Article(id=1324051103578456949, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050876230415089, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202512508, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1766851200000, receivedDateStr=2025-12-28, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793607982773, onlineDateStr=2026-11-02, pubDate=1781020800000, pubDateStr=2026-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793607982773, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793607982773, creator=13701087609, updateTime=1793607982773, updator=13701087609, issue=Issue{id=1324050876230415089, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='11', pageStart='1921', pageEnd='2112', issueExtLink='null', onlineDate='null', pubDate='1781020800000', pubDateStr='2026-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793607928569, creator='13701087609', updateTime=1793670049253, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311429322507008, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050876230415089, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311429322507009, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050876230415089, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1921, endPage=1928, ext={EN=ArticleExt(id=1324051104400540534, articleId=1324051103578456949, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Associations of adverse childhood experiences and adult intimate partner violence with Rush use among MSM, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

This study aims to analyze the independent, synergistic and interactive effects of adverse childhood experiences (ACE) and intimate partner violence (IPV) on alkyl nitrite inhalant (Rush) use among men who have sex with men (MSM).

Methods

A cross-sectional survey was conducted from 2023 to 2024 across three sites in China (Chengdu, Guangzhou, Hohhot) among HIV-negative MSM who had ever had a male intimate partner. An anonymous online questionnaire collected data on sociodemographic factors, ACE, IPV, Rush use, and sexual behaviors. Locally validated instruments were used to measure ACE and IPV. Rush use was defined as use in the past six months. The odds ratio (OR) was calculated using binary logistic regression.

Results

A total of 441 participants were included. The prevalence of Rush use in the past six months was 30.6%. The exposure rates for ACE and IPV were 68.9% and 23.6%, respectively. After adjusting for partial covariates, experiencing any ACE was positively associated with Rush use (OR=2.237, 95% CI: 1.375-3.640). For each additional category of ACE experienced, the strength of association increased by 33.9% (95% CI: 1.195-1.500). Experiencing any IPV was also positively associated with Rush use (OR=2.093, 95% CI: 1.317-3.325). The co-occurrence of ACE and IPV showed a trend toward higher Rush use risk compared with single exposure (P>0.05), but interaction analysis revealed no statistically significant interaction effect between ACE and IPV (interaction P>0.05).

Conclusion

The high prevalence of Rush use is a significant public health concern among MSM in China. Both ACE and IPV are significantly associated with Rush use in this population, and their co-occurrence demonstrates an additive effect trend. It is recommended to strengthen integrated screening for both ACE and IPV for early identification of substance use and related sexual transmission risks and timely intervention among MSM.

, authors=Abuduwayiti Refukaitijiang1, Hao LIN1, Ya-wei GUO2, Meng-ting LIU2, Feng-su HOU3, Ying WANG4, Jing-hua LI5, Wang-nan CAO1, authorsList=Abuduwayiti Refukaitijiang, Hao LIN, Ya-wei GUO, Meng-ting LIU, Feng-su HOU, Ying WANG, Jing-hua LI, Wang-nan CAO, authorCompany=null, correspAuthors=Wang-nan CAO, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324051108938777468, articleId=1324051103578456949, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=童年不良经历与成年亲密伴侣暴力与男男性行为人群Rush使用的关联分析, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

分析童年不良经历(adverse childhood experiences,ACE)与亲密伴侣暴力(intimate partner violence,IPV)对男男性行为人群(men who have sex with men,MSM)亚硝酸酯类吸入剂(Rush)使用的独立、协同和交互效应。

方法

于2023—2024年,在成都、广州、呼和浩特三中心开展横断面调查,面向无人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染且有过男性亲密伴侣的MSM,基于在线匿名平台开展问卷调查,调查内容包括社会人口学因素、ACE、IPV、Rush使用、性行为特征等,ACE和IPV测量均使用经过本土化验证的工具,Rush使用定义为近6个月有无使用。以二分类logistic回归计算比值比。

结果

共纳入441人,过去六个月的Rush使用率为30.6%,ACE和IPV暴露率分别为68.9%和23.6%。控制部分协变量后,经历任意一种ACE与Rush使用存在正向统计学关联(OR=2.237, 95% CI:1.375~3.640),经历ACE类别每增加1种,关联强度上升33.9%(95% CI:1.195~1.500);经历任意一种IPV与Rush使用呈正向统计学关联(OR=2.093, 95% CI:1.317~3.325)。ACE与IPV共存时存在Rush使用风险高于单一暴露趋势(P>0.05),但交互作用分析显示二者无统计学交互效应(交互P>0.05)。

结论

Rush使用流行率高是我国MSM重要的公共卫生问题,ACE和IPV均与我国MSM Rush使用显著相关,且两者并存时存在效应相加趋势;建议加强ACE和IPV双重创伤联合筛查,以及早识别并干预该人群的药物使用及相关性传播风险。

, authors=热甫凯提江·阿不都瓦依提1, 林浩1, 郭雅伟2, 刘梦婷2, 侯丰苏3, 王英4, 李菁华5, 曹望楠1, authorsList=热甫凯提江·阿不都瓦依提, 林浩, 郭雅伟, 刘梦婷, 侯丰苏, 王英, 李菁华, 曹望楠, authorCompany=null, correspAuthors=曹望楠, authorNote=

热甫凯提江·阿不都瓦依提(2001—),男,硕士在读,研究方向:弱势人群健康促进

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曹望楠,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=AlkcdwqARCAvkunMDW7YAA==, magXml=tMtMg3qE/tjD6folF8/m3g==, pdfUrl=null, pdf=mP0lZTeEL/UOH+w6icbgTA==, pdfFileSize=1001799, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=h9YaoxRoD4oghXjlQcD41A==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=HkhIsadm+4/9Z8VXVdJ8hg==, mapNumber=null, fund=null)}, authors=[Author(id=1324051113116304265, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1324051113510568843, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, authorId=1324051113116304265, language=EN, stringName=Abuduwayiti Refukaitijiang, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, address=Department of Social Medicine & Health Education, School of Public Health, Peking University, Beijing 100191, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1324051113636397964, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, authorId=1324051113116304265, language=CN, stringName=热甫凯提江·阿不都瓦依提, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, address=1.北京大学公共卫生学院社会医学与健康教育系,北京 100191, bio={"content":"

