Factors That Influence Risky Sexual Behaviors Among Men Who Have Sex with Men in Liaoning Province, China: A Structural Equation Model
Factors That Influence Risky Sexual Behaviors Among Men Who Have Sex with Men in Liaoning Province, China: A Structural Equation Model
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DOI：
10.1089/apc.2010.0333
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发表时间：
2011-07-01
影响因子：
4.9
通讯作者：
Sun, Gao
中科院分区：
文献类型：
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作者：
Liu, Jie;Qu, Bo;Sun, Gao
在中国，男男性行为者（MSM）的艾滋病毒感染率迅速上升。行为和生物干预是控制HIV在MSM人群中传播的关键，也是中国减少艾滋病传播的首要策略。本研究的目的是探讨艾滋病相关知识、受访者基本信息、服务利用与危险性行为之间的关系。采用受访者驱动抽样方法在中国抚顺和葫芦岛招募了 225 名男男性行为者。单变量分析结果显示，过去 6 个月的安全套使用情况与年龄、对 HIV 的了解更多、接受润滑剂分发和同伴教育相关（p < 0.05）。结构方程模型（SEM）结果如下，chi(2) = 863.45 (p < 0.01)；近似均方根误差 (RMSEA) = 0.04；拟合优度（GFI）= 0.94，表明模型与数据拟合良好。 HIV相关知识、受访者基本信息、服务利用和危险性行为的因子负荷分别为-0.06、0.07、-0.27，表明服务利用可能是对危险性行为产生负面影响的主要因素。对于服务利用率，最大的项目负载是润滑剂分配和同伴教育，分别为 0.69 和 0.68。艾滋病相关知识和服务利用的因子负荷为0.15，表明通过提高艾滋病知识提高服务利用可以间接减少危险性行为。基本信息（年龄、收入、婚姻状况、首次性行为年龄）对服务利用影响较大，负载系数为0.26。对于基本信息，最大的项目负载是年龄（0.96）。在干预策略上，必须对青少年进行公共卫生教育，最终减少MSM的危险行为。
HIV prevalence among men who have sex with men (MSM) has increased rapidly in China. Behavioral and biologic interventions are the key to control the spreading of HIV in the MSM population and the primary strategy for reducing the spread of AIDS in China. The objective of this study is to explore the relationship among HIV-related knowledge, the basic information of respondents, service utilization and risky sexual behavior. Respondent-driven sampling was used to recruit 225 MSM in Fushun and Huludao in China. The results of univariate analysis showed that condom use in the past 6 months was associated with age, being more knowledgeable about HIV, accepting lubricant distribution, and peer education (p < 0.05). The structural equation modeling (SEM) results was as following, chi(2) = 863.45 (p < 0.01); root mean square error of approximation (RMSEA) = 0.04; goodness of fit (GFI) = 0.94, which indicated the model fitted the data well. The factor loads of HIV-related knowledge, the basic information of respondents, service utilization and risky sexual behavior was -0.06, 0.07, -0.27, respectively, which indicated that service utilization was likely to be a major factor negatively impacting risky sexual behavior. For service utilization, the greatest item load was for distribution of lubricants and peer education, 0.69, 0.68, respectively. The factor load of HIV-related knowledge and service utilization was 0.15, which suggested that risky sexual behaviors might be indirectly reduced by improving HIV/AIDS knowledge to increase service utilization. Basic information (age, income, marital status, age at first sexual intercourse) had a greater impact on service utilization, with a load factor of 0.26. For basic information, the greatest item load was age (0.96). In terms of the intervention strategies, it is essential that public health education is provided for the young, to ultimately decrease risky behaviors in MSM.