The Study On Risk Factors And Intervention Of HIV-risk Behavior Among Men Who Have Sex With Men

Objective: Based on the actual needs of high-risk behavioral intervention for MSM population,this study investigated the current situation of HIV-risk behavior among MSM population and explored its risk factor.Under the guidance of the theory of planned behavior,it formulated targeted intervention measures for HIV-risk behavior among MSM population,and focused on the mental health status of MSM population.In order to provide theoretical and technical support for reducing the HIV-risk behavior in this population,we should implement intervention and evaluate the effect of intervention.Methods: In the study of exploring risk factors of HIV-risk behavior among MSM population,the qualitative and quantitative methods were used.Firstly,in the process of quantitative research,this study used cross-sectional questionnaire survey method and convenient sampling to survey 342 MSM population in Dalian to explore the risk factors of UAI.Secondly,in the qualitative research of HIV-risk behavior among MSM population,this study further explores the socio-cultural factors that affect the occurrence of HIV-risk behavior in MSM through focus group interviews and in-depth interviews,and understands the socio-cultural factors that affect the effectiveness of AIDS prevention and control services,so as to provide suggestions for the construction of effective and sustainable strategies for AIDS prevention and control among MSM population.Finally,on the basis of the above research,this study synthesizes the literature review and expert consultation results,and takes the theory of planned behavior(TPB)as the theoretical basis for formulating the intervention measures.The intervention is mainly conducted in the form of groups.The intervention sites are mainly MSM activity sites and MSM community organization sites,which are divided into high-risk behavioral intervention and psychological intervention.Under the guidance of the intervention conceptual framework,and combined with qualitative and quantitative research results,the main themes of behavioral intervention in this study are as follows: imparting AIDS-related knowledge to the research subjects,package.Including basic knowledge of AIDS,knowledge of high-risk behaviors,knowledge of transmission channels,etc.,change their attitudes towards insisting on safe sex such as condom use and maintaining regular sexual partners,enhance the awareness of safe sexual behavior of MSM population,carry out peer-to-peer learning activities,recruit influential peer health propagandists in the "circle" and adopt peer-to-peer influence methods among MSM population.Conduct safe sex promotion activities,and distribute condoms and water lubricants to peers.By carrying out peer-to-peer learning activities,we can reduce the pressure of MSM people on safe sex and improve their subjective norms.At the same time,we can teach them safe sex skills such as correct use of condoms and good communication with partners,so as to improve the perceived behavior control and self-efficacy of MSM people on safe sex.In this study,while intervening in HIV-risk behavior of MSM population,we also paid attention to their mental health.We mainly intervened in the following three aspects: establishing a sound monitoring system of psychological problems,publicizing and educating mental health knowledge,and carrying out psychological intervention activities.Volunteers from MSM community organizations recruited 300 MSM people to conduct intervention studies in places where MSM people live,such as bars,baths,parks and toilets.Questionnaires were conducted on the characteristics of HIV-risk behavior and mental health status before intervention(baseline),after intervention and 3 months after intervention.238 MSM puppies were evaluated for intervention.Results: The results showed that the high prevalence of UAI,poor mental health(AOR = 7.16,95% CI: 3.14-16.31),strong self-stigma in sexual orientation(AOR = 1.53,95% CI: 1.00-2.34),and physical abuse in childhood(AOR = 5.85,95% CI: 1.77-19.30)were all risk factors for UAI in MSM population.More MSM community organizations(number of community organizations = 1: AOR = 0.08,95% CI: 0.04-0.17;number of community organizations > 2: AOR = 0.04;95% CI: 0.01-0.09;control group: number of community organizations = 0)and frequent participation in community activities(AOR = 0.19,95% CI: 0.08-0.45)were protective factors for UAI in MSM population.The interview results show that the problems hindering the development of MSM community organizations mainly include lack of government support,lack of funds,and poor human resources.At present,the general survival status of MSM population in China is "identifying their sexual orientation" rather than "coming out",and the level of practicing safe sex is low.MSM population is not yet aware of the new technology of AIDS prevention.Before intervention,the UAI reporting rate in the last three months was 54.2%.After intervention,the UAI reporting rate decreased to 31.1%.During follow-up three months,the UAI reporting rate was 32.8%.Before intervention,the reporting rate of having multiple sexual partners in the last three months was 67.2%.After intervention,the reporting rate of multiple sexual partners decreased to 46.2%.At follow-up three months,the reporting rate of multiple sexual partners was 46.6%.The subjects' s elf-efficacy of safe sex baseline score was 2.78±0.08,the score increased to 3.52±0.04 after intervention and 3.13±0.06 after 3 months of follow-up.Before intervention,the incidence of depression was 35.7%.After intervention,the incidence of depression decreased to 16.8%.At 3 months of follow-up,the incidence of depression was 15.5%.In terms of anxiety,the results showed that before intervention,the incidence of anxiety was 26%.After intervention,the incidence of anxiety decreased to 16.0%.At 3 months of follow-up,the incidence of anxiety was 13.9%.There were significant differences in the evaluation indexes of intervention effect among baseline,post-intervention and follow-up stages(P < 0.05).Conclusion: The prevalence of HIV-risk behavior was high among MSM.Poor mental health and strong self-stigma in sexual orientation were risk factors of risk behavior.The subjects experienced physical abuse in childhood were more likely to have risk behavior,and active engagement in MSM community was protective factor of risk behavior.MSM population was not yet aware of the new technology of AIDS prevention.In AIDS intervention for MSM population,it is suggested that the media and MSM community organizations should be fully utilized to properly publicize new intervention methods,such as knowledge of Pr EP and circumcision,and improve the implementation and promotion mode of new intervention technology.In the aspect of promoting HIV testing among MSM population,it is suggested to explore the factors affecting the acceptance of confirmation testing and improve the quality of counseling services after testing,and to achieve rapid detection,result notification and confirmation testing referral services,so as to reduce the loss and improve the efficiency of detection of infected persons.The problems impeded the development of MSM community organizations mainly included lack of government support,lack of funds,and poor human resources.In addition,we should explore the cooperation mechanism with community organizations,give full play to their unique advantages and influence in the field of AIDS prevention and control,and mobilize MSM population for HIV testing by community organizations.It is suggested that MSM community organizations should be provided with a good legal,policy and public opinion environment.Government departments have increased their investment and explored in depth the mode of purchasing services to normalize the purchasing of AIDS prevention and control services of non-governmental organizations.