热甫凯提江·阿不都瓦依提(2001—),男,硕士在读,研究方向:弱势人群健康促进

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JMIR Formative Research, 2024, 8: e56606., articleTitle=Assessing the effectiveness of an mHealth intervention to support men who have sex with men engaging in chemsex (Budd): Single-Case and Pre-Post experimental design study, refAbstract=null)], funds=[Fund(id=1324051134628889541, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, awardId=82504531, language=CN, fundingSource=国家自然科学基金(82504531), fundOrder=null, country=null), Fund(id=1324051134695998406, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, awardId=SRG2025-00031-FHS, language=CN, fundingSource=Start-up Research Grant of the University of Macau(SRG2025-00031-FHS), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324051110310314877, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, xref=1., ext=[AuthorCompanyExt(id=1324051110587138942, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, companyId=1324051110310314877, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Social Medicine & Health Education, School of Public Health, Peking University, Beijing 100191, China), AuthorCompanyExt(id=1324051110595527551, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, companyId=1324051110310314877, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.北京大学公共卫生学院社会医学与健康教育系,北京 100191)]), AuthorCompany(id=1324051111027540864, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, xref=2., ext=[AuthorCompanyExt(id=1324051111048512385, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, companyId=1324051111027540864, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.中山大学公共卫生学院)]), AuthorCompany(id=1324051111409222530, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, xref=3., ext=[AuthorCompanyExt(id=1324051111430194051, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, companyId=1324051111409222530, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.深圳大学医学部公共卫生学院)]), AuthorCompany(id=1324051111908344708, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, xref=4., ext=[AuthorCompanyExt(id=1324051111933510533, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, companyId=1324051111908344708, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4.上海交通大学公共卫生学院)]), AuthorCompany(id=1324051112260666246, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, xref=5., ext=[AuthorCompanyExt(id=1324051112269054855, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, companyId=1324051112260666246, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=5.澳门大学健康科学学院)])], figs=[ArticleFig(id=1324051130329727928, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, language=EN, label=Figure 1, caption=Exposure rate of childhood adverse experiences based on specific items in the study subjects, figureFileSmall=3ndghvUR+E3KoA3kgalJMg==, figureFileBig=h9YaoxRoD4oghXjlQcD41A==, tableContent=null), ArticleFig(id=1324051130472334265, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, language=CN, label=图1, caption=研究对象基于具体条目的ACE暴露率, figureFileSmall=3ndghvUR+E3KoA3kgalJMg==, figureFileBig=h9YaoxRoD4oghXjlQcD41A==, tableContent=null), ArticleFig(id=1324051131168588730, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, language=EN, label=Table 1, caption=

Basic characteristics of study subjects

, figureFileSmall=null, figureFileBig=null, tableContent=
变量频数构成比(%)
区域
成都21348.3
广州14833.6
呼和浩特8018.1
年龄(岁)
18~2412528.3
25~2911526.1
30~349321.1
≥3510824.5
受教育程度
初中及以下7617.2
高中/中专/大专11024.9
本科20646.7
研究生4911.1
婚姻状况
未婚38787.8
已婚357.9
离异194.3
工作状况
全职29166.0
学生7817.7
兼职/待业/失业/退休等7216.3
个人平均月收入(元)
0~2 9999421.3
3 000~5 99916036.3
6 000~8 99911325.6
≥9 0007416.8
自我报告的性取向
同性恋39589.6
双性恋/异性恋/不确定4610.4
), ArticleFig(id=1324051131248280507, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, language=CN, label=表1, caption=

研究对象基本特征

, figureFileSmall=null, figureFileBig=null, tableContent=
变量频数构成比(%)
区域
成都21348.3
广州14833.6
呼和浩特8018.1
年龄(岁)
18~2412528.3
25~2911526.1
30~349321.1
≥3510824.5
受教育程度
初中及以下7617.2
高中/中专/大专11024.9
本科20646.7
研究生4911.1
婚姻状况
未婚38787.8
已婚357.9
离异194.3
工作状况
全职29166.0
学生7817.7
兼职/待业/失业/退休等7216.3
个人平均月收入(元)
0~2 9999421.3
3 000~5 99916036.3
6 000~8 99911325.6
≥9 0007416.8
自我报告的性取向
同性恋39589.6
双性恋/异性恋/不确定4610.4
), ArticleFig(id=1324051131793540028, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, language=EN, label=Table 2, caption=

Current status of adverse childhood experiences and intimate partner violence among study subjects

, figureFileSmall=null, figureFileBig=null, tableContent=
变量频数百分比(%)
遭受ACE
遭受ACE不同种类
同伴欺凌21749.2
家庭暴力20245.8
情感虐待19844.9
身体虐待15835.8
性虐待13731.1
家人物质滥用204.5
以上任意一种ACE30468.9
遭受ACE种类数(种)
013731.1
1~211125.2
3~412628.6
5~66715.2
遭受成年IPV
遭受成年IPV不同种类
辱骂5111.6
心理暴力4610.4
性暴力214.8
控制204.5
身体暴力143.2
任意一种IPV10423.6
遭受成年IPV种类数(种)
033776.4
16715.2
≥2378.4
), ArticleFig(id=1324051133420929982, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, language=CN, label=表2, caption=

研究对象遭受ACE和IPV现状

, figureFileSmall=null, figureFileBig=null, tableContent=
变量频数百分比(%)
遭受ACE
遭受ACE不同种类
同伴欺凌21749.2
家庭暴力20245.8
情感虐待19844.9
身体虐待15835.8
性虐待13731.1
家人物质滥用204.5
以上任意一种ACE30468.9
遭受ACE种类数(种)
013731.1
1~211125.2
3~412628.6
5~66715.2
遭受成年IPV
遭受成年IPV不同种类
辱骂5111.6
心理暴力4610.4
性暴力214.8
控制204.5
身体暴力143.2
任意一种IPV10423.6
遭受成年IPV种类数(种)
033776.4
16715.2
≥2378.4
), ArticleFig(id=1324051133609673663, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, language=EN, label=Table 3, caption=

