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Article(id=1241522929561817993, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202310145, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1696867200000, receivedDateStr=2023-10-10, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773931732787, onlineDateStr=2026-03-19, pubDate=1710000000000, pubDateStr=2024-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773931732787, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773931732787, creator=13701087609, updateTime=1773931732787, updator=13701087609, issue=Issue{id=1241522919977841545, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='5', pageStart='769', pageEnd='960', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773931730503, creator=13701087609, updateTime=1773931880386, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241523548695622547, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241523548695622548, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=925, endPage=929, ext={EN=ArticleExt(id=1241522931428283316, articleId=1241522929561817993, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis on the characteristics and influencing factors of commercial sexual behavior among men who have sex with men infected with HIV, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To describe the characteristics of commercial sexual behavior of HIV-infected men who have sex with men (MSM) and analyze its influencing factors.

Methods

An anonymous questionnaire survey was conducted through the recruitment of HIV-infected MSM by two social organizations in Chongqing. The χ2 test was used to compare the commercial sexual behavior of HIV infected with MSM with different social demographic characteristics, mental health status, and sexual behavioral characteristics. Multivariate Logistic regression model was used to analyze the influencing factors of commercial behavior.

Results

A total of 1 501 cases of HIV infection with MSM were investigated in this study. In total 12.50% of the respondents reported same-sex commercial sex in the past six months, of which 28.34% reported unprotected commercial sex behavior. The results of multivariate Logistic regression showed HIV-infected MSM with marital status as marriage/cohabitation (OR=2.345, 95%CI: 1.442-3.814), working status as part-time and others (OR=6.522, 95%CI: 3.575-11.900), monthly income exceeding 5 000 yuan (OR=7.890, 95%CI: 4.254-14.634), age of first sexual intercourse less than 18 years old (OR=1.818,95%CI: 1.014-3.260), using same-sex dating software (using one: OR=2.984, 95%CI: 1.477-6.030; using two: OR=3.683,95%CI: 1.650-8.221; using 3 and above: OR=21.777, 95%CI: 8.349-56.804), drinking (OR=2.528, 95%CI: 1.568-4.074), and using Rush (OR=3.114, 95%CI: 1.988-4.877) were more likely to have commercial sexual behavior (P < 0.05).

Conclusion

The commercial sexual behavior of HIV infection with MSM is common in Chongqing, and the proportion of commercial sexual behavior without condom is high. Comprehensive measures should be taken to intervene the drinking, Rush use, and commercial sexual behavior of this population in order to reduce the further spread of HIV/STIs.

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目的

描述HIV感染男男性行为人群（men who have sex with men, MSM）商业性行为特征，分析其影响因素。

方法

通过重庆地区2个社会组织招募HIV感染MSM进行匿名问卷调查，采用χ2检验对不同社会人口学特征、心理健康状态及行为特征的HIV感染MSM商业性行为情况进行比较，使用多因素logistic回归模型进行商业性行为影响因素分析。

结果

本研究共对1 501例HIV感染MSM进行调查。12.50%的调查对象报告近6个月有同性商业性行为，其中28.34%报告有无保护商业性行为。多因素logistic回归结果显示，婚姻状态为在婚/同居（OR=2.345, 95%CI: 1.442～3.814）、工作状态为兼职及其他（OR=6.522, 95%CI: 3.575～11.900）、月收入>5 000元（OR=7.890, 95%CI: 4.254～14.634）、首次性行为年龄<18岁（OR=1.818, 95%CI: 1.014～3.260）、使用同性交友软件（使用1种：OR=2.984, 95%CI: 1.477～6.030；使用2种：OR=3.683,95%CI: 1.650～8.221；使用3种及以上：OR=21.777, 95%CI: 8.349～56.804）、饮酒（OR=2.528, 95%CI: 1.568～4.074）及使用Rush（OR=3.114, 95%CI: 1.988～4.877）的HIV感染MSM更可能发生商业性行为（P<0.05）。

结论

重庆市HIV感染MSM商业性行为普遍，且商业性行为中未使用安全套比例较高，应采取综合性措施，对该人群饮酒、Rush使用及商业性行为进行干预，以减少HIV、性传播疾病（sexually transmitted infections, STIs）进一步传播。

