Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei, Taiwan.
Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei, 10055, Taiwan.
Arch Sex Behav. 2018 Oct;47(7):2041-2050. doi: 10.1007/s10508-017-1081-7. Epub 2017 Nov 28.
In recent years, men who have sex with men (MSM) have accounted for over 80% of all new HIV cases in Taiwan. More than 70% of new cases have occurred in those aged 15-34 years. Condomless anal intercourse (CAI) has been identified as the main route of HIV transmission among MSM. To systematically examine CAI intention and associated factors among young MSM in Taiwan, an anonymous online survey based on the Theory of Planned Behavior (TPB) was conducted. Data from 694 MSM aged 15-39 years were included in the analysis. This study found that, overall, all five TPB factors (i.e., attitudes toward positive and negative outcomes regarding CAI, perceived support for CAI from important others, and perceived behavioral control of CAI under facilitating and constraining conditions) were significantly associated with CAI intention. When data were stratified by sexual role (i.e., receptive, versatile, and insertive), the associations between TPB factors and CAI intention varied. Of the five TPB factors, positive attitudes toward positive outcomes regarding CAI were most strongly associated with high CAI intention (AOR 5.68 for all young MSM; AOR 3.80-15.93, depending on sexual role). Findings from this study could inform the development of theory-driven HIV prevention programs as well as future research and practice. These results also highlight the importance of tailoring HIV prevention initiatives for young MSM of different sexual roles to optimize the program effectiveness.
近年来，男男性行为者（MSM）占台湾所有新 HIV 病例的 80%以上。超过 70%的新病例发生在 15-34 岁的人群中。无保护肛交（CAI）已被确定为 MSM 中 HIV 传播的主要途径。为了系统地研究台湾年轻 MSM 的 CAI 意图和相关因素，基于计划行为理论（TPB）进行了一项匿名在线调查。分析中纳入了 694 名年龄在 15-39 岁的 MSM 的数据。这项研究发现，总体而言，TPB 的所有五个因素（即对 CAI 的积极和消极结果的态度、对来自重要他人的 CAI 的支持感、以及在有利和限制条件下对 CAI 的感知行为控制）均与 CAI 意图显著相关。当按性行为角色（接受者、多伴侣和插入者）对数据进行分层时，TPB 因素与 CAI 意图之间的关联也会有所不同。在五个 TPB 因素中，对 CAI 的积极态度与高 CAI 意图的关联最强（所有年轻 MSM 的 AOR 为 5.68；取决于性行为角色，AOR 为 3.80-15.93）。本研究的结果可以为基于理论的 HIV 预防计划的制定以及未来的研究和实践提供信息。这些结果还强调了针对不同性行为角色的年轻 MSM 量身定制 HIV 预防计划的重要性，以优化计划效果。