Association between sociodemographic variables and Rush use

, figureFileSmall=null, figureFileBig=null, tableContent=
变量OR(95%CI)P值
区域
成都1.000
广州0.660 (0.390~1.117)0.122
呼和浩特7.673 (4.312~13.654)<0.001
年龄(岁)
18~241.000
25~291.974 (1.099~3.546)0.023
30~342.000 (1.082~3.698)0.027
≥352.448 (1.363~4.397)0.003
受教育程度
初中及以下1.000
高中、大专1.011 (0.539~1.895)0.973
本科1.044 (0.594~1.837)0.880
研究生0.488 (0.204~1.164)0.106
婚姻状况
未婚1.000
已婚0.799 (0.363~1.757)0.577
离异2.077 (0.822~5.245)0.122
工作状况
全职1.000
学生0.524 (0.287~0.957)0.035
其他0.953 (0.549~1.657)0.866
个人平均月收入(元)
0~2 9991.000
3 000~5 9992.245 (1.235~4.081)0.008
6 000~8 9992.163 (1.147~4.078)0.017
≥9 0001.269 (0.610~2.637)0.524
自我报告的性取向
同性恋1.000
双性恋/异性恋/不确定0.519 (0.243~1.109)0.090
), ArticleFig(id=1324051133706142656, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, language=CN, label=表3, caption=

社会人口学变量与Rush使用的关联

, figureFileSmall=null, figureFileBig=null, tableContent=
变量OR(95%CI)P值
区域
成都1.000
广州0.660 (0.390~1.117)0.122
呼和浩特7.673 (4.312~13.654)<0.001
年龄(岁)
18~241.000
25~291.974 (1.099~3.546)0.023
30~342.000 (1.082~3.698)0.027
≥352.448 (1.363~4.397)0.003
受教育程度
初中及以下1.000
高中、大专1.011 (0.539~1.895)0.973
本科1.044 (0.594~1.837)0.880
研究生0.488 (0.204~1.164)0.106
婚姻状况
未婚1.000
已婚0.799 (0.363~1.757)0.577
离异2.077 (0.822~5.245)0.122
工作状况
全职1.000
学生0.524 (0.287~0.957)0.035
其他0.953 (0.549~1.657)0.866
个人平均月收入(元)
0~2 9991.000
3 000~5 9992.245 (1.235~4.081)0.008
6 000~8 9992.163 (1.147~4.078)0.017
≥9 0001.269 (0.610~2.637)0.524
自我报告的性取向
同性恋1.000
双性恋/异性恋/不确定0.519 (0.243~1.109)0.090
), ArticleFig(id=1324051133802611649, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, language=EN, label=Table 4, caption=

Association between childhood adverse experiences, intimate partner violence, and Rush use

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2模型3
OR(95%CI)P值OR(95%CI)P值OR(95%CI)P值
遭受ACE类型(以未经历该维度ACE为参考组)1.0001.0001.000
同伴欺凌1.644 (1.092~2.475)0.0171.639 (1.084~2.479)0.0191.127 (0.711~1.786)0.611
家庭暴力2.624 (1.729~3.983)<0.0012.654 (1.738~4.052)<0.0011.424 (0.883~2.297)0.146
情感虐待2.651 (1.748~4.022)<0.0012.638 (1.730~4.023)<0.0011.226 (0.736~2.044)0.433
身体虐待2.033 (1.341~3.082)<0.0011.963 (1.288~2.991)0.0021.109 (0.681~1.806)0.605
性虐待2.616 (1.707~4.010)<0.0012.566 (1.665~3.953)<0.0011.655 (1.019~2.687)0.042
家人物质滥用2.927 (1.184~7.240)0.0202.951 (1.176~7.404)0.0213.627 (1.391~9.456)0.008
任意一种ACE2.245 (1.386~3.635)<0.0012.237 (1.375~3.640)<0.0011.172 (0.688~1.998)0.570
遭受ACE种类数(连续)1.349 (1.206~1.510)<0.0011.339 (1.195~1.500)<0.0011.126 (0.987~1.284)0.077
遭受ACE种类数(种)
01.0001.0001.000
1~21.065 (0.571~1.985)0.8431.090 (0.583~2.040)0.7870.856 (0.449~1.632)0.182
3~42.863 (1.651~4.964)<0.0012.802 (1.610~4.875)<0.0011.306 (0.697~2.449)0.624
5~63.954 (2.090~7.482)<0.0013.793 (1.996~7.208)<0.0011.802 (0.879~3.694)0.096
遭受IPV(以未经历该维度IPV为参考组)1.0001.0001.000
辱骂0.752 (0.386~1.462)0.4000.736 (0.373~1.451)0.3760.519 (0.244~1.107)0.090
心理暴力1.873 (1.005~3.489)0.0481.876 (0.996~3.534)0.0510.935 (0.437~2.001)0.906
性暴力1.750 (0.719~4.258)0.2171.851 (0.737~4.650)0.1901.151 (0.405~3.271)0.834
控制联系3.634 (1.450~9.109)0.0063.380 (1.335~8.558)0.0101.538 (0.523~4.527)0.379
身体暴力0.610 (0.167~2.221)0.4530.709 (0.188~2.669)0.6111.006 (0.265~3.812)0.967
任意一种暴力2.093 (1.326~3.305)0.0022.093 (1.317~3.325)0.0021.013 (0.578~1.776)0.917
遭受IPV种类数(连续)1.232 (0.939~1.618)0.1321.216 (0.918~1.610)0.1720.921 (0.657~1.291)0.616
), ArticleFig(id=1324051133878109122, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, language=CN, label=表4, caption=