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陈瑾，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=o1YRVuSYnH8wzaS3w/xaQg==, magXml=/AMBzHjUdS5hfZjkfYmvWQ==, pdfUrl=null, pdf=cICxZa7h17rNu+5Pfa6QsQ==, pdfFileSize=567644, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=3CKQnlvb8n2/k/qSsbqKpw==, mapNumber=null, authorCompany=null, fund=null, authors=

陈怀良（1986—），男，硕士，主管医师，研究方向:传染性疾病预防控制

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陈怀良（1986—），男，硕士，主管医师，研究方向:传染性疾病预防控制

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Drug and Alcohol Dependence, 2016, 168:239-246., articleTitle=Alcohol misuse, risky sexual behaviors, and HIV or syphilis infections among Chinese men who have sex with men, refAbstract=null)], funds=[Fund(id=1241678324745949689, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522929561817993, awardId=2022QNXM052, language=CN, fundingSource=重庆市科学技术委员会/重庆市卫生健康委员会科卫联合项目(2022QNXM052), fundOrder=null, country=null), Fund(id=1241678324959859204, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522929561817993, awardId=2020-49, language=CN, fundingSource=成都市卫生健康委员会医学科研课题(2020-49), fundOrder=null, country=null), Fund(id=1241678325324763657, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522929561817993, awardId=TL2020-51, language=CN, fundingSource=重庆市铜梁区科学技术局项目(TL2020-51), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241678290537205851, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522929561817993, xref=1., ext=[AuthorCompanyExt(id=1241678290545594460, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522929561817993, companyId=1241678290537205851, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=People’s Hospital of Tianfu New District, Chengdu, Sichuan 610213, China), AuthorCompanyExt(id=1241678290549788765, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522929561817993, companyId=1241678290537205851, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.四川天府新区人民医院，四川 成都 610213)]), AuthorCompany(id=1241678292558860387, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522929561817993, xref=2., ext=[AuthorCompanyExt(id=1241678292563054692, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522929561817993, companyId=1241678292558860387, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.重庆市铜梁区人民医院，重庆 402560)])], figs=[ArticleFig(id=1241678321700884930, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522929561817993, language=EN, label=Table 1, caption=

Comparison between commercial sex behaviors and demographic characteristics among HIV-infected MSM in Chongqing ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量调查人数有商业性行为(n=187)无商业性行为(n=1 314)χ2值P值
年龄(岁)
18～25211(14.06)45(24.06)166(12.63)17.817<0.001
26～35718(47.83)81(43.32)637(48.48)
>35572(38.11)61(32.62)511(38.89)
婚姻状态
在婚/同居271(18.05)43(22.99)228(17.35)3.5230.061
未婚/离异/丧偶1 230(81.95)144(77.01)1 086(82.65)
户籍地
本市1 190(79.28)119(63.64)1 071(81.51)31.826<0.001
其他311(20.72)68(36.36)243(18.49)
文化程度
高中及以下340(22.65)68(36.36)272(20.70)22.924<0.001
大专及以上1 161(77.35)119(63.64)1 042(79.30)
工作状态
全职1 176(78.35)101(54.01)1 075(81.81)74.582<0.001
兼职/其他325(21.65)86(45.99)239(18.19)
月收入（元）
≤5 000585(38.97)58(31.02)527(40.11)5.6880.017
>5 000916(61.03)129(68.98)787(59.89)
性取向
同性恋1 224(81.55)118(63.10)1 106(84.17)48.288<0.001
其他277(18.45)69(36.90)208(15.83)
HIV感染(年)
≤1154(10.26)18(9.62)136(10.35)0.2360.889
2～4568(37.84)69(36.90)499(37.98)
≥5779(51.90)100(53.48)679(51.67)
近1年病毒载量(拷贝/ml)
≥1 000及未检测234(15.59)41(21.93)193(14.69)6.5160.011
<1 0001 267(84.41)146(78.07)1 121(85.31)
), ArticleFig(id=1241678321986097606, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522929561817993, language=CN, label=表1, caption=

