| Background HIV/AIDS show rapid spreading among MSM in China, they were classified3groups according to anal intercourse (insertive, receptive, both) in present research. The most research among MSM as a whole about the associated factors for recent HIV infection, ignore the different roles in physiological, psychological, behavioral differences, which is able to have effect the number of sexual partners, safety, the regional distribution, sex frequency, condom use, STD treatment, drug abuse, so which affects the spread of HIV/AIDS and sexually transmitted diseases. There are very few related researches in China so far.Objectives To understand the different roles of the characteristics of sexual behavior, the infection of AIDS, STD and so on. To compare the different sex role HIV infection among MSM cohort study, through the single factor and multiple factors analysis, to explore the influencing factors. To analyze the difference of different sex role risk behavior characteristics, provide the basis for the next step for the development of targeted interventions.Methods Quantitative research data derived from the National S&T Major Project on AIDS in the11th Five-Year Plan of China, including demography, AIDS related knowledge, sexual behavior, sexually transmitted infections, circumcision operation and other information,2044MSM up to standard were incorporated into the analysis. SPSS13.0were used to statistical analysis. Qualitative study recruited60people, through personal interviews, in-depth interviews the high risk behavior, understanding of the different sex role AIDS/STD related factors.Results The total number was2044MSM, the insertive group contain405, the receptive group198, both group1441.1. The cohort of the insertive group had a cumulative follow-up period of436.69person-years(PYs),14turned HIV positive during follow-up visits. The HIV incidence density was3.21(95%CI:1.55,4.86)/100PY. The cohort of the receptive group had a cumulative follow-up period of202.38person-years,17turned HIV positive during follow-up visits. The HIV incidence density was8.40(95%CI:4.58,12.22)/100PY. The cohort of the both group had a cumulative follow-up period of1532.60person-years.98turned HIV positive during follow-up visits. The HIV incidence density was6.39(95%CI:5.17,7.62)/100PY. Log-rank test statisticx2=8.479, v=2, P=0.014, the difference has statistical significance.2. The single factor analysis the results showed statistically significant (P<0.05) variable for marital status, every time sex insist on condom use, HSV-2infection, syphilis infection, multiple factor analysis the results showed always insist on condom use was advantageous factor (β<0), syphilis and HSV-2infection was harmful factors (β>0) in the insertive group. The single factor analysis the results showed statistically significant (P<0.05) variable for the Age, occupation, AIDS knowledge, circumcision (medical), syphilis infection, multiple factor analysis the results showed age senior occupation of housework or unemployed, condom use in the last sexual behavior, had circumcision was advantageous factor (β<0), syphilis and HSV-2infection was harmful factors (β>0) in the both group.3. Qualitative research showed that MSM had different reason to enter the circle and choose different role, and sexual partners, condom use, STD history types, drug use, heterosexual sex, physiological and psychological changes after infection were also different, and these had great influence on the spread of AIDS.Conclusion1. The seroconversion risk of the receptive group was greater than the both and insertive group, the insertive group was lower than others. The receptive group HIV new infections risk was the insertive group2.62times, the both group HIV new infections risk was the insertive group1.99times.2. In spite of the same proportion of sex partners in sexual behavior, condom use, there was still difference seroconversion in different roles, illustratived that different sex role on HIV seroconversion have a significant impact on. So the receptive group MSM populations should be classified as AIDS focus groups.3. Sexually transmitted infections can increase HIV infection, so in addition to expand HIV testing, should also be expanded STD screening and treatment.4. Continue to strengthen the MSM HIV infection risk consciousness, form the habits of having sex with condom. Promote gay special condom, reduce the harm of the common condom seminal vesicle on anal and rectal carded if the men who did not like ordinary condom, improve the acceptability and utilization;Mobilization and promotion of the using rate of the oral sex condom.5. Should actively expand Treatment strategies, once the infected persons was found, timely treatment, reduce the infectious risk; Strengthen the psychological intervention and support services for the positive receptive persons.6. Promote the circumcision as an effective method of intervention in the insertive and both MSM groups. |
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