ACE、IPV与Rush使用的关联

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2模型3
OR(95%CI)P值OR(95%CI)P值OR(95%CI)P值
遭受ACE类型(以未经历该维度ACE为参考组)1.0001.0001.000
同伴欺凌1.644 (1.092~2.475)0.0171.639 (1.084~2.479)0.0191.127 (0.711~1.786)0.611
家庭暴力2.624 (1.729~3.983)<0.0012.654 (1.738~4.052)<0.0011.424 (0.883~2.297)0.146
情感虐待2.651 (1.748~4.022)<0.0012.638 (1.730~4.023)<0.0011.226 (0.736~2.044)0.433
身体虐待2.033 (1.341~3.082)<0.0011.963 (1.288~2.991)0.0021.109 (0.681~1.806)0.605
性虐待2.616 (1.707~4.010)<0.0012.566 (1.665~3.953)<0.0011.655 (1.019~2.687)0.042
家人物质滥用2.927 (1.184~7.240)0.0202.951 (1.176~7.404)0.0213.627 (1.391~9.456)0.008
任意一种ACE2.245 (1.386~3.635)<0.0012.237 (1.375~3.640)<0.0011.172 (0.688~1.998)0.570
遭受ACE种类数(连续)1.349 (1.206~1.510)<0.0011.339 (1.195~1.500)<0.0011.126 (0.987~1.284)0.077
遭受ACE种类数(种)
01.0001.0001.000
1~21.065 (0.571~1.985)0.8431.090 (0.583~2.040)0.7870.856 (0.449~1.632)0.182
3~42.863 (1.651~4.964)<0.0012.802 (1.610~4.875)<0.0011.306 (0.697~2.449)0.624
5~63.954 (2.090~7.482)<0.0013.793 (1.996~7.208)<0.0011.802 (0.879~3.694)0.096
遭受IPV(以未经历该维度IPV为参考组)1.0001.0001.000
辱骂0.752 (0.386~1.462)0.4000.736 (0.373~1.451)0.3760.519 (0.244~1.107)0.090
心理暴力1.873 (1.005~3.489)0.0481.876 (0.996~3.534)0.0510.935 (0.437~2.001)0.906
性暴力1.750 (0.719~4.258)0.2171.851 (0.737~4.650)0.1901.151 (0.405~3.271)0.834
控制联系3.634 (1.450~9.109)0.0063.380 (1.335~8.558)0.0101.538 (0.523~4.527)0.379
身体暴力0.610 (0.167~2.221)0.4530.709 (0.188~2.669)0.6111.006 (0.265~3.812)0.967
任意一种暴力2.093 (1.326~3.305)0.0022.093 (1.317~3.325)0.0021.013 (0.578~1.776)0.917
遭受IPV种类数(连续)1.232 (0.939~1.618)0.1321.216 (0.918~1.610)0.1720.921 (0.657~1.291)0.616
), ArticleFig(id=1324051134146544579, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, language=EN, label=Table 5, caption=

Cumulative effects of single-type childhood adverse experiences and any intimate partner violence on Rush and their interaction

, figureFileSmall=null, figureFileBig=null, tableContent=
变量OR(95%CI)P值交互P值
遭受ACE维度
同伴欺凌0.740
无同伴欺凌且无IPV1.000
仅有同伴欺凌1.125 (0.661~1.915)0.807
仅有IPV0.886 (0.367~2.142)0.693
有同伴欺凌且有IPV1.201 (0.588~2.450)0.661
家庭暴力0.859
无家庭暴力且无IPV1.000
仅有家庭暴力1.506 (0.873~2.599)0.264
仅有IPV1.104 (0.462~2.639)0.695
有家庭暴力且有IPV1.432 (0.691~2.970)0.657
情感虐待0.903
无情感虐待且无IPV1.000
仅有情感虐待1.264 (0.712~2.245)0.712
仅有IPV0.919 (0.344~2.460)0.711
有情感虐待且有IPV1.251 (0.609~2.569)0.702
身体虐待0.613
无身体虐待且无IPV1.000
仅有身体虐待1.048 (0.587~1.871)0.890
仅有IPV0.861 (0387~1.916)0.657
有身体虐待且有IPV1.192 (0.573~2.482)0.590
性虐待0.152
无性虐待且无IPV1.000
仅有性虐待1.330 (0.746~2.370)0.412
仅有IPV0.720 (0.343~1.511)0.118
有性虐待且有IPV2.065 (0.948~4.497)0.055
家人物质滥用0.589
无家人物质滥用且无IPV1.000
仅有家人物质滥用3.316 (1.011~9.728)0.048
仅有IPV0.953 (0.534~1.699)0.870
有家人物质滥用且有IPV5.109 (0.826~31.597)0.079
任意一种ACE0.260
无ACE且无IPV1.000
仅有ACE1.098 (0.623~1.935)0.958
仅有IPV0.312 (0.037~2.668)0.272
有ACE且有IPV1.233 (1.600~2.535)0.572
), ArticleFig(id=1324051134494671812, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324051103578456949, language=CN, label=表5, caption=