重庆市HIV感染MSM社会人口学特征与商业性行为情况比较［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量调查人数有商业性行为(n=187)无商业性行为(n=1 314)χ2值P值
年龄(岁)
18～25211(14.06)45(24.06)166(12.63)17.817<0.001
26～35718(47.83)81(43.32)637(48.48)
>35572(38.11)61(32.62)511(38.89)
婚姻状态
在婚/同居271(18.05)43(22.99)228(17.35)3.5230.061
未婚/离异/丧偶1 230(81.95)144(77.01)1 086(82.65)
户籍地
本市1 190(79.28)119(63.64)1 071(81.51)31.826<0.001
其他311(20.72)68(36.36)243(18.49)
文化程度
高中及以下340(22.65)68(36.36)272(20.70)22.924<0.001
大专及以上1 161(77.35)119(63.64)1 042(79.30)
工作状态
全职1 176(78.35)101(54.01)1 075(81.81)74.582<0.001
兼职/其他325(21.65)86(45.99)239(18.19)
月收入（元）
≤5 000585(38.97)58(31.02)527(40.11)5.6880.017
>5 000916(61.03)129(68.98)787(59.89)
性取向
同性恋1 224(81.55)118(63.10)1 106(84.17)48.288<0.001
其他277(18.45)69(36.90)208(15.83)
HIV感染(年)
≤1154(10.26)18(9.62)136(10.35)0.2360.889
2～4568(37.84)69(36.90)499(37.98)
≥5779(51.90)100(53.48)679(51.67)
近1年病毒载量(拷贝/ml)
≥1 000及未检测234(15.59)41(21.93)193(14.69)6.5160.011
<1 0001 267(84.41)146(78.07)1 121(85.31)
), ArticleFig(id=1241678322409722318, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522929561817993, language=EN, label=Table 2, caption=

Comparison between commercial sex behaviors and mental health and behavioral characteristics among HIV-infected MSM in Chongqing [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量调查人数有商业性行为(n=187)无商业性行为(n=1 314)χ2值P值
抑郁
是612(40.77)83(44.39)529(40.26)1.1540.283
否889(59.23)104(55.61)785(59.74)
焦虑
是445(29.65)52(27.81)393(29.91)0.3470.556
否1 056(70.35)135(72.19)921(70.09)
首次性行为年龄(岁)
<18228(15.19)67(35.83)161(12.25)70.632<0.001
≥181 273(84.81)120(64.17)1 153(87.75)
近6个月使用同性交友软件寻找性伴情况
未使用436(29.04)12(6.42)424(32.27)229.597<0.001
使用1种714(47.57)76(40.64)638(48.55)
使用2种255(16.99)43(22.99)212(16.13)
使用3种及以上96(6.40)56(29.95)40(3.05)
近6个月饮酒
是903(60.16)159(85.03)744(56.62)55.111<0.001
否598(39.84)28(14.97)570(43.38)
近6个月Rush使用
是487(32.45)139(74.33)348(26.48)170.990<0.001
否1 014(67.55)48(25.67)966(73.52)
近6个月群交
是139(9.26)55(29.41)84(6.39)103.229<0.001
否1 362(90.74)132(70.59)1 230(93.61)
近6个月有同性固定性伴
是958(63.82)108(57.75)850(64.69)3.4090.065
否543(36.18)79(42.25)464(35.31)
近6个月有同性临时性伴
是930(61.96)161(86.10)769(58.52)52.803<0.001
否571(38.04)26(13.90)545(41.48)
近6个月肛交无套内射
是514(34.24)112(59.89)402(30.59)62.410<0.001
否987(65.76)75(40.11)912(69.41)
), ArticleFig(id=1241678323022090707, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522929561817993, language=CN, label=表2, caption=

