摘要目的 了解在婚男男性行为者(MSM)亚群特征、艾滋病感染状况、性行为和安全套使用情况.方法 在北京、哈尔滨、郑州和成都市采用“滚雪球”方法招募调查对象,通过匿名的方式进行问卷调查,包括社会人口学特征、同性和异性性伴种类、同性和异性性行为、安全套使用情况等,并进行HIV抗体检测.结果 4个市共有858名在婚MSM参加调查,平均年龄(38.3±9.1)岁,其中初中及以下文化程度占36.7％；自认为是同性、双性性取向和异性性取向/不确定者所占的比例分别为40.9％、54.3％和4.8％.感染HIV检出率为8.0％,其中成都市最高为13.3％.多因素分析显示,非本市户籍、同性性取向、居住在哈尔滨市、第一次发生插入性行为年龄＜18岁可能增加最近6个月与男性肛交时从不使用安全套的危险性(OR=1.5～2.1).年龄≥46岁、非本市户籍、居住在北京、异性性取向或性取向未确定、近6个月与男性肛交性行为从未使用安全套者可能增加与女性性交时从不使用安全套的危险性(OR=1.7～5.9).结论 在婚MSM亚群中HIV感染已处于高流行状态,该亚群存在的高比例无保护同性和异性性行为,加剧HIV在MSM和在婚女性人群间传播.

abstractsObjective To find out the status of HIV infection,sexual behaviors with both men and women as well as condom use among currently married men who have sex with men (MSM) so as to document for HIV intervention targeting this sub-population,in Beijing,Chengdu,Harbin and Zhengzhou cities.Methods “Snowballing” sampling method was used to recruit subjects in four cities.Participants were investigated by anonymous questionnaire containing demographics,sexual orientation,both homosexual and heterosexual behaviors and condom use during the past 6 months.Blood samples from participants were used to test HIV antibodies.Results Of the 858 participants for four cities,the average age was 38.3 (SD=9.1) years.36.7％ of them had completed the junior high school or under.The percentage of participants who identified themselves as homosexual,bisexual,and heterosexual or undecided were 40.9％,54.3％ and 4.8％,respectively.The overall HIV prevalence was 8.0％,and among four cities the HIV prevalence in Chengdu was the highest ( 13.3％ ).Results from the Multiple logistic regression analysis showed that never used condoms when having anal sex with men during the past 6 months among participants who did not have a city residential card,identifying himself as having homosexual orientation,living in Harbin,having first anal sex experience before 18 years of age the range of OR value was 1.5-2.1.In addition,the faetors associated with never using condoms in vaginal sex with women during the past 6 months were as follows:being over 46 years old,not having a city residential card,living in Beijing,identifying himself as heterosexual orientated or with unknown sexual orientation,never using condoms in anal sex with men during the past 6 months,the range of OR value was 1.7-5.9.Conclusion The prevalence of HIV infection seemed to be quite high among those currently married MSM.High rates of unprotected homosexual and heterosexual behaviors might accelerate the spreading of HIV from currently married MSM to their wives.