单一类型的ACE和任意一种IPV的累积作用与Rush的关联及其交互作用

, figureFileSmall=null, figureFileBig=null, tableContent=
变量OR(95%CI)P值交互P值
遭受ACE维度
同伴欺凌0.740
无同伴欺凌且无IPV1.000
仅有同伴欺凌1.125 (0.661~1.915)0.807
仅有IPV0.886 (0.367~2.142)0.693
有同伴欺凌且有IPV1.201 (0.588~2.450)0.661
家庭暴力0.859
无家庭暴力且无IPV1.000
仅有家庭暴力1.506 (0.873~2.599)0.264
仅有IPV1.104 (0.462~2.639)0.695
有家庭暴力且有IPV1.432 (0.691~2.970)0.657
情感虐待0.903
无情感虐待且无IPV1.000
仅有情感虐待1.264 (0.712~2.245)0.712
仅有IPV0.919 (0.344~2.460)0.711
有情感虐待且有IPV1.251 (0.609~2.569)0.702
身体虐待0.613
无身体虐待且无IPV1.000
仅有身体虐待1.048 (0.587~1.871)0.890
仅有IPV0.861 (0387~1.916)0.657
有身体虐待且有IPV1.192 (0.573~2.482)0.590
性虐待0.152
无性虐待且无IPV1.000
仅有性虐待1.330 (0.746~2.370)0.412
仅有IPV0.720 (0.343~1.511)0.118
有性虐待且有IPV2.065 (0.948~4.497)0.055
家人物质滥用0.589
无家人物质滥用且无IPV1.000
仅有家人物质滥用3.316 (1.011~9.728)0.048
仅有IPV0.953 (0.534~1.699)0.870
有家人物质滥用且有IPV5.109 (0.826~31.597)0.079
任意一种ACE0.260
无ACE且无IPV1.000
仅有ACE1.098 (0.623~1.935)0.958
仅有IPV0.312 (0.037~2.668)0.272
有ACE且有IPV1.233 (1.600~2.535)0.572
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童年不良经历与成年亲密伴侣暴力与男男性行为人群Rush使用的关联分析
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热甫凯提江·阿不都瓦依提 1 , 林浩 1 , 郭雅伟 2 , 刘梦婷 2 , 侯丰苏 3 , 王英 4 , 李菁华 5 , 曹望楠 1
现代预防医学 | 流行病与统计方法 2026,53(11): 1921-1928
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现代预防医学 |流行病与统计方法 2026 , 53 (11) : 1921 -1928
童年不良经历与成年亲密伴侣暴力与男男性行为人群Rush使用的关联分析
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热甫凯提江·阿不都瓦依提1, 林浩1, 郭雅伟2, 刘梦婷2, 侯丰苏3, 王英4, 李菁华5, 曹望楠1
作者信息
  • 1.北京大学公共卫生学院社会医学与健康教育系,北京 100191
  • 2.中山大学公共卫生学院
  • 3.深圳大学医学部公共卫生学院
  • 4.上海交通大学公共卫生学院
  • 5.澳门大学健康科学学院
通讯作者:
曹望楠,E-mail:
作者简介:

热甫凯提江·阿不都瓦依提(2001—),男,硕士在读,研究方向:弱势人群健康促进

Associations of adverse childhood experiences and adult intimate partner violence with Rush use among MSM
Abuduwayiti Refukaitijiang1, Hao LIN1, Ya-wei GUO2, Meng-ting LIU2, Feng-su HOU3, Ying WANG4, Jing-hua LI5, Wang-nan CAO1
Affiliations
  • Department of Social Medicine & Health Education, School of Public Health, Peking University, Beijing 100191, China
出版时间: 2026-06-10 doi: 10.20043/j.cnki.MPM.202512508
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目的

分析童年不良经历(adverse childhood experiences,ACE)与亲密伴侣暴力(intimate partner violence,IPV)对男男性行为人群(men who have sex with men,MSM)亚硝酸酯类吸入剂(Rush)使用的独立、协同和交互效应。

方法

于2023—2024年,在成都、广州、呼和浩特三中心开展横断面调查,面向无人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染且有过男性亲密伴侣的MSM,基于在线匿名平台开展问卷调查,调查内容包括社会人口学因素、ACE、IPV、Rush使用、性行为特征等,ACE和IPV测量均使用经过本土化验证的工具,Rush使用定义为近6个月有无使用。以二分类logistic回归计算比值比。

结果

共纳入441人,过去六个月的Rush使用率为30.6%,ACE和IPV暴露率分别为68.9%和23.6%。控制部分协变量后,经历任意一种ACE与Rush使用存在正向统计学关联(OR=2.237, 95% CI:1.375~3.640),经历ACE类别每增加1种,关联强度上升33.9%(95% CI:1.195~1.500);经历任意一种IPV与Rush使用呈正向统计学关联(OR=2.093, 95% CI:1.317~3.325)。ACE与IPV共存时存在Rush使用风险高于单一暴露趋势(P>0.05),但交互作用分析显示二者无统计学交互效应(交互P>0.05)。

结论

Rush使用流行率高是我国MSM重要的公共卫生问题,ACE和IPV均与我国MSM Rush使用显著相关,且两者并存时存在效应相加趋势;建议加强ACE和IPV双重创伤联合筛查,以及早识别并干预该人群的药物使用及相关性传播风险。

童年不良经历  /  亲密伴侣暴力  /  男男性行为人群  /  RUSH
Objective

This study aims to analyze the independent, synergistic and interactive effects of adverse childhood experiences (ACE) and intimate partner violence (IPV) on alkyl nitrite inhalant (Rush) use among men who have sex with men (MSM).

Methods

A cross-sectional survey was conducted from 2023 to 2024 across three sites in China (Chengdu, Guangzhou, Hohhot) among HIV-negative MSM who had ever had a male intimate partner. An anonymous online questionnaire collected data on sociodemographic factors, ACE, IPV, Rush use, and sexual behaviors. Locally validated instruments were used to measure ACE and IPV. Rush use was defined as use in the past six months. The odds ratio (OR) was calculated using binary logistic regression.

Results

A total of 441 participants were included. The prevalence of Rush use in the past six months was 30.6%. The exposure rates for ACE and IPV were 68.9% and 23.6%, respectively. After adjusting for partial covariates, experiencing any ACE was positively associated with Rush use (OR=2.237, 95% CI: 1.375-3.640). For each additional category of ACE experienced, the strength of association increased by 33.9% (95% CI: 1.195-1.500). Experiencing any IPV was also positively associated with Rush use (OR=2.093, 95% CI: 1.317-3.325). The co-occurrence of ACE and IPV showed a trend toward higher Rush use risk compared with single exposure (P>0.05), but interaction analysis revealed no statistically significant interaction effect between ACE and IPV (interaction P>0.05).

Conclusion

The high prevalence of Rush use is a significant public health concern among MSM in China. Both ACE and IPV are significantly associated with Rush use in this population, and their co-occurrence demonstrates an additive effect trend. It is recommended to strengthen integrated screening for both ACE and IPV for early identification of substance use and related sexual transmission risks and timely intervention among MSM.

