| Objective: To understand the adherence and influencing factors of MSM to ecological instantaneous assessment method(EMA)in Urumqi.To compare the consistency between EMA survey and traditional questionnaire survey events to understand the magnitude of recall bias of traditional questionnaires.To explore the influencing factors of high-risk sexual behavior among MSM based on EMA survey.Methods: The MSM was recruited through the network based on the social organizations in Urumqi.The baseline questionnaire collected general demographic characteristics and sexual behavior characteristics over the past 14 days.MSM sexual behavior information was collected in real time twice a day using the ecological instantaneous assessment questionnaire for 14 consecutive days.Response rate through the EMA questionnaire reflected the MSM adherence.Respondents with 80% of the questionnaire response rate were considered as having high adherence.Multivariate Logistic regression was used to explore the factors influencing MSM adherence to EMA investigative behavior.The Kappa consistency test was used to analyze the behavior of the EMA survey and the baseline survey and the traditional questionnaire separately.The generalized estimating equation model was used to explore the influencing factors of high-risk sexual behavior in MSM in Urumqi.Results: A total of MSM 156 individuals were included.The mean age was 33.61±8.88 years.78.85% of MSM were high-compliant.The EMA questionnaire response rate for MSM sex was 81.00%.The completion rate of the EMA questionnaire within three hours after the EMA survey reminder was 82.11%.MSM over 30 years showed higher adherence to EMA(OR=2.439,95%CI: 1.023～5.816).MSM in practice had higher adherence to EMA(OR = 3.073,95%CI: 1.055～8.953).Nonsmoking showed higher adherence to EMA(OR = 3.469,95%CI: 1.450 ～ 8.299).MSM without anxiety symptoms showed higher adherence to EMA(OR=2.562,95%CI: 1.021～6.427).All MSM behaviors between EMA and DD surveys,and EMA and 14-day traditional follow-up survey,baseline survey and 14-day traditional follow-up survey showed high consistency(Kappa values> 0.40).Moderate consistency of MSM 14 days sex behavior,use of psychoactive substances,smoking and Pr EP obtained between baseline and EMA surveys.Moderate consistency of psychoactive substances in MSM and smoking obtained from traditional questionnaire and EMA surveys.Based on the EMA survey to explore the influencing factors of high-risk sexual behavior in MSM.It was found that MSM who used psychoactive substances(OR=4.084,95%CI: 1.820～9.167)and sexual partners who took Pr EP(OR=3.302,95%CI: 1.139～9.572)had a higher risk of high-risk sexual behaviors.Based on the DD survey toexplore the influencing factors of high-risk sexual behavior in MSM.It was found that MSM who used Pr EP(OR=6.400,95%CI: 1.689～24.249)and psychoactive substances(OR=4.404,95%CI: 1.234～15.716)had a higher risk of high-risk sexual behaviors.In addition,The intention of condom use in planned sexual behavior is that MSM who are more likely to use condoms have a higher risk of high-risk sexual activity(OR=6.684,95%CI: 1.565～30.093).Conclusion: MSM of Urumqi,Xinjiang showed high compliance to EMA survey behavior for 14 consecutive days.It is feasible to use EMA to investigate MSM sexual behavior in a short time.There is some degree of recall bias in traditional questionnaires on alcohol consumption and partial sexual information in MSM.Risk factors for high-risk sexual behavior in MSM include Pr EP administration,use of psychoactive substances,alcohol consumption,Pr EP administration by sexual partners,and planned sexual behavior. |
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