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基于健康信念模型的中国男男性行为者与固定和非固定男性性伴使用安全套的心理因素关联:一项定量研究。

Association between Psychological Factors and Condom Use with Regular and Nonregular Male Sexual Partners among Chinese MSM: A Quantitative Study Based on the Health Belief Model.

机构信息

Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu 610041, China.

West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Biomed Res Int. 2020 Sep 28;2020:5807162. doi: 10.1155/2020/5807162. eCollection 2020.

Abstract

OBJECTIVE

The Chinese men who have sex with men (MSM) population is suffering from a high HIV infection rate owing to unprotected anal sex. The Health Belief Model (HBM) has been proven to be an effective frame associated with behavior maintenance. Based on HBM, we analyzed the beliefs associated with consistent condom use behavior with regular and nonregular partners among MSM to better provide targeted interventions and services.

METHODS

A study was conducted in Sichuan Province, China, from November 2018 to April 2019, and 801 eligible participants were recruited by snowball sampling. Sociodemographic characteristics, AIDS-related characteristics, sexual behaviors, condom use behavior, and dimensions of HBM were investigated. Univariate, single multivariate, and summary multivariate models were employed to analyze the factors associated with consistent condom use.

RESULTS

Of all participants, 39.1% and 53.6% had had anal sex with regular and nonregular partners in the last six months, respectively. Only 56.5% of them had used condoms consistently with regular partners, and only 60% of them had used condoms consistently with nonregular partners. When taking consistent condoms use with regular partners as the dependent variable, the dimensions of perceived threats (ORM = 1.28, 95% CI: 1.10, 1.49), perceived barriers (ORM = 0.70, 95% CI: 0.60, 0.82), self-efficacy (ORM = 1.23, 95% CI: 1.14, 1.32), and cues to action (ORM = 1.21, 95% CI: 1.02, 1.43) showed significant associations with the dependent variable. When taking consistent condoms use with nonregular partners as the dependent variable, the dimensions of perceived barriers (ORM = 0.77, 95% CI: 0.67, 0.89), self-efficacy (ORM = 1.22, 95% CI: 1.13, 1.32), and cues to action (ORM = 1.53, 95% CI: 1.30, 1.80) showed significant associations with the dependent variable.

CONCLUSIONS

More attention should be focused on how to decrease the obstructive factors of condom use, how to improve the confidence of condom use, and how to layout more cues to action to promote consistent condom use behavior with regular and nonregular partners during anal sex among Chinese MSM.

摘要

目的

由于无保护肛交,中国男男性行为者(MSM)群体正面临着较高的 HIV 感染率。健康信念模型(HBM)已被证明是一种与行为维持相关的有效框架。基于 HBM,我们分析了 MSM 与固定和非固定性伴侣发生性行为时与坚持使用 condom 相关的信念,以便更好地提供有针对性的干预和服务。

方法

本研究于 2018 年 11 月至 2019 年 4 月在四川省进行,通过滚雪球抽样法招募了 801 名符合条件的参与者。调查了参与者的社会人口统计学特征、艾滋病相关特征、性行为、 condom 使用行为以及 HBM 的各个维度。采用单变量、单多变量和综合多变量模型分析了与坚持 condom 使用相关的因素。

结果

所有参与者中,分别有 39.1%和 53.6%的人在过去 6 个月中与固定和非固定性伴侣发生过肛交。只有 56.5%的人与固定性伴侣坚持使用 condom,只有 60%的人与非固定性伴侣坚持使用 condom。以与固定性伴侣坚持使用 condom 为因变量时,感知威胁(ORM=1.28,95%CI:1.10,1.49)、感知障碍(ORM=0.70,95%CI:0.60,0.82)、自我效能(ORM=1.23,95%CI:1.14,1.32)和行动线索(ORM=1.21,95%CI:1.02,1.43)维度与因变量显著相关。以与非固定性伴侣坚持使用 condom 为因变量时,感知障碍(ORM=0.77,95%CI:0.67,0.89)、自我效能(ORM=1.22,95%CI:1.13,1.32)和行动线索(ORM=1.53,95%CI:1.30,1.80)维度与因变量显著相关。

结论

应更加关注如何减少 condom 使用的障碍因素,如何提高 condom 使用的信心,以及如何布置更多的行动线索,以促进 MSM 与固定和非固定性伴侣发生性行为时坚持使用 condom。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c7f/7539081/46ecb6f8a732/BMRI2020-5807162.001.jpg

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