Adverse childhood experiences  /  Intimate partner violence  /  Men who have sex with men  /  Rush
热甫凯提江·阿不都瓦依提, 林浩, 郭雅伟, 刘梦婷, 侯丰苏, 王英, 李菁华, 曹望楠. 童年不良经历与成年亲密伴侣暴力与男男性行为人群Rush使用的关联分析. 现代预防医学, 2026 , 53 (11) : 1921 -1928 . DOI: 10.20043/j.cnki.MPM.202512508
Abuduwayiti Refukaitijiang, Hao LIN, Ya-wei GUO, Meng-ting LIU, Feng-su HOU, Ying WANG, Jing-hua LI, Wang-nan CAO. Associations of adverse childhood experiences and adult intimate partner violence with Rush use among MSM[J]. Modern Preventive Medicine, 2026 , 53 (11) : 1921 -1928 . DOI: 10.20043/j.cnki.MPM.202512508
Rush Poppers(亚硝酸酯类吸入剂,简称Rush)是在男男性行为人群(men who have sex with men, MSM)中广泛流行的助性药物,通过吸入短时间内产生血管扩张、头晕和欣快感以增强性体验,但其使用可能导致心率失常、低血压、视网膜损伤等急性健康风险,并可能因降低安全套使用意愿而显著增加人类免疫缺陷病毒(human immunodeficiency virus,HIV)及其他性传播感染风险[1]。在MSM中,助性药物(如Rush、0号胶囊等)使用普遍,中国部分城市MSM中Rush的使用率已超过30%[2],且与HIV传播风险密切相关[3-4]。
MSM的Rush使用受到多层次因素的影响,包括个体心理行为特征(物质使用动机)、同伴压力、特定的性行为场景等[5-6]。在各类心理社会因素中,需要重点关注童年不良经历(adverse childhood experiences, ACE)与亲密伴侣暴力(intimate partner violence, IPV)。ACE作为早期生命逆境,可能通过影响个体的情绪调节、认知模式与人际关系[7-8],奠定成年后风险行为的基础[9]。而IPV作为成年期重要的压力与创伤来源,不仅可能直接导致心理痛苦进而加剧物质使用,还可能放大早期创伤的负面影响,形成叠加的创伤暴露模式[4]。
然而,目前针对中国MSM的研究,未能充分整合早期与成年期的创伤经历进行系统分析。尤其缺乏探讨ACE与IPV这两种贯穿生命历程的创伤压力源对Rush使用的单独影响、协同效应和交互效应的研究。因此,本研究旨在中国MSM中,系统考察ACE与IPV对Rush使用行为的影响,重点分析二者的独立关联及其可能存在的协同增强效应和交互效应。本研究结果将有助于识别具有累积创伤风险的高危亚群,为制定针对MSM、贯穿生命历程的创伤干预与药物使用防控策略提供关键的科学依据。
本研究为横断面研究,数据来源于“中国男男性行为者心理社会健康多中心队列研究”[10]项目。本研究旨在探讨MSM中ACE、IPV与Rush使用之间的关联。研究对象为在成都、广州和呼和浩特市及周边地区招募的符合以下条件的男性:(1)年满18周岁;(2)出生性别为男性;(3)近6个月内与男性发生过性行为;(4)HIV阴性;(5)有男性亲密伴侣(本研究中亲密伴侣定义为处于约会或者持续亲密关系中的主要男性伴侣,如男朋友,非临时性伴);(6)自愿参与研究并签署电子知情同意书。参与者通过“滚雪球+场所抽样”的方式招募,调查时间为2023—2024年,共收到问卷443份,有效问卷441份。调查采用匿名在线问卷形式,由当地社区组织协助招募与随访。问卷通过RED Cap平台发放,参与者扫描二维码后自行填写。本研究已获得北京大学伦理委员会(IRB00001052-22167)和中山大学伦理委员会(2021105)的伦理批准。调查内容涵盖人口学特征、性行为、ACE、IPV等多个模块。
本研究为横断面研究,采用以下公式计算样本量:
其中,Z1-α/2为显著性水平对应的双侧临界值(本研究中α=0.05,取1.96),δ为容许误差,本研究容许误差控制在0.05,参考既往调查结果,p为中国MSM中Rush的使用率为31.6%[3],考虑滚雪球抽样和场所抽样的设计效应,扩大30%样本量,计算后得n=432人。
本研究以“过去6个月是否使用过Rush”为结局变量,回答“是”定义为使用者,回答“否”定义为非使用者。另外,本研究还关注了研究对象的性行为相关特征以及其他助性药物使用情况。性行为特征包括是否存在男性固定性伴侣、男性固定性伴侣数量、和男性固定性伴发生肛交时安全套使用状况,针对男临时性伴和男商业性伴也询问了这三个问题。其他助性药物使用包括,过去六个月中:(1)是否使用过伟哥、万艾可;是否使用过0号胶囊;是否使用过其他助性药物(神仙水、开心水、G水/鸡水、“奶茶”、K粉、冰毒、摇头丸、大麻/“上头电子烟”、“邮票”/LSD、可卡因、海洛因等)。(2)使用过助性药物的人群中,主动使用与被动使用状况的占比。(3)使用过助性药物人群中,助性药物使用的次数。
本研究采用经过本土化验证的ACE国际问卷(adverse childhood experiences international questionnaire,ACE-IQ)[11-12],回顾调查对象18岁前的ACE经历。研究考察了与本研究主题相关的6个维度:(1)身体虐待;(2)情感虐待;(3)性虐待;(4)家庭物质滥用;(5)家庭暴力;(6)同伴欺凌。每一个维度由1~4个的条目进行测量,除“家庭物质滥用”维度对应条目为“是”“否”二分类选项外,其余5个维度13个条目均为4分类选项,包括“从来没有”“只有一次”“只有几次”“非常多次”。在本研究中,某一维度下全部条目均选择“从来没有”,才会视为该研究对象没有经历过该维度的ACE,其余情况均视为经历过。本研究构建了6个二分类变量(1=是、0=否)以获得研究对象的6种ACE暴露状况,进一步累加得ACE种类数(连续变量)(0~6种),并构建了“是否遭受任意一类ACE”的二分类变量(1=是、0=否)和ACE种类数(多分类变量)(0、1~2、3~4、5~6种)。
