摘要目的：调查社会文化因素对男性性行为人群（MSM）性观念、性行为及其对HIV传播的影响。方法于2013年4月至2015年10月，以四川省成都市、江西省南昌市和新余市、河南省郑州市、黑龙江省哈尔滨市以及重庆市为研究场所，采用方便抽样方法招募MSM，并预约访谈时间。纳入标准：男性，年龄15岁以上，最近6个月与男性发生过性行为（口交/肛交），在MSM圈内的活跃度较高，即熟识的圈内人较多，对于访谈的话题有较多的理解，表达能力较强，愿意与访谈员进行交流。共纳入研究对象184名。选用定性访谈中的个人深入访谈法，对每名研究对象约访谈1 h。访谈内容主要包括基本信息、个人对同性恋身份的认同、对同性性行为的看法和实践、对同性性行为与艾滋病相关问题的了解和认识、对MSM圈内亚文化的理解等。结果184名研究对象中，河南省48名，江西省12名，黑龙江省50名，重庆市47名，四川省27名。30岁以下者占66.3%（122名），大专以上学历者占61.3%（111名），未婚者占76.5%（140名），在校学生占18%（33名），非政府组织专职人员占6%（11名），HIV抗体阳性者占40.2%（74例）。访谈主要发现，社会规范与社会认同等使MSM隐蔽自己的性取向，并选择与异性结婚，有将HIV由高危人群向一般人群传播的风险；MSM之间性行为较随意，且同性性文化容易忽视健康需求，加之合成药品广泛使用等特点，共同促成了MSM的高危性行为的发生，为HIV传播带来不利影响。此外，MSM内部不同亚人群的性行为与HIV传播风险不同，青年人群感染HIV的风险更大。结论社会文化大环境和MSM内部亚文化都对MSM的HIV相关行为和疾病传播产生不利影响；MSM内部不同亚人群的行为特点与HIV传播风险不同，未来应进一步深入探索，为构建有人群针对性的防治策略提供依据。

abstractsObjective To understand how social and cultural factors influence sexual perceptions, sexual practices, and HIV transmission among men who have sex with men at selected sites in China. Methods Qualitative methodology was used and face to face, semi-structured, in-depth interviews conducted from April 2013 to October 2015 in Sichuan, Jiangxi, Henan, Heilongjiang provinces and Chongqing municipality of China. Results A total of 184 men who have sex with men participated in the interviews. Forty-eight originated from Henan Province, and 12, 50, 47, and 27 from Jiangxi, Heilongjiang, Sichuan provinces and Chongqing municipality, respectively. A total of 122 participants (66.3%) were under 30 years of age, 111 were college graduates (61.3%), 140 were unmarried (76.5%), and 74 were HIV positive (40.2%). Among interviewees, 6% (11 MSM) were employed at nongovernmental organizations. The main findings revealed that:Owing to sociocultural influences and social norms, most homosexual men concealed their sexual orientation and married females so as to fulfill their family obligation;this may encourage HIV transmission from a high-risk population to the general population; the main features of male homosexual behaviors, as well as those of the associated community and subculture, included hedonism, less concern about health, drug abuse, encouraging of high risk behaviors among men who have sex with men, and negative attitudes regarding HIV prevention; subgroups among MSM were found to have differential HIV transmission risk behaviors, with young men more vulnerable to infection with HIV. Conclusion Sociocultural factors, including external socioenvironmental circumstances and internal MSM community subcultures, have adverse impacts on HIV transmission among men who have sex with men. Because there were varied behavior modes and HIV transmission risks among MSM subgroups, further study focusing on MSM subgroups is imperative, to provide a basis for more targeted and effective prevention strategies.