School of Public Health and Management, Research Center for Medicine and Social Development, Chongqing Medical University.
School of Medical Informatics, Chongqing Medical University.
Environ Health Prev Med. 2022;27:21. doi: 10.1265/ehpm.22-00066.
Men who have sex with men (MSM), as a marginal population, has been largely ignored by health service projects. We assessed the utilization of HIV testing and counselling services and its influencing factors based on Andersen's Behavioral Model, so as to provide a theoretical basis for future infectious disease prevention and control strategies and health services policy formulation for these population.
This was a cross-sectional study. A sample survey was conducted in Western China, and an anonymous self-administered questionnaire survey was conducted among MSM. Based on Andersen's Behavioral Model, the questionnaire divided the influencing factors into predisposing factor, enabling factor and need factor. Multivariate logistic regression analysis was used to explore the factors influencing the utilization of HIV testing and counselling.
There were 3184 valid questionnaires. In the survey of HIV health services, 82.85% MSM had HIV testing and 64.98% MSM had HIV counselling, respectively. Among the predisposing factor, age 25 years old and over was a facilitator of HIV testing and counselling, and ethnicity was a factor associated with HIV testing. Among the enabling factor, MSM living in urban were more likely to have access to testing and counselling services, and income was also linked to HIV testing. Among the need factor, a high level of HIV knowledge could promote testing and counselling, and a history of sexually transmitted diseases (STD) was a facilitator of testing.
HIV testing is widespread in Western China and higher than counselling service. MSM with high-risk characteristics should be identified as a priority in the future public health services.
男男性行为者（MSM）作为边缘人群，在很大程度上被卫生服务项目所忽视。本研究基于安德森行为模型评估了 HIV 检测和咨询服务的利用情况及其影响因素，以期为今后针对该人群的传染病防控策略和卫生服务政策制定提供理论依据。
本研究采用横断面调查方法，在中国西部进行了抽样调查，对 MSM 进行了匿名自填式问卷调查。基于安德森行为模型，问卷将影响因素分为倾向因素、促成因素和需求因素。采用多因素 logistic 回归分析探讨 HIV 检测和咨询服务利用的影响因素。
共回收有效问卷 3184 份。在 HIV 卫生服务调查中，82.85%的 MSM 接受过 HIV 检测，64.98%的 MSM 接受过 HIV 咨询。在倾向因素中，25 岁及以上年龄是 HIV 检测和咨询的促进因素，民族是 HIV 检测的影响因素。在促成因素中，城市居住的 MSM 更有可能获得检测和咨询服务，收入也与 HIV 检测有关。在需求因素中，较高的 HIV 知识水平可以促进检测和咨询，性传播疾病（STD）史是检测的促进因素。
在中国西部，HIV 检测较为普及，咨询服务相对较少。未来公共卫生服务应优先关注具有高危特征的 MSM。