本研究使用经过本土化验证的改编版《同性恋和双性恋男性亲密伴侣暴力量表》(Intimate Partner Violence Scale for Gay and Bisexual Men,IPV-GBM)[13],测量研究对象在亲密伴侣关系中的IPV状况,具体包括询问是否遭受以下五种IPV:身体暴力、性暴力、心理暴力、控制联系及辱骂。本研究基于原始条目构建5个单一维度IPV二分类变量(1=是、0=否),再累加得经历IPV种类数(连续变量)(0~5种),并构建“是否遭受任意一类IPV”二分类变量(1=是、0=否)和多分类变量(多分类变量)(0、1和≥2种)。
为进一步探索ACE和IPV与Rush使用关联的协同作用,分别构建了各个维度ACE与任意一种IPV经历状况交叉的互斥变量,将调查对象分为4类:(1)未遭受(某一种)ACE且未遭受任意一种IPV;(2)仅遭受(某一种)ACE;(3)仅遭受任意一种IPV;(4)遭受(某一种)ACE且遭受任意一种IPV。
包括区域(成都、广州和呼和浩特)、年龄(18~24、25~29、30~34和≥35岁)、受教育程度(初中及以下、高中/中专/大专、本科和研究生)、婚姻状况(未婚、已婚、离异)、工作状况(全职、学生和兼职/待业/失业/退休等)、个人平均月收入(0~2 999、3 000~5 999、6 000~8 999和≥9 000元)、自我报告的性取向(通过“您认为您的性取向是”这一条目进行评估,包括同性恋和双性恋/异性恋/不确定)。
采用 SPSS 27.0进行统计分析。描述性统计以(均值±标准差)(中位数+百分位数)或频数(%)表述。构建logistic回归模型(后退法),估计ACE、IPV、ACE与任意一种IPV构建的互斥变量与Rush使用的关联,计算比值比和95%CI;建立ACE与任意一种IPV的交互项并分析二者是否存在交互作用。采用逐步调整策略构建协变量模型,模型1未调整模型;模型2在模型1基础上调整年龄分组、工作状况、个人平均月收入水平;模型3为完全调整模型,进一步调整区域。检验水准α=0.05,双侧检验。
在纳入分析的441位研究对象中,成都213人(48.3%)、广州148人(33.6%)、呼和浩特80人(18.1%)。有153(34.7%)人曾在过去6个月使用过任意一种助性药物,其中有135(30.6%)人使用过Rush,36(8.2%)人使用过伟哥、万艾可,5(1.1%)人使用过0号胶囊,1(0.2%)人使用过其他助性药物。153人中,主动、被动和不知情情况下的助性药物使用率分别为29.7%、10.7%、0.7%;助性药物平均使用次数为2.6(SD=1.1)次,有40(26.1%)人使用次数超过5次;有14(9.1%)人存在多药物滥用。
研究对象的平均年龄为(29.79±7.64)岁,76(17.2%)人受教育程度为初中及以下,387(87.8%)人未婚,291(66.0%)人为全职工作状态、78(17.7%)人为学生,160(36.3%)人月收入为3 000~5 999元,395(89.6%)人的性取向为同性恋。从性行为角度看,373(84.6%)人有男性固定性伴,227(51.5%)人有男性临时性伴,14(3.2%)人有男性商业性伴。见表1。
441位研究对象中,304(68.9%)人遭受过至少一种ACE,遭受ACE合计种类数的中位数为2(IQR:0~4)种,最常见的是遭受同伴欺凌、家庭暴力和情感虐待,分别为217(49.2%)、202(45.8%)和198(44.9%)人。104(23.6%)人经历过至少一种IPV,最常见为遭受辱骂和心理暴力,分别为51(11.6%)和46(10.4%)人。见表2。
图1显示研究对象各ACE维度下具体条目的暴露率:同伴欺凌(被排挤/嘲笑)最高,达49.2%;家庭暴力(目睹父母肢体冲突)与情感虐待(被羞辱)次之,分别为45.8%与44.9%;性虐待(被迫性接触)报告率为31.1%;家人物质滥用最低,为4.5%。整体呈现同伴欺凌、家庭暴力、情感虐待高于身体与性虐待,家庭物质滥用相对罕见的分布特征。
单因素分析显示,调查区域为呼和浩特(相较于成都)、年龄越大、全职工作(相比于学生)、月收入3 000~8 999元者(相比于0~2 999元)的Rush使用率更高(P<0.05);受教育程度、婚姻状况、自我报告的性取向与Rush使用无统计学关联。见表3。
在模型2(控制年龄、工作状况、个人平均月收入)中,6种维度ACE均与Rush使用有统计学上的关联,经历家人物质滥用这一种ACE者相较其他维度,Rush使用风险最高(OR=2.951,95% CI: 1.176~7.404);经历过任意一种ACE者Rush使用风险相较于未经历者更高(OR=2.237,95% CI: 1.375~3.640);ACE种类数每增加1种,与Rush使用的关联强度增加33.9%(OR=1.339,95% CI: 1.195~1.500)。在模型3(在模型2基础上控制区域)中,仅经历性虐待与家庭物质滥用维度ACE与Rush使用的关联有统计学差异。
在模型2中,心理暴力和控制联系这两种IPV与Rush使用有统计学上的关联;经历过任意一种IPV者Rush使用风险相较于未经历者更高(OR=2.093,95% CI: 1.317 ~3.325)。IPV种类数与Rush使用风险的关联无统计学差异。在模型3中,各维度IPV与Rush使用关联均无统计学差异。见表4。
在调整了区域、年龄、工作状况、个人平均月收入水平后,以未经历家庭物质滥用且从未经历IPV为参照组,仅经历家庭物质滥用时,Rush使用风险为3.316(95% CI:1.011~9.728),其他维度关联无统计学差异;一旦叠加IPV,同伴欺凌、身体虐待、性虐待和家庭物质滥用维度ACE与Rush使用的关联强度均有增强,但是结果无统计学差异。各维度ACE与任意IPV的交互项结果均无统计学差异。见表5。
本研究基于三个城市441名MSM的数据发现,MSM的Rush使用率高,ACE和成年IPV也呈现高水平,反映了该人群多维度且全生命周期的脆弱性。研究对象过去6个月的Rush使用率为30.6%,与2024年一项汇总我国MSM使用率的meta分析结果(29.0%,95%CI:25.0%~33.0%))基本一致[2],但高于欧美MSM助性药物使用水平(17.7%,2021年)[14]。ACE任何类型暴露率为68.9%,童年性虐待、家庭暴力和家庭物质滥用的暴露率为31.1%、45.8%和4.5%,略低于许慧芳等[12]学者针对我国MSM的调查结果(33.5%、62.1%和7.7%),但远高于吕小平等[15]学者研究中一般青年群体的ACE暴露率(8.2%、23.5%和2.6%),提示了MSM的ACE高暴露风险。与美国MSM相比[16](34.2%、17.6%和35.8%),本研究中MSM的家庭暴力维度暴露更高、家庭物质滥用维度较低,可能反映两国社会文化背景和物质管控政策的差异。任意一种类型IPV暴露率为23.6%,略高于国内男性婚姻暴力的流行率(22.8%)[17],提示MSM面临更高的IPV受暴风险。
