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目的了解男男性行为人群(MSM)艾滋病防治中同伴教育覆盖现状及其影响因素。方法 2014年4—10月,以绵阳市辖区9县(市、区)MSM为对象,在固定场所在知情同意下应用滚雪球抽样法,进行调查对象招募和自填式匿名行为学调查和血清学检测。结果共调查1 097人,年龄中位数为23岁,高中、中专及以下文化程度569人(51.9%),未婚906人(82.6%)。近1年接受过同伴教育覆盖率为72.6%(796/1 097),HIV阳性率为3.8%(42/1 097),梅毒阳性率为5.9%(41/733)。近1年接受、未接受过同伴教育HIV感染率分别为2.4%(19/796)、7.6%(23/301),两者差异具有统计学意义(P<0.01);梅毒感染率分别为5.2%(29/554)、6.7%(12/179),差异无统计学意义(P>0.05)。非条件logistic回归分析结果显示,调查对象接受同伴教育的可能性:户籍为本市其他县区、本省其他地区分别是本县区的0.390和0.420倍,认识当地MSM朋友数>10人是≤10人的4.591倍,寻找性伴范围为本市其他县区/省内其他地区是本县区的2.719倍,找性伴途径通过网络的是其他的0.510倍,近1周肛交次数≥2次是≤1次的2.280倍,近6月肛交有采取保护性措施是无保护者的4.228倍,HIV检测结果阳性是HIV阴性的0.186倍。结论 MSM同伴教育覆盖率地区间不平衡,整体水平有待进一步提高。同伴教育有效促进了安全性行为,降低了HIV感染风险,应巩固加强。
Objective To understand the current situation and influential factors of peer education in HIV / AIDS prevention and treatment of men who have sex with men (MSM). Methods From April to October 2014, MSM in 9 counties (cities and districts) of Mianyang City was used as the target. The snowball sampling method was used in the fixed place with informed consent to investigate the recruitment and self-signed anonymous behavioral investigation and serology Detection. Results A total of 1 097 people were surveyed, with a median age of 23 years. There were 569 (51.9%) and 906 (82.6%) unmarried students with a high school education or below. In the past year, peer education coverage rate was 72.6% (796/1 097), HIV positive rate was 3.8% (42/1 097) and syphilis positive rate was 5.9% (41/733). The prevalence of HIV infection among those who received peer education in the past year was 2.4% (19/796) and 7.6% (23/301) respectively, with a statistically significant difference (P <0.01). The prevalence of syphilis was 5.2 % (29/554), 6.7% (12/179), the difference was not statistically significant (P> 0.05). The results of unconditional logistic regression analysis showed that the respondents were likely to receive peer education: the household registration was other counties in the municipality, 0.390 and 0.420 times in the rest of the province respectively, and the number of acquaintances with MSM> 10 were ≤10 People 4.591 times, looking for sexual partners range for the county other county / other parts of the province is 2.719 times the county to find partner routes through the network is the other 0.510 times, 1 week anal sex times ≥ 2 times is ≤1 times 2.280 times, nearly 6 months of anal sex to take protective measures are 4.228 times those without protection, HIV test results were HIV-negative 0.186 times. Conclusion The coverage of MSM peer education is uneven among regions, and the overall level needs to be further improved. Peer education effectively promotes safe sex behavior, reduces the risk of HIV infection and should be consolidated and strengthened.