Status and associated factors of recreational drug use among man who have sex with man in Nanjing
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摘要:
目的 了解南京市男男性行为者（men who have sex with men，MSM）新型毒品的使用情况及其相关因素。 方法 采用滚雪球、同伴推荐和互联网招募等方式招募MSM参加调查。采用多因素Logistic回归分析模型分析新型毒品使用的相关因素。 结果 876名MSM中，29.6%自述使用过新型毒品，人类免疫缺陷病毒（human immunodeficiency virus，HIV）和梅毒的感染率分别为9.5%和9.0%。控制了相关社会人口学因素的影响后，新型毒品使用者近6个月与同性发生无保护肛交（OR=1.83，95% CI：1.35~2.47，P < 0.001）、近6个月多性伴（OR=2.25，95% CI：1.65~3.05，P < 0.001）、HIV感染（OR=1.95，95% CI：1.21~3.17，P=0.007）和梅毒感染（OR=1.71，95% CI：1.02~2.84，P=0.040）的可能性较高。多因素分析结果显示，年龄<30岁（OR=1.50，95% CI：1.07~2.11，P=0.020）、性取向自我认定为同性恋（OR=1.65，95% CI：1.16~2.34，P=0.005）、互联网交友（OR=1.58，95% CI：1.07~2.35，P=0.022）、月收入≥ 5000元（OR=1.57，95% CI：1.13~2.17，P=0.007）、性角色自我认定为"被插入方"（OR=1.55，95% CI：1.04~2.32，P=0.033）的MSM使用新型毒品的可能性较高。 结论 南京市MSM新型毒品使用比例较高，新型毒品使用和HIV感染、梅毒感染及高危性行为有关联，新型毒品使用的危害性和警示性教育应成为MSM社区参与宣传教育关注的重点。 Abstract:Objective To understand the prevalence of synthetic drug use among man who have sex with man (MSM) in Nanjing and the associated factors. Methods MSM were recruited by snow-ball sampling, peer recommendation and network recruitment. Multivariate logistic regression analysis was performed to evaluate the correlated factors of recreational drug use. Results 29.6% of the 876 MSM ever used recreational drugs. The prevalence of HIV and syphilis infections were 9.5% and 9.0% respectively. After controlling the influence of correlated factors, recreational drug use was correlated with unprotected anal intercourse in the past 6 months(OR=1.83, 95% CI: 1.35-2.47, P < 0.001), multiple male sex partnership in the past 6 months(OR=2.25, 95% CI: 1.65-3.05, P < 0.001), higher HIV prevalence (OR=1.95, 95% CI: 1.21-3.17, P=0.007) and higher syphilis prevalence(OR=1.71, 95% CI: 1.02-2.84, P=0.040). Multivariate Logistic analysis showed that demographic and behavioral factors associated with recreational drug use including: less than 30 years old (OR=1.50, 95% CI: 1.07-2.11, P=0.020), self-identified as homosexual orientation (OR=1.65, 95% CI: 1.16-2.34, P=0.005), seeking male partners mainly via the internet(OR=1.58, 95% CI: 1.07-2.35, P=0.022), higher monthly income(OR=1.57, 95% CI: 1.13-2.17, P=0.007), receptive sexual role(OR=1.55, 95% CI: 1.04-2.32, P=0.033). Conclusions MSM has a high prevalence of recreational drug use in Nanjing, which was positively correlated with HIV/syphilis infection and high risk behaviors. Intervention efforts should be devoted to reduce and combat drug use among MSM. -
Key words:
- Men who have sex with men /
- HIV /
- Sexual behaviors /
- Recreational drug
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表 1 南京市MSM新型毒品使用者和未使用者的社会人口学特征[n (%)]
Table 1. Comparison of social-demographic characteristics of MSM in Nanjing by recreational drug use [n (%)]
变量 全部对象
(n=876)未使用者
(n=617)使用者
(n=259)χ2/t值 P值 平均年龄(岁) 29.3±9.3 30.1±10.3 27.4±5.9 4.993 ＜0.001 年龄(岁) 8.344 0.004 < 30 566(64.6) 380(61.6) 186(71.8) ≥30 310(35.4) 237(38.4) 73(28.2) 婚姻状况 1.668 0.196 未婚、离异或丧偶 736(84.0) 512(83.0) 224(86.5) 在婚或同居 140(16.0) 105(17.0) 35(13.5) 户口 0.714 0.398 本省 603(68.8) 430(69.7) 173(66.8) 非本省 273(31.2) 187(30.3) 86(33.2) 在本地居住时间
(年)2.618 0.106 ≤2 228(26.0) 151(24.5) 77(29.7) > 2 648(74.0) 466(75.5) 182(70.3) 文化程度 9.935 0.002 大专以下 229(26.1) 180(29.2) 49(18.9) 大专及以上 647(73.9) 437(70.8) 210(81.1) 性取向 14.044 ＜0.001 同性恋 604(68.9) 402(65.2) 202(78.0) 异性恋/双性恋/
