Participation of HIV prevention programs among men who have sex with men in two cities of China--a mixed method study.
Participation of HIV prevention programs among men who have sex with men in two cities of China--a mixed method study.
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DOI：
10.1186/1471-2458-12-847
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发表时间：
2012-10-08
影响因子：
4.5
通讯作者：
Xiao Y
中科院分区：
文献类型：
--
作者：
Ma W;Raymond HF;Wilson EC;McFarland W;Lu H;Ding X;Lu R;Ma X;Xia D;Xu J;He X;Feng L;Fan S;Li X;Sun J;Jia Y;Shao Y;Ruan Y;Xiao Y
尽管中国有针对男男性行为者（MSM）的各种艾滋病预防项目，但这些项目是否以及如何被利用尚不清楚。本研究探讨了中国两个城市男男性行为者参与艾滋病预防项目的情况及其影响因素。这是一项在北京和重庆进行的混合方法研究。采用质性研究方法，于2009年和2010年分别对54名男男性行为者、11名关键知情人和8名焦点小组进行了深入访谈，并对998名男男性行为者进行了问卷调查。定性研究结果与定量的多元因素相结合，以解释定量研究结果。重庆市和北京市的MSM中，分别有五十六%和75.1%的人参加过至少一种HIV预防项目（P = 0.001）。影响MSM参与艾滋病预防项目的因素包括年龄、民族、收入、对艾滋病风险的认知、与男朋友一起生活、居住在城市地区、MSM社会网络的规模、是否与伴侣谈论过艾滋病状况以及是否认识艾滋病阳性者。男男性接触者不参加艾滋病毒预防计划的原因包括后勤问题，如参与时间有限和距离服务;计划内容和交付问题，如感知的低质量服务和对提供者的不信任;以及，文化问题，如艾滋病毒相关的耻辱和低风险的看法。研究表明，中国在接触MSM方面还有很大的改进空间。针对中国男男性行为者的艾滋病预防项目可能需要更加全面，并纳入人群的文化，后勤和艾滋病相关需求，以有效地达到和影响这一人群的艾滋病风险。
Although various HIV prevention programs targeting men who have sex with men (MSM) are operating in China, whether and how these programs are being utilized is unclear. This study explores participation of HIV prevention programs and influencing factors among MSM in two cities in China. This is a mixed-method study conducted in Beijing and Chongqing. A qualitative study consisting of in-depth interviews with 54 MSM, 11 key informants, and 8 focus group discussions, a cross-sectional survey using respondent-driven sampling among 998 MSM were conducted in 2009 and 2010 respectively to elicit information on MSM’s perception and utilization of HIV prevention programs. Qualitative findings were integrated with quantitative multivariate factors to explain the quantitative findings. Fifty-six percent of MSM in Chongqing and 75.1% in Beijing ever participated in at least one type of HIV prevention program (P=0.001). Factors related to participation in HIV prevention programs included age, ethnicity, income, HIV risk perception, living with boyfriend, living in urban area, size of MSM social network, having talked about HIV status with partners, and knowing someone who is HIV positive. Reasons why MSM did not participate in HIV prevention programs included logistical concerns like limited time for participation and distance to services; program content and delivery issues such as perceived low quality services and distrust of providers; and, cultural issues like HIV-related stigma and low risk perception. The study shows that there is much room for improvement in reaching MSM in China. HIV prevention programs targeting MSM in China may need to be more comprehensive and incorporate the cultural, logistic and HIV-related needs of the population in order to effectively reach and affect this population’s risk for HIV.
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