SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China.
University of North Carolina Project-China, Guangzhou, China.
BMC Public Health. 2019 Jul 22;19(1):978. doi: 10.1186/s12889-019-7307-y.
Condom use remains consistently low among Chinese men who have sex with men (MSM). This study aims to identify factors associated with condom use after online video intervention.
This is a secondary data analysis of data collected from an online non-inferiority trial comparing the effectiveness of two condom use promotion video interventions among Chinese MSM. Participants from the two groups were combined since the effectiveness of two video interventions were shown to be non-inferior. Univariable and multivariable logistic regression were used to identify factors associated with condomless sex after the intervention during the follow-up interval.
Overall, 1173 participants were recruited at baseline and 791 (67.4%) completed the three-month follow-up survey. 57.3% (453/791) of the participants reported condomless sex after intervention in the three-month follow-up interval. MSM who have had sex under the influence of alcohol in the last 3 months (Odds Ratio(OR) = 1.90; 95% CI: 1.22, 2.97; Adjusted OR(AOR) = 1.79; 95% CI: 1.13, 2.83) and ever have had sex tourism (OR = 2.75; 95% CI: 1.34, 5.63; AOR = 2.40; 95% CI: 1.15, 5.07) at baseline were more likely to have condomless sex after intervention in the three-month follow-up period. MSM who had a higher level of community engagement in sexual health (OR = 0.54; 95% CI: 0.35, 0.82; AOR = 0.49; 95% CI: 0.32, 0.75 with substantial engagement) and who viewed additional condom promotion videos during the follow-up period by themselves (OR = 0.67; 95% CI = 0.50, 0.89; AOR = 0.67; 95% CI: 0.50, 0.91). were less likely to have condomless sex during the follow-up period.
The intervention appeared to be effective among MSM who reported viewing additional condom promotion videos by themselves and more community engagement after the intervention. In MSM who reported risky sexual behaviors at baseline, the intervention appeared less effective. Tailored intervention videos that target particular subgroups, active in-person community engagement, and optimized intervention frequency should be considered in future sexual health interventions.
在中国男男性行为者（MSM）中，避孕套的使用仍然普遍较低。本研究旨在确定与在线视频干预后使用避孕套相关的因素。
这是一项对来自在线非劣效性试验的数据进行的二次数据分析，该试验比较了两种避孕套使用促进视频干预在中 MSM 中的效果。由于两种视频干预的效果被证明是非劣效的，因此将两组参与者合并。使用单变量和多变量逻辑回归来确定在随访期间干预后与无保护性行为相关的因素。
总体而言，共有 1173 名参与者在基线时被招募，其中 791 名（67.4%）完成了三个月的随访调查。在三个月的随访期间，57.3%（453/791）的参与者报告了干预后的无保护性行为。在过去 3 个月中因饮酒而发生性行为的 MSM（优势比（OR）=1.90；95%CI：1.22，2.97；调整后的 OR（AOR）=1.79；95%CI：1.13，2.83）和有过性旅游史的 MSM（OR=2.75；95%CI：1.34，5.63；AOR=2.40；95%CI：1.15，5.07）在基线时更有可能在三个月的随访期间进行干预后发生无保护性行为。在性健康方面社区参与程度较高的 MSM（OR=0.54；95%CI：0.35，0.82；AOR=0.49；95%CI：0.32，0.75）和在随访期间自行观看更多避孕套推广视频的 MSM（OR=0.67；95%CI=0.50，0.89；AOR=0.67；95%CI=0.50，0.91）在随访期间发生无保护性行为的可能性较小。
该干预措施似乎对报告自行观看更多避孕套推广视频和干预后社区参与度更高的 MSM 有效。在基线时报告有风险性行为的 MSM 中，该干预措施的效果似乎较差。在未来的性健康干预中，应考虑针对特定亚组的定制干预视频、积极的现场社区参与和优化干预频率。
