摘要目的:分析MSM商业同性性行为特征及无保护肛交（UAI）的相关因素，为制定MSM干预措施提供参考依据。方法:研究对象为≥16岁男性且最近6个月发生同性肛交行为者，于2023年1-12月在福州市通过网络方式招募研究对象，根据横断面研究设计估计样本量为283人。采用多因素logistic 回归模型分析研究对象最近6个月发生UAI的相关因素。采用SPSS 25.0软件进行统计学分析 。结果:在调查的MSM 4 484人中，发生商业同性性行为的比例为9.59%（430/4 484），年龄（27.00±9.07）岁。在发生商业同性性行为的MSM中，最近1周发生肛交的比例为70.00%（301/430），最近6个月发生肛交的性伴数>10人的比例为43.02%（185/430）。最近6个月发生UAI的比例为75.58%（325/430）。多因素分析结果表明，在最近6个月发生商业同性性行为的MSM中，相比于学生、首次发生性行为年龄>18岁、最近1周未发生肛交和最近6个月发生肛交性伴数≤10人者，非学生（a OR=1.99，95% CI：1.18~3.36）、首次发生性行为年龄≤18岁（a OR=2.04，95% CI：1.26~3.29）、最近1周发生肛交（a OR=2.04，95% CI：1.25~3.33）和最近6个月发生肛交性伴数>10人者（a OR=1.97，95% CI：1.16~3.35）发生UAI的风险较高。 结论:福州市发生商业同性性行为的MSM中发生UAI风险较高，应针对该人群加强以提高安全性行为的认知、倡导固定性伴、坚持使用安全套和预防药物滥用为主的干预措施。

abstractsObjective:To understand the commercial homosexual behavior characteristics of men who have sex with men (MSM) and the factors associated with unprotected anal intercourse (UAI) in this population, and provide reference for the development of intervention strategy in MSM.Methods:Men who were aged ≥16 years and had anal sex with men in the past 6 months were recruited through internet in Fuzhou from January to December 2023 for a cross-sectional study with a sample size of 283. Multivariate logistic regression model was used to analyze the factors associated with the incidence of UAI in the past 6 months in MSM. The SPSS 25.0 software was used for statistical analysis.Results:In 4 484 MSM, the proportion of those with commercial homosexual behaviors was 9.59% (430/4 484), the average age was (27.00±9.07) years. In the MSM with commercial homosexual behaviors, 70.00% (301/430) had anal sex in the past one week, and 43.02% (185/430) had anal sex with more than 10 partners in the past 6 months. The proportion of MSM with UAI was 75.58% (325/430) in the past 6 months. The results of multivariate analysis showed showed that in MSM with commercial homosexual behaviors in the past 6 months, compared with those who were students, age >18 years at the first sexual intercourse, had not anal sex in the past one week, and anal sex with less than 10 partners in the past 6 months, the risk for UAI was higher in those who were not students (a OR=1.99,95% CI:1.18-3.36), those who were aged ≤18 years at first sexual intercourse sex (a OR=2.04,95% CI:1.26-3.29), those who had anal sex in the past one week (a OR=2.04,95% CI:1.25-3.33), and those who had anal sex with more than 10 partners in the past 6 months (a OR=1.97,95% CI:1.16-3.35). Conclusions:The risk for UAI was high in MSM with commercial homosexual behaviors in Fuzhou, so it is necessary to improve the awareness of safe sex and promote sex with regular partners and condom use, and preventing drug abuse in MSM.