Lei Yunxiao, Zhang Kaili, Xiao Xueling, Tang Chulei, Li Xianhong, Wang Honghong
School of Nursing of Henan University of Science and Technology, 263 Kaiyuan Road, Luolong District, Luoyang 471003, China.
Xiangya School of Nursing of Central South University, 172 Tong Zi Po Road, Changsha 410013, Hunan, China.
Curr HIV Res. 2018;16(2):174-181. doi: 10.2174/1570162X16666180711101643.
HIV infection is prevalent among men who have sex with men (MSM), and sexual roles may be important factors related to it. This study aims to describe the sexual roles, risky sexual behaviors and HIV prevalence among MSM, and to determine associated factors for HIV prevalence.
A convenient sampling method was used to recruit participants in a non-government organization in Changsha, China. The participants were asked to complete a 38-item self-administered questionnaire regarding demographic characteristics and risky sexual behaviours before collecting blood samples for HIV testing. Chi-square tests and logistic regression analysis were conducted with the Statistical Package for the Social Sciences Version 18.0 and other indexes were statistically described.
A total of 601 MSMs who came to a local non-government organization for voluntary counseling and testing completed a pencil-and-paper survey and were tested for HIV. The overall HIV prevalence of this sample was 13.3%, and that of the bottoms (16.3%) was similar to the versatiles (15.9%) but higher than the tops (6.1%). Bivariate analyses showed that there were significant differences in age, marital status, monthly income, sexual orientation, age at first sex, sex of the first sex partner, sex with a woman in the last 6 months, oral sex with a man in the last 6 months and role of oral sex among 3 subgroups of MSM (p < 0.05). Multivariate analyses indicated that MSMs who played the role of either the bottoms or the versatiles were more likely to be HIV positive than the tops. While MSMs who used condoms in anal sex in the last 6 months, had sex with a woman in the last 6 months or had oral sex with a man in the last 6 months were less likely to be HIV positive.
Different sexual roles are associated with high-risk sexual behaviors among MSMs and their HIV infection status. Further research should target preventive interventions, and improve the effectiveness of the intervention according to the characteristics of the subgroups to reduce the HIV transmission among Chinese MSM.
男男性行为者（MSM）中HIV感染较为普遍，性行为角色可能是与之相关的重要因素。本研究旨在描述MSM的性行为角色、危险性行为及HIV感染率，并确定HIV感染率的相关因素。
采用方便抽样法在中国长沙的一个非政府组织招募参与者。在采集血样进行HIV检测前，要求参与者完成一份关于人口统计学特征和危险性行为的38项自填式问卷。使用社会科学统计软件包第18.0版进行卡方检验和逻辑回归分析，并对其他指标进行统计学描述。
共有601名到当地非政府组织进行自愿咨询和检测的MSM完成了纸笔调查并接受了HIV检测。该样本的总体HIV感染率为13.3%，被动方（16.3%）和可变换角色方（15.9%）的感染率相似，但高于主动方（6.1%）。双变量分析显示，MSM的3个亚组在年龄、婚姻状况、月收入、性取向、首次性行为年龄、首个性伴侣性别、近6个月与女性发生性行为、近6个月与男性发生口交以及口交角色方面存在显著差异（p<0.05）。多变量分析表明，扮演被动方或可变换角色方的MSM比主动方更易感染HIV。而近6个月在肛交中使用避孕套、近6个月与女性发生性行为或近6个月与男性发生口交的MSM感染HIV的可能性较小。
不同的性行为角色与MSM的高危性行为及其HIV感染状况相关。应针对预防性干预措施开展进一步研究，并根据亚组特征提高干预效果，以减少中国MSM中的HIV传播。