其他272(31.1) 215(34.8) 57(22.0) 主要交友场所 13.047 ＜0.001 浴池/公园/公厕/
酒吧等209(23.9) 168(27.2) 41(15.8) 互联网 667(76.1) 449(72.8) 218(84.2) 职业 0.175 0.676 学生 205(23.4) 142(23.0) 63(24.3) 非学生 671(76.6) 475(77.0) 196(75.7) 月收入(元) 6.897 0.009 < 5000 568(64.8) 417(67.6) 151(58.3) ≥5000 308(35.2) 200(32.4) 108(41.7) 性角色 7.671 0.022 插入方 292(33.3) 218(35.3) 74(28.6) 被插入方 210(24.0) 133(21.6) 77(29.7) 双重角色者 374(42.7) 266(43.1) 108(41.7) 
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表 2 南京市MSM新型毒品使用的多因素Logistic回归模型分析
Table 2. Multivariable Logistic regression analysis of factors associated with recreational drug use among MSM in Nanjing
变量 β值 sx χ2值 aOR(95% CI)值 P值 年龄(岁) ≥30 1.00 < 30 0.406 0.174 5.444 1.50(1.07~2.11) 0.020 文化程度 大专以下 1.00 大专及以上 0.276 0.195 2.005 1.32(0.90~1.93) 0.157 性取向 其他 1.00 同性恋 0.497 0.179 7.714 1.65(1.16~2.34) 0.005 主要交友场所 浴池/公园/公
厕/酒吧等1.00 互联网 0.460 0.201 5.227 1.58(1.07~2.35) 0.022 月收入(元) < 5000 1.00 ≥5000 0.450 0.166 7.391 1.57(1.13~2.17) 0.007 性角色 插入方 1.00 0.103 被插入方 0.437 0.205 4.525 1.55(1.04~2.32) 0.033 双重角色者 0.176 0.181 0.940 1.19(0.87~1.70) 0.332
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表 3 南京市MSM新型毒品使用者和未使用者的相关行为特征[n (%)]
Table 3. Comparison of Behavioral characteristics of MSM in Nanjing by recreational drug use [n (%)]
变量 全部对象(n=876) 未使用者(n=617) 使用者(n=259) aOR(95% CI)值a P值 近6个月性伴数 ≤1 503(57.4) 387(62.7) 116(44.8) 1.00 ≥2 373(42.6) 230(37.3) 143(55.2) 2.25(1.65~3.05) < 0.001 最近6个月是否与同性发生无保护肛交 否 518(59.1) 390(63.2) 128(49.4) 1.00 是 358(40.9) 227(36.8) 131(50.6) 1.83(1.35~2.47) < 0.001 做1时，近6个月是否与同性发生无保护肛交 否 590(67.4) 441(71.5) 149(57.5) 1.00 是 286(32.6) 176(28.5) 110(42.5) 2.18(1.58~3.01) < 0.001 做0时，近6个月是否与同性发生无保护肛交 否 641(73.2) 468(75.9) 173(66.8) 1.00 是 235(26.8) 149(24.1) 86(33.2) 1.58(1.12~2.22) 0.010 近6个月是否与同性发生群交 否 806(92.0) 572(92.7) 234(90.3) 1.00 是 70(8.0) 45(7.3) 25(9.7) 1.63(0.95~2.8) 0.076 近6个月是否与同性固定性伴发生无保护肛交 否 575(65.6) 433(70.2) 142(54.8) 1.00 是 301(34.4) 184(29.8) 117(45.2) 1.92(1.41~2.61) < 0.001 最近6个月同性临时性伴数(个) 0 395(45.1) 303(49.1) 92(35.5) 1.00 1~2 416(47.5) 281(45.5) 135(52.1) 1.81(1.31~2.51) < 0.001 ≥3 65(7.4) 33(5.3) 32(12.4) 3.56(2.02~6.25) < 0.001 近6个月是否与同性临时性伴发生无保护肛交 否 683(78) 495(80.2) 188(72.6) 1.00 是 193(22) 122(19.8) 71(27.4) 1.81(1.26~2.58) 0.001 最近6个是否发生无商业性行为 否 831(93.9) 585(93.6) 246(94.4) 1.00 是 45(6.1) 32(6.4) 13(5.6) 0.81(0.4~1.65) 0.567 最近6个月是否发生异性性行为 否 724(82.6) 497(80.6) 227(87.6) 1.00 是 152(17.4) 120(19.4) 32(12.4) 1.11(0.7~1.76) 0.660 最近1年是否被诊断过性病 否 803(91.7) 571(92.5) 232(89.6) 1.00 是 73(8.3) 46(7.5) 27(10.4) 1.65(0.98~2.79) 0.060 最近1年是否做过HIV检测 否 314(35.8) 240(38.9) 74(28.6) 1.00 是 562(64.2) 377(61.1) 185(71.4) 1.69(1.22~2.34) 0.001 注：a所有回归模型均纳入了表 1中差异有统计学意义的变量，包括年龄、文化程度、主要交友场所、月收入、性取向、性角色。
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表 4 南京市MSM新型毒品使用者和未使用者的HIV/梅毒感染情况分析[n (%)]
Table 4. Prevalence of HIV/syphilis infections among MSM in Nanjing by recreational drug use [n (%)]
变量 全部对象(n=876) 未使用者(n=617) 使用者(n=259) aOR(95% CI) 值a P值 HIV感染 否 793(90.5) 570(92.4) 223(86.1) 1.00 是 83(9.5) 47(7.6) 36(13.9) 1.95(1.21~3.17) 0.007 梅毒感染 否 797(91.0) 567(91.9) 230(88.8) 1.00 是 79(9.0) 50(8.1) 29(11.2) 1.71(1.02~2.84) 0.040 注：a所有回归模型均纳入了表 1中差异有统计学意义的变量，包括年龄、文化程度、主要交友场所、月收入、性取向、性角色。
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