重庆市HIV感染MSM心理状态及行为特征与商业性行为情况比较[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量调查人数有商业性行为(n=187)无商业性行为(n=1 314)χ2值P值
抑郁
是612(40.77)83(44.39)529(40.26)1.1540.283
否889(59.23)104(55.61)785(59.74)
焦虑
是445(29.65)52(27.81)393(29.91)0.3470.556
否1 056(70.35)135(72.19)921(70.09)
首次性行为年龄(岁)
<18228(15.19)67(35.83)161(12.25)70.632<0.001
≥181 273(84.81)120(64.17)1 153(87.75)
近6个月使用同性交友软件寻找性伴情况
未使用436(29.04)12(6.42)424(32.27)229.597<0.001
使用1种714(47.57)76(40.64)638(48.55)
使用2种255(16.99)43(22.99)212(16.13)
使用3种及以上96(6.40)56(29.95)40(3.05)
近6个月饮酒
是903(60.16)159(85.03)744(56.62)55.111<0.001
否598(39.84)28(14.97)570(43.38)
近6个月Rush使用
是487(32.45)139(74.33)348(26.48)170.990<0.001
否1 014(67.55)48(25.67)966(73.52)
近6个月群交
是139(9.26)55(29.41)84(6.39)103.229<0.001
否1 362(90.74)132(70.59)1 230(93.61)
近6个月有同性固定性伴
是958(63.82)108(57.75)850(64.69)3.4090.065
否543(36.18)79(42.25)464(35.31)
近6个月有同性临时性伴
是930(61.96)161(86.10)769(58.52)52.803<0.001
否571(38.04)26(13.90)545(41.48)
近6个月肛交无套内射
是514(34.24)112(59.89)402(30.59)62.410<0.001
否987(65.76)75(40.11)912(69.41)
), ArticleFig(id=1241678323307303385, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522929561817993, language=EN, label=Table 3, caption=

Multivariate logistic regression analysis on commercial sex behaviors among HIV-infected MSM in Chongqing

, figureFileSmall=null, figureFileBig=null, tableContent=
变量β Walds χ2值OR值（95%CI）P值
年龄(岁)
18～251.000
26～350.0260.3780.0051.026(0.489～2.154)0.946
>350.1820.4320.1781.200(0.515～2.797)0.673
婚姻状态
未婚/离异/丧偶1.000
在婚/同居0.8520.24811.7902.345(1.442～3.814)0.001
户籍地
本市1.000
其他0.3870.2262.9401.472(0.946～2.291)0.086
文化程度
高中及以下1.000
大专及以上-0.2950.2541.3570.744(0.453～1.223)0.244
工作状态
全职1.000
兼职/其他1.8750.30737.3626.522(3.575～11.900)<0.001
月收入（元）
≤5 0001.000
>5 0002.0660.31542.9577.890(4.254～14.634)<0.001
性取向
同性恋1.000
其他0.4480.2433.3941.564(0.972～2.518)0.065
近1年病毒载量(拷贝/ml)
<1 0001.000
≥1 000及未检测-0.3760.2931.6440.687(0.387～1.220)0.200
首次性行为年龄(岁)
≥181.000
<180.5980.2984.0211.818(1.014～3.260)0.045
近6个月使用同性交友软件寻找性伴情况
未使用1.000
使用1种1.0930.3599.2752.984(1.477～6.030)0.002
使用2种1.3040.41010.1263.683(1.650～8.221)0.001
使用3种及以上3.0810.48939.66621.777(8.349～56.804)<0.001
近6个月饮酒
否1.000
是0.9270.24414.4952.528(1.568～4.074)<0.001
近6个月Rush使用
否1.000
是1.1360.22924.6063.114(1.988～4.877)<0.001
近6个月群交
否1.000
是0.2180.2990.5351.244(0.693～2.234)0.465
近6个月肛交无套内射
否1.000
是0.2140.2260.8931.238(0.795～1.929)0.345
近6个月有同性固定性伴
否1.000
是0.1920.2470.5991.211(0.746～1.967)0.439
近6个月有同性临时性伴
否1.000
是0.3120.2951.1131.366(0.765～2.436)0.291
), ArticleFig(id=1241678323814814178, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522929561817993, language=CN, label=表3, caption=

