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中国男男性行为者以及有男女性行为的男性中的亲密伴侣暴力及其与危险行为和艾滋病毒/性传播感染诊断的相关性:一种隐匿的流行病

Intimate Partner Violence and Correlates With Risk Behaviors and HIV/STI Diagnoses Among Men Who Have Sex With Men and Men Who Have Sex With Men and Women in China: A Hidden Epidemic.

作者信息

Davis Alissa, Best John, Wei Chongyi, Luo Juhua, Van Der Pol Barbara, Meyerson Beth, Dodge Brian, Aalsma Matthew, Tucker Joseph

机构信息

From the *Department of Epidemiology & Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN; †UNC-Project China, Guangzhou, China; ‡Rural Center for AIDS/STD Prevention, Indiana University School of Public Health-Bloomington, Bloomington, IN; §School of Medicine and ¶Department of Epidemiology & Biostatistics and Global Health Sciences, University of California-San Francisco, San Francisco, CA; ∥School of Medicine, University of Alabama-Birmingham, Birmingham, AL; **Department of Applied Health Science and ††Center for Sexual Health Promotion, Indiana University School of Public Health-Bloomington, Bloomington, IN; ‡‡Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN; §§School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, CA; and ¶¶Social Entrepreneurship for Sexual Health Research Group, University of North Carolina and Guangdong Provincial Center for Skin Diseases & STI Control, Guangzhou, China.

出版信息

Sex Transm Dis. 2015 Jul;42(7):387-92. doi: 10.1097/OLQ.0000000000000302.

Abstract

BACKGROUND

Intimate partner violence (IPV) research has primarily focused on heterosexual couples but has largely ignored IPV among men who have sex with men (MSM). We examined IPV prevalence among MSM and men who have sex with men and women (MSMW) in China.

METHODS

Men who have sex with men older than 16 years were recruited through 3 MSM-focused Web sites in China. An online survey containing items on sociodemographics, risk behaviors, IPV, and self-reported HIV or sexually transmitted infection diagnosis was completed. Multivariate regression was used to examine associations between IPV and risk behaviors and an HIV or sexually transmitted infection diagnosis.

RESULTS

Among 610 participants, 182 (29.8%) reported experiencing at least 1 type of IPV. Men who have sex with both men and women were at significantly greater risk for IPV (adjusted odds ratio [AOR], 1.65; 95% confidence interval [CI], 1.08-2.53) compared with MSM. Men who had experienced IPV were more likely to have participated in group sex (AOR, 1.86; 95% CI, 1.08-3.21), to have had sex in exchange for gifts or money (AOR, 5.06; 95% CI, 2.47-10.35), and to report a positive HIV diagnosis (AOR, 2.59; 95% CI, 1.22-5.51).

CONCLUSIONS

There is a hidden epidemic of IPV among MSM in China, especially among MSMW. The hidden nature of MSM and MSMW suggests the need for a clinical environment more conducive to disclosure. Research is needed to understand the pathways linking IPV and HIV risk among MSM to optimize the design of effective interventions.

摘要

背景

亲密伴侣暴力(IPV)研究主要聚焦于异性恋伴侣,却很大程度上忽视了男男性行为者(MSM)中的亲密伴侣暴力情况。我们调查了中国男男性行为者以及男男性行为和男女两性性行为者(MSMW)中的亲密伴侣暴力流行情况。

方法

通过中国3个专注于男男性行为者的网站招募16岁以上的男男性行为者。完成一项在线调查,内容包括社会人口统计学、风险行为、亲密伴侣暴力以及自我报告的艾滋病毒或性传播感染诊断情况。采用多变量回归分析亲密伴侣暴力与风险行为以及艾滋病毒或性传播感染诊断之间的关联。

结果

在610名参与者中,182人(29.8%)报告曾经历至少一种类型的亲密伴侣暴力。与男男性行为者相比,男男性行为和男女两性性行为者遭受亲密伴侣暴力的风险显著更高(调整优势比[AOR]为1.65;95%置信区间[CI]为1.08 - 2.53)。曾经历亲密伴侣暴力的男性更有可能参与群交(AOR为1.86;95%CI为1.08 - 3.21)、以性换物或换钱(AOR为5.06;95%CI为2.47 - 10.35),以及报告艾滋病毒检测呈阳性(AOR为2.59;95%CI为1.22 - 5.51)。

结论

中国男男性行为者中存在亲密伴侣暴力的隐性流行情况,尤其是在男男性行为和男女两性性行为者中。男男性行为者和男男性行为和男女两性性行为者的隐蔽性表明需要一个更有利于披露情况的临床环境。需要开展研究以了解男男性行为者中亲密伴侣暴力与艾滋病毒风险之间的关联途径,从而优化有效干预措施的设计。

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