除了Rush主动使用的高流行率以外,Rush还存在被动和不知情使用(11.4%)、高频次使用(26.1% MSM>5次)和多药滥用(9.1%)的复杂情况,提示了Rush宣教和干预的重要意义[18-19]。既往Rush干预主要集中在健康宣教、基于网络和基于行为改变技术的干预措施,其中,结合筛查、干预与转诊的综合干预模式对中国MSM的适用性较好[20-21]。
与既往研究结果方向一致[16,22],本研究发现在未控制和控制部分协变量的分析中,6种ACE维度均与Rush使用呈正向关联,效应值介于1.639~2.951;在纳入区域变量后,经历家人物质滥用与性虐待两维度的关联仍存在统计学差异,提示不同城市MSM在ACE、IPV暴露与Rush使用水平方面存在差异。其中家人物质滥用维度虽暴露率低(4.5%),但与Rush使用的关联值最高。童年经历家庭物质滥用者,在成年后的性行为场景更有可能使用Rush。童年经历性虐待者,在性行为中的偏好和选择可能更缺乏自信心或者规则,导致更容易使用Rush。本研究还发现心理暴力与控制联系两类成年IPV经历与Rush使用正相关,与既往部分研究结果一致,心理暴力与控制联系均可能通过降低自我效能,从而促进Rush使用增加[23]。
ACE与IPV的协同和交互作用分析显示,任意ACE叠加任意IPV后,Rush使用风险升至1.233倍,高于单一暴露,但结果无统计学差异(P>0.05)。家庭物质滥用和性虐待维度增幅相对突出(P>0.05),提示对于曾暴露于物质滥用或性虐待环境的MSM,经历成年伴侣暴力可能激活早期创伤记忆、进而转向Rush使用,即使当前证据强度有限,该亚群仍可作为临床关注的优先筛查对象[24-25]。干预层面,建议在常规服务中嵌入ACE与IPV联合询问以识别潜在风险;整合创伤知情访谈、同伴支持小组及伴侣关系辅导等服务,构建多层级连续支持网络;同时推动MSM IPV的政策关注,为降低双重负担背景下的Rush使用及HIV风险提供制度基础[20,26]。
本研究仍存在以下局限性:首先,横断面设计无法推断因果,ACE、IPV与Rush使用的时间顺序需未来纵向数据验证。其次,变量测量方面,所有变量均依赖研究对象自报,且为回顾性数据,可能存在社会期望偏倚和回忆偏倚,导致ACE、IPV及药物使用频率被低报;ACE模块仅纳入与主题密切相关的六类维度,未覆盖 ACE-IQ全部条目,虽可提升调查针对性,但可能低估总体暴露水平;IPV部分仅收集受暴视角,未记录施暴经历,后续研究可同步收集双向暴力信息,以辨析不同暴力角色对药物使用的差异影响;本研究未收集Rush使用剂量、使用场景及性角色等细节,未来可结合定性访谈与生物标记,进一步解析暴力创伤与助性药物使用之间的路径机制。最后,样本代表性方面,样本通过成都、广州、呼和浩特三地社区组织采用“滚雪球+场所抽样”方式招募,与非政府组织联系密切的MSM可能与普通隐匿人群在暴力暴露、药物使用等行为上存在差异,选择偏倚难以完全避免;且本研究仅分析有亲密伴侣者,无伴侣群体可能因主动回避IPV而被排除,但对比发现,全样本三地Rush使用率(成都23.0%、广州19.8%、呼和浩特76.7%)与最终纳入样本的三地比例(24.4%、17.6%、71.3%)基本一致,提示伴侣状态对主要结局影响有限。另外,本研究未覆盖农村MSM,而城乡在文化开放度、服务可及性和社会支持等方面的差异,可能导致农村地区ACE暴露模式、Rush使用流行率及其关联机制与城市地区存在差异。
本研究首次在国内MSM同时检验ACE和IPV对Rush使用的单一、协同和交互效应,发现部分维度存在正向关联,为心理健康促进项目的设计奠定了基础。我国MSM的Rush使用已成为紧迫的公共卫生议题,该群体同时承受着过高的ACE与IPV负担。建议未来研究依托多中心、前瞻性队列,整合多维数据,阐明双重创伤作用于Rush发生与维持的机制路径。与此同时,卫生政策与公共服务需在现有HIV防控平台中制度化嵌入ACE/IPV联合筛查,实现早发现、早干预,从源头减少Rush使用及其健康危害,切实降低MSM的HIV脆弱性。
  • 国家自然科学基金(82504531)
  • Start-up Research Grant of the University of Macau(SRG2025-00031-FHS)
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2026年第53卷第11期
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doi: 10.20043/j.cnki.MPM.202512508
  • 接收时间:2025-12-28
  • 首发时间:2026-11-02
  • 出版时间:2026-06-10
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  • 收稿日期:2025-12-28
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国家自然科学基金(82504531)
Start-up Research Grant of the University of Macau(SRG2025-00031-FHS)
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    1.北京大学公共卫生学院社会医学与健康教育系,北京 100191
    2.中山大学公共卫生学院
    3.深圳大学医学部公共卫生学院
    4.上海交通大学公共卫生学院
    5.澳门大学健康科学学院

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2种不同金属材料的力学参数
科
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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