重庆市HIV感染MSM商业性行为的多因素logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量β Walds χ2值OR值（95%CI）P值
年龄(岁)
18～251.000
26～350.0260.3780.0051.026(0.489～2.154)0.946
>350.1820.4320.1781.200(0.515～2.797)0.673
婚姻状态
未婚/离异/丧偶1.000
在婚/同居0.8520.24811.7902.345(1.442～3.814)0.001
户籍地
本市1.000
其他0.3870.2262.9401.472(0.946～2.291)0.086
文化程度
高中及以下1.000
大专及以上-0.2950.2541.3570.744(0.453～1.223)0.244
工作状态
全职1.000
兼职/其他1.8750.30737.3626.522(3.575～11.900)<0.001
月收入（元）
≤5 0001.000
>5 0002.0660.31542.9577.890(4.254～14.634)<0.001
性取向
同性恋1.000
其他0.4480.2433.3941.564(0.972～2.518)0.065
近1年病毒载量(拷贝/ml)
<1 0001.000
≥1 000及未检测-0.3760.2931.6440.687(0.387～1.220)0.200
首次性行为年龄(岁)
≥181.000
<180.5980.2984.0211.818(1.014～3.260)0.045
近6个月使用同性交友软件寻找性伴情况
未使用1.000
使用1种1.0930.3599.2752.984(1.477～6.030)0.002
使用2种1.3040.41010.1263.683(1.650～8.221)0.001
使用3种及以上3.0810.48939.66621.777(8.349～56.804)<0.001
近6个月饮酒
否1.000
是0.9270.24414.4952.528(1.568～4.074)<0.001
近6个月Rush使用
否1.000
是1.1360.22924.6063.114(1.988～4.877)<0.001
近6个月群交
否1.000
是0.2180.2990.5351.244(0.693～2.234)0.465
近6个月肛交无套内射
否1.000
是0.2140.2260.8931.238(0.795～1.929)0.345
近6个月有同性固定性伴
否1.000
是0.1920.2470.5991.211(0.746～1.967)0.439
近6个月有同性临时性伴
否1.000
是0.3120.2951.1131.366(0.765～2.436)0.291
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HIV感染男男性行为人群商业性行为特征及影响因素分析
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陈怀良 1 , 石波 1 , 江灿 1 , 马萍 1 , 高春梅 1 , 陈瑾 2
现代预防医学 | 疾病预防控制 2024,51(5): 925-929
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现代预防医学 | 疾病预防控制 2024, 51(5): 925-929
HIV感染男男性行为人群商业性行为特征及影响因素分析
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陈怀良1, 石波1, 江灿1, 马萍1, 高春梅1, 陈瑾2
作者信息
  • 1.四川天府新区人民医院，四川 成都 610213
  • 2.重庆市铜梁区人民医院，重庆 402560

    • 陈怀良（1986—），男，硕士，主管医师，研究方向:传染性疾病预防控制

通讯作者:

陈瑾，E-mail:
Analysis on the characteristics and influencing factors of commercial sexual behavior among men who have sex with men infected with HIV
Huai-liang CHEN1, Bo SHI1, Can JIANG1, Ping MA1, Chun-mei GAO1, Jin CHEN2
Affiliations
  • People’s Hospital of Tianfu New District, Chengdu, Sichuan 610213, China
出版时间: 2024-03-10 doi: 10.20043/j.cnki.MPM.202310145
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摘要
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目的

描述HIV感染男男性行为人群（men who have sex with men, MSM）商业性行为特征，分析其影响因素。

方法

通过重庆地区2个社会组织招募HIV感染MSM进行匿名问卷调查，采用χ2检验对不同社会人口学特征、心理健康状态及行为特征的HIV感染MSM商业性行为情况进行比较，使用多因素logistic回归模型进行商业性行为影响因素分析。

结果

本研究共对1 501例HIV感染MSM进行调查。12.50%的调查对象报告近6个月有同性商业性行为，其中28.34%报告有无保护商业性行为。多因素logistic回归结果显示，婚姻状态为在婚/同居（OR=2.345, 95%CI: 1.442～3.814）、工作状态为兼职及其他（OR=6.522, 95%CI: 3.575～11.900）、月收入>5 000元（OR=7.890, 95%CI: 4.254～14.634）、首次性行为年龄<18岁（OR=1.818, 95%CI: 1.014～3.260）、使用同性交友软件（使用1种：OR=2.984, 95%CI: 1.477～6.030；使用2种：OR=3.683,95%CI: 1.650～8.221；使用3种及以上：OR=21.777, 95%CI: 8.349～56.804）、饮酒（OR=2.528, 95%CI: 1.568～4.074）及使用Rush（OR=3.114, 95%CI: 1.988～4.877）的HIV感染MSM更可能发生商业性行为（P<0.05）。

结论

重庆市HIV感染MSM商业性行为普遍，且商业性行为中未使用安全套比例较高，应采取综合性措施，对该人群饮酒、Rush使用及商业性行为进行干预，以减少HIV、性传播疾病（sexually transmitted infections, STIs）进一步传播。

男男性行为人群  /  商业性行为  /  HIV感染  /  影响因素
Objective

To describe the characteristics of commercial sexual behavior of HIV-infected men who have sex with men (MSM) and analyze its influencing factors.

