本文選題：男男性行為 + 同性固定性伴�。� 參考：《廣西醫(yī)科大學》2017年碩士論文

【摘要】：背景及目的在中國,艾滋病(AIDS)己進入快速增長期,且流行形勢日趨嚴峻。近年來我國由男男同性性行為引起的艾滋病傳播和感染的人數比例上升明顯,男性性行為人群(Men who have sex with men,MSM)中艾滋病呈高水平流行趨勢。MSM多性伴現象普遍,性行為方式多樣,安全套使用率低,是HIV感染和傳播的重點人群。隨著社會文化多元發(fā)展,國內社會對同性戀包容性有所增加,越來越多的MSM開始追求個人情感上的滿足,男性固定伴侶逐漸成為MSM人群崇尚的亞文化。同性固定性伴對減少MSM性伴數量、偶然性行為,預防控制HIV在男男性行為人群中流行具有重要作用。MSM人群由于同性性取向和艾滋病感染高風險等多種因素長期不被社會所接受,較普通人承受更大的來自周圍環(huán)境的歧視和壓力,該人群的心理健康問題尤為突出。為了解MSM人群擁有男性固定性伴現狀,分析MSM確定固定性伴關系的影響因素,探討該人群擁有男性固定性伴與其心理健康狀況間的關系,本研究在南寧市進行了相關調查。方法本研究采用橫斷面調查的方法,通過“滾雪球”等方式在廣西南寧市招募年齡在16歲及以上、近6個月有過男男性行為的445名MSM,對研究對象進行匿名問卷調查,獲得有效答卷440份。問卷的主要內容包括一般人口學特征、性行為特征、接受艾滋病干預服務情況、心理狀況等。使用抑郁自評量表、焦慮自評量表、生活滿意度量表對MSM心理狀況進行調查。將研究對象分成擁有男性固定性伴和無固定性伴兩組,調查南寧市MSM人群擁有男性固定性伴現狀并探討其影響因素,分析該人群的心理特征(包括抑郁癥狀、焦慮癥狀、生活滿意度)。應用SPSS22.0軟件進行卡方檢驗、t檢驗及多因素Logistic回歸分析處理資料。結果本次招募的調查對象中擁有男性固定性伴的比例為35.7%(157/440),無男性固定性伴比例占64.3%(283/440)。年齡范圍在16-48歲之間,平均年齡為(23.12±5.76)歲,年齡在35歲以下的占83.2%(366/440),67.3%(296/440)為大專及以上文化程度,職業(yè)為非體力勞動者的比例為49.7%(219/440),未婚者占44.5%(196/440),在本市居住一年以上的比例為61.4%(270/440),自認為是同性性取向者占52.5%(231/440)。單因素分析結果顯示與調查對象擁有男性固定性伴的相關因素(P0.05)包括年齡、婚姻狀況、個人月收入、本市居住時間、首次男男性行為年齡、首次男男性行為至今時間、HIV抗體檢測狀況、有過同性性行為的網友數量、加入男同交友軟件聊天群狀況、接受艾滋病干預措施情況、最后一次接受干預措施至今時間、最近1年獨居狀況。多因素Logistic回歸分析結果表明,在本市居住時間≥1年(OR=2.35,95%CI=1.56~3.81),首次男男性行為至今≥3年(OR=2.86,95%CI=1.32~6.23),近一年獨居(OR=5.87,95%CI=3.80~9.06),個人月收入≥3000元(OR=3.24,95%CI=1.15~5.62)使MSM擁有固定性伴的可能性增加;有過同性性行為的網友數量≥10(OR=0.28,95%CI=0.15~0.58),加入男同qq/微信/blue等同伴聊天群(OR=0.08,95%CI=0.04~0.16)降低MSM確定固定性伴的可能性。對MSM心理健康狀況的調查發(fā)現,43.5%(185/435)的調查對象存在抑郁癥狀,37.0%(158/427)存在焦慮癥狀;無男性固定性伴的調查對象出現抑郁、焦慮的癥狀比例(47.5%、42.2%)均高于擁有男性固定性伴者(分別為33.5%、27.3%),差異均具有統(tǒng)計學意義(P0.05);擁有男性固定性伴的調查對象SDS標準得分(38.71士15.45)低于無男性固定性伴者(45.72士15.07),生活滿意度評分(14.44士4.49)高于無男性固定性伴者(12.77士4.82),差異均具有統(tǒng)計學意義(P0.05)。結論本次調查發(fā)現南寧市MSM擁有男性固定性伴的比例為35.7%。本市居住時間、首次男男性行為至今時間、有過同性性行為的網友數量、加入男同交友軟件聊天群狀況、近一年獨居狀況、月收入是MSM擁有男性固定性伴的影響因素。今后應注重對影響MSM確定固定性伴的因素進行探討,采取針對性的干預措施促進MSM伴侶關系的的穩(wěn)定,減少艾滋病高危行為的發(fā)生。MSM人群存在不良心理的現象較為普遍,其中擁有男性固定性伴的MSM出現抑郁、焦慮癥狀比例較無男性固定性伴者少并且對生活的滿意程度更高,需加強對沒有固定性伴的MSM的社會和心理支持,同時創(chuàng)造對MSM寬容的社會環(huán)境,增加MSM發(fā)展固定伴侶關系的機會。
[Abstract]:Background and purpose in China, AIDS (AIDS) has entered a rapid growth period, and the epidemic situation is becoming increasingly severe. In recent years, the proportion of AIDS transmission and infection caused by male sex behavior in our country has risen obviously. The high prevalence trend of AIDS in the male sex population (Men who have sex with men, MSM) is a high prevalence trend of.MSM multiple partners. It is common, the diversity of sexual behavior and low use of condoms is the key population of HIV infection and transmission. With the development of social and cultural diversity, homosexual inclusiveness has increased in domestic society, and more and more MSM began to pursue personal emotional satisfaction. The male fixed partner gradually became the subculture of the MSM crowd. The importance of reducing the number of MSM sexual partners, incidental behavior, prevention and control of the prevalence of HIV in men's men's behavior, the.MSM population is not accepted by the society for a long time because of homosexual sexual orientation and high risk of AIDS infection, and the general people are subjected to more discrimination and pressure from the surrounding environment. In order to understand the current status of the MSM population with male fixed partners, the factors affecting the determination of the fixed partner relationship by MSM were analyzed, and the relationship between the male fixed partner and the mental health status of the population was discussed. The study was conducted in Nanning. In Nanning, Guangxi, we recruited 445 MSM aged 16 and above and had male male behavior in the last 6 months. An anonymous questionnaire survey was conducted to obtain 440 valid answers. The main contents of the questionnaire included general demographic characteristics, sexual behavior characteristics, acceptance of AIDS intervention services, psychological status, and