ZHANG Hong, CHEN Jianhui, LIU Meiyan, LIN Chunzhong, XU Shaoyi, XUE Honghong. Factors associated with unprotected anal sex behavior among adolescent boys who have sex with men in and out of school in Fuzhou City[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(12): 1446-1453. doi: 10.16462/j.cnki.zhjbkz.2024.12.013
Citation:
ZHANG Hong, CHEN Jianhui, LIU Meiyan, LIN Chunzhong, XU Shaoyi, XUE Honghong. Factors associated with unprotected anal sex behavior among adolescent boys who have sex with men in and out of school in Fuzhou City[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(12): 1446-1453. doi: 10.16462/j.cnki.zhjbkz.2024.12.013
ZHANG Hong, CHEN Jianhui, LIU Meiyan, LIN Chunzhong, XU Shaoyi, XUE Honghong. Factors associated with unprotected anal sex behavior among adolescent boys who have sex with men in and out of school in Fuzhou City[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(12): 1446-1453. doi: 10.16462/j.cnki.zhjbkz.2024.12.013
Citation:
ZHANG Hong, CHEN Jianhui, LIU Meiyan, LIN Chunzhong, XU Shaoyi, XUE Honghong. Factors associated with unprotected anal sex behavior among adolescent boys who have sex with men in and out of school in Fuzhou City[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(12): 1446-1453. doi: 10.16462/j.cnki.zhjbkz.2024.12.013
Objective To analyze the characteristics of in-school and out-of-school adolescent men who have sex with men (MSM) populations and factors associated with the occurrence of unprotected anal intercourse (UAI) in Fuzhou City, and to provide a basis for the development of acquired immune deficiency syndrome(AIDS) prevention and control strategies for adolescent MSM.Methods From April to December 2022, MSM aged 15 to 24 years who had engaged in oral/anal sex with men in the last 6 months were recruited online and grouped according to in-school and out-of-school subgroups, and descriptive epidemiological methods were used to analyse differences in population characteristics, and logistic regression models were used to analyse differences in the factors associated with the occurrence of UAI.Results A total of 2 276 MSM aged 15-24 years were surveyed, including 1 306 in-school and 970 out-of-school. The HIV knowledge rates of in-school and out-of-school adolescent MSM were 88.51% (1 156/1 306) and 86.08% (835/970), respectively. The proportion of in-school adolescent MSM who consistently used condoms in anal sex and heterosexual sex in the last 6 months was higher than that of out-of-school; the proportion of out-of-school adolescent MSM with junior high school education or less, commercial same-sex sex in the last 6 months, heterosexual sex, use of psychoactive substances, and HIV antibody testing in the last year was higher than that of out-of-school, and the differences were statistically significant (all P < 0.05). The proportions of in-school and out-of-school adolescents MSM experiencing UAI were 49.81% (530/1 064) and 56.16% (488/869), respectively, and the difference was statistically significant (χ2 =7.724, P=0.005). Factors associated with the occurrence of UAI among in-school adolescent MSM: age at first sexual intercourse > 18-24 years was 0.742 of 15-18 years (95% CI: 0.580-0.950); 1-2 episodes of anal sex in the last week was 1.775 times higher than no episodes (95% CI: 1.353-2.330); and no use of psychoactive substances was 0.611 of users (95% CI: 0.440-0.849).Factors associated with the occurrence of UAI among out-of-school adolescent MSM: out-of-province household registration was 1.867 times more common than Fujian Province household registration (95% CI: 1.365-2.555); college and above education level was 0.545 of junior high school and below (95% CI: 0.350-0.848); internet searching for a sexual partner was 0.564 of place (95% CI: 0.329-0.967); having anal intercourse in the last week 1-2 times was 1.858 (95% CI: 1.353-2.553) times more likely to not have occurred; having anal sex >2 times in the last week was 1.711 (95% CI: 1.085-2.698) times more likely to not have occurred; and not having heterosexual sex in the last 6 months was 0.705 (95% CI: 0.517-0.962) of have occurred.Conclusions Out-of-school adolescent MSM have low educational attainment, low age at first sex, and low adherence to condom use, but have a high proportion of commercial sex and a high risk of UAI; In-school adolescent MSM have a low proportion of prior human immunodeficiency virus(HIV) testing, and both have different characteristics and factors associated with the occurrence of UAI. Therefore, differentiated interventions should be explored to reduce the risk of HIV transmission.
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