Methods

An anonymous questionnaire survey was conducted through the recruitment of HIV-infected MSM by two social organizations in Chongqing. The χ2 test was used to compare the commercial sexual behavior of HIV infected with MSM with different social demographic characteristics, mental health status, and sexual behavioral characteristics. Multivariate Logistic regression model was used to analyze the influencing factors of commercial behavior.

Results

A total of 1 501 cases of HIV infection with MSM were investigated in this study. In total 12.50% of the respondents reported same-sex commercial sex in the past six months, of which 28.34% reported unprotected commercial sex behavior. The results of multivariate Logistic regression showed HIV-infected MSM with marital status as marriage/cohabitation (OR=2.345, 95%CI: 1.442-3.814), working status as part-time and others (OR=6.522, 95%CI: 3.575-11.900), monthly income exceeding 5 000 yuan (OR=7.890, 95%CI: 4.254-14.634), age of first sexual intercourse less than 18 years old (OR=1.818,95%CI: 1.014-3.260), using same-sex dating software (using one: OR=2.984, 95%CI: 1.477-6.030; using two: OR=3.683,95%CI: 1.650-8.221; using 3 and above: OR=21.777, 95%CI: 8.349-56.804), drinking (OR=2.528, 95%CI: 1.568-4.074), and using Rush (OR=3.114, 95%CI: 1.988-4.877) were more likely to have commercial sexual behavior (P < 0.05).

Conclusion

The commercial sexual behavior of HIV infection with MSM is common in Chongqing, and the proportion of commercial sexual behavior without condom is high. Comprehensive measures should be taken to intervene the drinking, Rush use, and commercial sexual behavior of this population in order to reduce the further spread of HIV/STIs.