so on. The psychological status of MSM was investigated by self rating Anxiety Scale and life satisfaction scale. The subjects were divided into two groups of male fixed partners and unfixed partners. The status of male fixed partners in Nanning MSM was investigated and its influencing factors were investigated. The psychological characteristics of the population (including depressive symptoms, anxiety symptoms and life) were analyzed. SPSS22.0 software was used for chi square test, t test and multiple factor Logistic regression analysis. Results the proportion of male fixed partners was 35.7% (157/440), 64.3% (283/440), the age range was between 16-48 years, and the average age was (23.12 + 5.76) years. The age under 35 years was 83.2% (366/440), 67.3% (296/440) was college and above, the proportion of non manual workers was 49.7% (219/440), unmarried persons accounted for 44.5% (196/440), and the proportion of people living in this city was 61.4% (270/440) for more than one year, and 52.5% (231/440). Related factors (P0.05) including age, marital status, personal monthly income, the city residence time, the first male male behavior age, the first male male behavior age, the first male male behavior time, the HIV antibody test status, the number of netizens with the same sex sex, the status of the male and the same friend software chat group, and the AIDS intervention. Measures, the last time for the intervention, the last 1 years of living alone. The results of multiple factor Logistic regression analysis showed that the residence time in this city was more than 1 years (OR=2.35,95%CI=1.56~3.81), the first male male behavior was more than 3 years (OR=2.86,95%CI=1.32~6.23), only one year alone (OR=5.87,95%CI=3.80~9.06), and the individual monthly income was more than 3000. The possibility of OR=3.24,95%CI=1.15~5.62 to make MSM have a fixed partner increased; the number of netizens with sex sex was more than 10 (OR=0.28,95%CI=0.15~0.58), and the same qq/ WeChat /blue and other peer chat groups (OR=0.08,95%CI=0.04~0.16) reduced the possibility of MSM determination of fixed partners. A survey of the mental health of MSM found that 43.5% (185/43) 5) the subjects were depressive symptoms and 37% (158/427) had anxiety symptoms; the subjects without male fixed partners had depression, and the proportion of anxiety symptoms (47.5%, 42.2%) were higher than those with male fixed partners (33.5%, 27.3% respectively), and the difference had the significance of unified planning (P0.05); the SDS standard for the investigation of male fixed partners The scores (38.71 men and 15.45) were lower than those without male fixer (45.72 and 15.07), and the life satisfaction score (14.44) was higher than those without male fixer (12.77. 4.82). The difference was statistically significant (P0.05). Conclusion this survey found that the proportion of MSM with male sex partners in Nanning was 35.7%. city residence time, the first male male So far, the number of netizens who have sex sex, the status of the chat group of male and female friends, the status of living alone in the last year, the monthly income is the influence factor of MSM with male fixed partners. In the future, we should pay attention to the factors affecting the determination of the fixed partner of MSM, and take the targeted intervention measures to promote the MSM partner relationship. Stability, reducing the incidence of high risk behavior of AIDS in the.MSM population is more common, in which the MSM of male fixed partner has depression, the proportion of anxiety symptoms is less than that of no male fixer, and the satisfaction of life is higher. It is necessary to strengthen the social and psychological support for the MSM without a fixed partner, at the same time Create a tolerant social environment for MSM and increase MSM's chances of developing a fixed partnership.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R512.91

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