目的：了解大学生男男性行为者（ MSM）利用艾滋病自愿咨询检测（ VCT）服务情况及影响因素。方法在前期现场介入调查的基础上，于2012年9月—2013年1月在长沙市区13所高校内，以“滚雪球”抽样方式共招募了256名MSM大学生，采用自编问卷以面对面访谈形式，对受试者进行访谈调查。剔除应答不完整问卷后，收回有效问卷217份，回收率为84.8%（217/256）。以是否利用过VCT服务将MSM大学生分为曾利用VCT组和未利用VCT组。以回答正确总题数的80%为界，将MSM大学生HIV/AIDS相关知识知晓程度划分为“知晓程度较低”和“知晓程度较高”两个等级。结果被调查MSM大学生中91.2%（198/217）知晓VCT服务，应答人次数前3位的知晓途径依次为：通过同伴/朋友知晓80名（25.0%，80/320），通过网络知晓74名（23.1%，74/320），通过医疗机构知晓为44名（13.8%，44/320）。70.5%（153/217）曾经接受过VCT服务，最常去的检测场所主要是“同志工作小组”（79名，51.6%），其次是疾病预防控制机构（47名，30.7%）、医院（17名，11.1%）。曾利用VCT组和未利用VCT组大学生月生活费、性取向、VCT知晓情况比较，差异有统计学意义（ P<0.05）。大学生VCT服务利用的主要心理障碍前3位因素依次为：害怕阳性结果109名（50.2%），担心他人误会73名（33.6%），自认无感染危险57名（26.3%）。曾利用VCT组和未利用VCT组MSM大学生害怕阳性结果、担心他人误会、自认无感染危险比较，差异有统计学意义（ P<0.05）。曾利用VCT组MSM大学生HIV/AIDS相关知识知晓程度较高率（78.4%）高于未利用VCT组（21.6%）（χ2=10.986，P<0.01）；曾利用VCT组MSM大学生的HIV/AIDS传播途径、感染后果以及感染危险性行为知晓程度较高率高于未利用VCT组（ P<0.05）。多因素Logistic回归分析显示，HIV/AIDS知识知晓程度高、知晓VCT服务、自认无感染危险、害怕阳性结果是MSM大学生利用VCT服务的影响因素（ P<0.05）。结论大学生MSM 更愿意在同志工作小组接受VCT服务；加强与社区同志工作小组的合作，对该特殊人群有针对性地开展 HIV/AIDS相关健康教育、帮助其掌握有效预防及应对HIV感染的知识和技能、消除其对HIV感染的恐惧是提高该人群VCT利用率的可行途径。%Objective To get the knowledge of the utilization status of HIV voluntary counseling and testing( VCT) in undergraduate men who have sex with men( MSM) and its influencing factors. Methods Based on on-site investigation in the early,useing self-made questionnaire to investigate 256 MSM undergraduates in 13 universities of Changsha from September 2012 to January 2013. Excluding the incomplete,there were 217 valid questionnaires(84. 8%). Whether the use of a VCT service by the subjects were divided into VCT group and unused VCT group. To answer the right questions 80% as the boundary, the MSM of College Students' HIV/AIDS knowledge were divided into" low awareness"and" high awareness"two grades. Re-sults In 217 eligible college MSMs,91. 2% knew about VCT,top 3 ways as follows:knowledge through peer / friends know that 80(25. 0%,80/320),knowing the 74 through the network(23. 1%,74/320),by the medical institution known as the 44(13. 8%,44/320). And 70. 5% had ever received VCT services. The most common place to detect mainly " Comrade Working Groups"(79,51. 6%),followed by the disease prevention and control mechanism(47,30. 7%),hospitals(17, 11. 1%). VCT group had used and unused VCT group of college students monthly living expenses,sexual orientation,whether aware of VCT,the difference was statistically significant(P<0. 05). Psychological barrier before three factors were:fear of a positive result 109(50. 2%),fear of others misunderstand 73(33. 6%),and claims that no infection risk of 57(26. 3%). VCT group and unused VCT group using MSM students afraid of positive results, worry about others misunderstanding, and claims that there is no risk of infection compared,the difference was statistically significant(P<0. 05). VCT group of MSM students had a higher degree of knowledge of the HIV/AIDS rate ( 78. 4%) was higher than that of unused VCT group (21. 6%)(χ2 =10. 986,P<0. 01). Used HIV/AIDS route of transmission,VCT group of MSM students infection and infec-tion risk sexual behavior consequences awareness higher rate was higher than the unused VCT group ( P<0. 05 ). Multivariate Logistic regression suggested that high knowledge related to HIV/AIDS,acquaintance of VCT services,unawareness of HIV in-fection risk,and being afraid of positive results were risk factors of VCT utilization among MSM undergraduates. Conclusion MSM undergraduates prefer receiving VCT services in homosexual " Comrade Working Groups". Strengthening the cooperation with community" Comrade Working Groups"to carry out targeted HIV/AIDS-related health education and help them master the knowledge and skills about effective prevention of HIV infection to eliminate their fear of HIV infection is a feasible way to improve VCT service utilization.
展开▼