Men who have sex with men  /  Commercial sex  /  HIV infection  /  Influencing factors
陈怀良, 石波, 江灿, 马萍, 高春梅, 陈瑾. HIV感染男男性行为人群商业性行为特征及影响因素分析. 现代预防医学, 2024 , 51 (5) : 925 -929 . DOI: 10.20043/j.cnki.MPM.202310145
Huai-liang CHEN, Bo SHI, Can JIANG, Ping MA, Chun-mei GAO, Jin CHEN. Analysis on the characteristics and influencing factors of commercial sexual behavior among men who have sex with men infected with HIV[J]. Modern Preventive Medicine, 2024 , 51 (5) : 925 -929 . DOI: 10.20043/j.cnki.MPM.202310145
正文
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一项对全国59个城市355项横断面研究进行的系统综述估计[1]，2001—2018年全国男男性行为人群（men who have sex with men, MSM）HIV总感染率为5.7%，且感染率呈逐年递增的趋势。相关研究发现[2-4]，部分MSM存在商业性行为，有商业性行为的MSM性伴更多，更可能发生酒精/药物滥用及无保护性行为，因此，该人群HIV及其他性传播疾病（sexually transmitted infections, STIs）感染率显著高于普通MSM[4]。
调查显示[1,5]，重庆市MSM性行为活跃，且HIV及梅毒等其他STIs感染水平居全国前列。作为普通MSM HIV感染的主要传染源，HIV感染MSM参与商业性行为可能导致HIV/STIs迅速扩散，将对HIV/STIs防控形成严重挑战。目前，国内鲜有HIV感染MSM同性商业性行为相关文献报道。本研究通过对重庆地区HIV感染MSM商业性行为现状进行调查，分析其影响因素，有利于制定针对性的干预策略和措施，从而降低HIV/STIs传播风险。
1　对象与方法
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1.1　研究对象
通过重庆地区2个社会组织招募HIV感染MSM参与本研究。研究对象须年满18周岁、确证HIV感染≥6个月、近12个月与男性发生过口交或肛交性行为，且愿意参加问卷调查。研究方案通过了四川天府新区人民医院伦理委员会（编号：2020-002）及重庆市铜梁区人民医院伦理委员会（编号：2021-20）审查。
1.2　调查方法
2022年6月—2023年6月，社会组织在知情同意的原则下招募HIV感染MSM参与本研究。HIV感染MSM到社会组织寻求关怀、检测服务及领取抗病毒治疗药物时，工作人员向潜在研究对象介绍本研究的目的、意义及内容，愿意参与本研究的MSM在签订知情同意书后，通过问卷星完成自填式匿名问卷调查。问卷收集调查对象的社会人口学特征、性取向、HIV感染年限、饮酒、物质使用、寻找性伴途径、性行为、安全套使用及心理健康状态（焦虑和抑郁）等内容。本文中商业性行为定义为近6个月以获取或付出金钱、药品或其他物质利益为目的与其他男性发生性行为。
使用患者健康问卷抑郁量表（patient health questionnaire-9, PHQ-9）进行抑郁状况筛查，该量表评分范围为0～27分，评分>4分为抑郁症状阳性[6]。采用广泛性焦虑障碍量表（generalized anxiety disorder screener-7, GAD-7）进行焦虑状况筛查，该量表评分范围为0～21分，评分>4分为焦虑症状阳性[7]。
1.3　统计学分析
从问卷星导出调查问卷数据库，使用Excel 2007进行数据整理，采用SPSS 19.0进行数据分析。不同社会人口学特征、HIV感染年限、心理健康状态及行为特征的HIV感染MSM商业性行为比较采用χ2检验。将χ2检验中P<0.10的变量纳入二分类多因素logistic回归分析HIV感染MSM商业性行为的影响因素，检验水准α=0.05。
2　结果
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2.1　基本情况
本研究共对1 501名HIV感染MSM完成问卷调查，平均年龄（34.00±8.57）岁。研究对象中，25岁以上者占85.94%，未婚/离异/丧偶者占81.95%，重庆户籍者占79.28%，大专及以上文化程度者占77.35%，月收入≥5 000元者占61.03%，同性性取向者占81.55%，HIV感染时间>1年者占89.74%，病毒载量<1 000拷贝/ml者占84.41%。12.50%的调查对象报告近6个月有同性商业性行为，有商业性行为的调查对象中，28.34%（53/187）报告近6个月发生过无保护商业性行为。调查对象近6个月同性商业性行为情况在年龄、户籍地、文化程度、工作状态、月收入、性取向及病毒载量结果等方面差异存在统计学意义（P<0.05）。见表1。
2.2　心理状态及行为情况
1 501名HIV感染MSM中，40.77%有抑郁症状，29.65%有焦虑症状，15.19%报告首次性行为年龄<18岁，70.96%报告近6个月使用同性交友软件寻找性伴，60.16%报告近6个月饮酒，32.45%报告近6个月使用Rush，9.26%报告近6个月参与群交，63.82%报告近6个月有同性固定性伴，61.96%报告近6个月有同性临时性伴，34.24%报告近6个月肛交有无套内射。调查对象近6个月商业性行为情况在首次性行为年龄、使用同性交友软件寻找性伴、饮酒、Rush使用、群交、同性临时性伴及肛交无套内射等方面的差异存在统计学意义（P<0.05）。见表2。
