85，P = 0.14），沙眼衣原体阳性率分别为5.1%（4/79）、9.4%（11/117）和4.2%（4/95）（χ² = 2.70，P = 0.26）。初中组梅毒感染率为19.9%（41/206），高于高中组（12.2%，31/254）（χ² = 5.11，P < 0.05）和大学组（10.2%，20/197）（χ² = 7.45，P < = 0.05）。
教育程度与高危性行为之间无明显相关性；教育程度较低的男男性行为者感染梅毒的风险较高。
