中国男男性行为者的生活质量与无保护肛交之间的关系：一项横断面研究。
Relationship between quality of life and unprotected anal intercourse among Chinese men who have sex with men: a cross-sectional study.
作者信息
Zhu Yaxin, Liu Jie, Qu Bo, Hu Bingxue, Zhang Yang
机构信息
Department of Health Statistics, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, People's Republic of China.
出版信息
BMC Public Health. 2016 May 10;16:382. doi: 10.1186/s12889-016-3076-z.
BACKGROUND
The prevalence of unprotected anal intercourse (UAI) is high among Chinese men who have sex with men (MSM). As important aspects of quality of life (QOL), psychological health and social relationships have been found to be associated with UAI among MSM, which was of great concern for intervening on UAI.
METHODS
We conducted a cross-sectional study in Zhengzhou, Henan province, and in Huludao, Liaoning province, China, to measure quality of life (QOL) using the brief version of the World Health Organization Quality of Life (WHOQOL-BREF). Cronbach's α coefficient was used to test the internal consistency of the questionnaire items, and construction validity was assessed by exploratory factor analysis. T-test, chi-square test and multivariate logistic analysis were carried out to test the relationship between quality of life and unprotected anal intercourse.
RESULTS
The questionnaires of 320 of the 373 men who have sex with men that were surveyed met our validity criteria (response rate: 85.8 %). A total of 161 subjects (50.3 %) reported having unprotected anal sex in the last 6 months. The results of univariate analysis indicated that having unprotected anal sex was significantly associated with psychological health (PSYCH), social relationships (SOCIL), age, and marital status (P-value <0.05). The 3 items ("Negative feelings", "Hopeness on your life", and "Be able to concentrate") in the PSYCH subscale were associated with UAI significantly (P-value <0.05). Multivariate analysis showed that psychological health (adjusted odd ratio (AOR) 0.979, 95 % confidence interval (CI) 0.961-0.998) was independent factor affecting the likelihood of having UAI in the population of Chinese MSM, and participants who aged 45 or more had higher odds of UAI (AOR 3.986, 95 % CI 1.199-13.255).
CONCLUSIONS
WHOQOL-BREF was acceptable for evaluating the quality of life of MSM. Psychological health, as one important aspect of quality of life, was negatively associated with unprotected anal intercourse. The finding underscored the needs to incorporate the strategies on improving psychological health into the UAI intervention to reduce the HIV transmission among MSM.
背景
在中国男男性行为者（MSM）中，无保护肛交（UAI）的发生率很高。心理健康和社会关系作为生活质量（QOL）的重要方面，已被发现与男男性行为者中的无保护肛交有关，这对干预无保护肛交至关重要。
方法
我们在中国河南省郑州市和辽宁省葫芦岛市进行了一项横断面研究，使用世界卫生组织生活质量简表（WHOQOL - BREF）来测量生活质量（QOL）。采用克朗巴哈α系数检验问卷项目的内部一致性，并通过探索性因子分析评估结构效度。进行t检验、卡方检验和多因素逻辑分析，以检验生活质量与无保护肛交之间的关系。
结果
在接受调查的373名男男性行为者中，320份问卷符合我们的效度标准（应答率：85.8%）。共有161名受试者（50.3%）报告在过去6个月中有过无保护肛交。单因素分析结果表明，有无保护肛交与心理健康（PSYCH）、社会关系（SOCIL）、年龄和婚姻状况显著相关（P值<0.05）。心理健康子量表中的3个项目（“负面情绪”、“对生活的希望”和“能够集中注意力”）与无保护肛交显著相关（P值<0.05）。多因素分析表明，心理健康（调整后的比值比（AOR）为0.979，95%置信区间（CI）为0.961 - 0.998）是影响中国男男性行为者人群中有无保护肛交可能性的独立因素，45岁及以上的参与者有无保护肛交的几率更高（AOR为3.986，95%CI为1.199 - 13.255）。
结论
WHOQOL - BREF可用于评估男男性行为者的生活质量。心理健康作为生活质量的一个重要方面，与无保护肛交呈负相关。这一发现强调了将改善心理健康的策略纳入无保护肛交干预措施以减少男男性行为者中艾滋病毒传播的必要性。
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