2.3　HIV感染MSM商业性行为的多因素分析
以HIV感染MSM近6个月是否发生商业性行为为应变量，以χ2检验中P<0.10的变量为自变量进行多因素logistic回归分析。结果显示，婚姻状态为在婚/同居、工作状态为兼职及其他、月收入>5 000元、首次性行为年龄<18岁、使用同性交友软件、饮酒及使用Rush的HIV感染MSM更可能发生商业性行为（P<0.05）。见表3。
3　讨论
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目前，国内有部分研究对普通MSM商业性行为情况进行了调查，MSM商业性行为比例在5.8%～24.3%之间[8-9]，而HIV感染MSM商业性行为情况鲜有文献报道。本次调查发现，重庆市HIV感染MSM近6个月同性商业性行为比例为12.50%，有商业性行为的调查对象在发生商业性行为时未坚持使用安全套比例超过四分之一。MSM中HPV及梅毒等其他性传播疾病感染水平较高[5,10]，应对该人群商业性行为进行干预，以降低HIV/STIs传播风险。
多因素logistic回归结果显示，婚姻状态为已婚或同居、工作状态为兼职/其他及月收入>5 000元的HIV感染MSM发生商业性行为可能更高，这与既往研究结果一致[3,8,11]。MSM渴望与男性发生性关系，已婚或同居状态的MSM难以与男性保持长期稳定的性关系而不暴露自身性取向，因此，该人群更可能通过商业性行为的方式获取同性性服务[12]。重庆市流动人口较多，部分MSM可能因为没有稳定的全职工作，而通过从事商业性行为维持生活[11]。此外，研究发现[9]，国内男男商业性服务价格较高，与收入较低的MSM相比，收入较高的调查对象更能负担商业性行为相关支出，因此，其发生商业性行为比例更高。
本次调查发现，15.19%的对象首次性行为年龄<18岁，相关研究表明[13]，MSM首次性行为对其未来性行为轨迹影响较大，首次性行为年龄较早的MSM性感觉寻求水平更高，该人群更愿意参加冒险、刺激和新奇的活动，因此，不难理解其商业性行为比例更高。此外，本研究发现，超过三分之二的HIV感染MSM报告近6个月使用同性交友软件，约四分之一的调查对象近6个月至少使用2种及以上同性交友软件，与不使用同性交友软件的MSM比较，使用同性交友软件更多的MSM发生商业性行为可能性更大。国内MSM中流行的同性交友软件主要为Blued[14]，以此为代表的同性交友软件用户数量较大，且隐蔽性强、操作简单，使用者可通过软件快速定位附近的同伴，继而为HIV感染MSM寻找商业性伴提供了便利条件。
本研究还发现，饮酒及Rush使用是HIV感染MSM发生商业性行为的危险因素，这与既往研究结果一致[2-4]。相关研究表明[15-16]，由于HIV感染MSM面临HIV感染和男男性取向的双重歧视和污名化，该人群常通过饮酒和药物使用来应对相关不良情绪，但饮酒使用会降低人的风险意识和自控能力，而药物使用可能诱发性冲动[17]，因此，MSM更可能在酒后或药物使用后发生商业性行为。另外，有研究发现饮酒及Rush使用还可导致无保护性行为，从而可能进一步增加HIV传播风险[18]。
综上所述，重庆市HIV感染MSM近6个月商业性行为情况普遍，且有相当比例的对象在商业性行为中未使用安全套。由于MSM中其他性传播疾病感染水平较高，该人群商业性行为可能导致HIV/STIs进一步传播。同时，因已婚或同居的HIV感染MSM商业性行为比例更高，还应重视该人群作为桥梁人群，将HIV/STIs传播给其异性性伴。此外，饮酒及药物使用是HIV感染MSM发生商业性行为的促进因素，且可能导致无保护性行为，因此，应采取综合性干预措施对HIV感染MSM饮酒、Rush使用及商业性行为进行干预。
由于HIV感染MSM隐蔽性较强，本研究通过非概率抽样的方法招募研究对象参与问卷调查，因此可能存在选择性偏倚，存在一定的局限性。
基金
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  • 重庆市科学技术委员会/重庆市卫生健康委员会科卫联合项目(2022QNXM052)
  • 成都市卫生健康委员会医学科研课题(2020-49)
  • 重庆市铜梁区科学技术局项目(TL2020-51)
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参考文献 引证文献
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2024年第51卷第5期
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doi: 10.20043/j.cnki.MPM.202310145
  • 接收时间：2023-10-10
  • 首发时间：2026-03-19
  • 出版时间：2024-03-10
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  • 收稿日期：2023-10-10
基金
重庆市科学技术委员会/重庆市卫生健康委员会科卫联合项目(2022QNXM052)
成都市卫生健康委员会医学科研课题(2020-49)
重庆市铜梁区科学技术局项目(TL2020-51)
作者信息
    1.四川天府新区人民医院，四川 成都 610213
    2.重庆市铜梁区人民医院，重庆 402560

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陈瑾，E-mail:
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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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