Evaluation Of Sexual Behavior Based On IMB Model Among Men Who Have Sex With Men

Objective:To understand the current status of condom use among men who have sex with men(MSM)in Guangzhou.Based on the Information-Motivation-Behavioral Skills Model(IMB model)theory,integrate relevant influencing factors to improve the IMB model,so as to establish a theoretical model suitable for MSM safety behavior intervention,analyze the mutual influence factors and provide comprehensive interventions to promote safe sex in this population.Methods:From May to November in 2017,with the assistance of the Guangzhou Center for Disease Control and Prevention(CDC),a cross-sectional survey was conducted using a non-probability sampling method.Through the Voluntary Counseling Testing(VCT)clinic of CDC,Lingnan Partners and Zhitong Charity,the MSM of Guangzhou City were recruited to conduct an anonymous questionnaire survey.Survey respondents completed the electronic questionnaire to collected social demographic characteristics,sexual behavior-related characteristics,social psychological characteristics,HIV/AIDS prevention services,condom use condition and three basic components(information,motivation and behavioral skills)of IMB model.SPSS 20.0 and SAS 9.4 software were used to describe the results,construct and analyze the structural equation model.Results:1.Socio-demographic characteristics: A total of 1,113 respondents were recruited.The median age was 27 years old.The survey respondents were mainly Han nationality(97.3%),local residence time more than one year(88.2%),unmarried(87.2%),college degree(75.0%),and monthly income more than 5,000 yuan(49.0%).2.Sexual behavior-related characteristics: 72.7% of respondents self-identified as homosexual,and 89.7% of MSM mainly searched for sexual partners through the Internet.The proportion of homosexual,heterosexual and homosexual commercial sex in the last six months was 87.7%,18.1%,and 5.5% respectively.52.4% of MSM had multiple partners.The proportions of drinking alcohol and using club drug before sexual intercourse were 31.7% and 32.1%,respectively.3.Social psychology characteristics: The incidence of depressive symptoms,childhood sexual abuse and intimate partner violence were 43.4%,26.7%,and 13.4%,respectively.4.Access HIV prevention services conditon: 63.8% of the respondents had received HIV prevention services within the last year.5.Condom use and association analysis: In the last six months,when sexual intercourse with homosexuals occurred,52.0% were able to insist on using condoms every time.Marital status,personal income,education,the main method of finding sexual partners,HIV prevention service,depressive symptoms,and childhood sexual abuse were associated with MSM condom using(P<0.05).6.IMB model: The survey respondents information score was(6.6±1.4),and three dimensions of the motivation were: personal attitude with a score(17.5±4.3),subjective norm(17.1±3.8),and behavioral intention(18.0±3.4).The two dimensions of behavioral skills were perceived difficulty(25.9±3.8)and perceived effectiveness(19.8±5.7).After the structural equation model analysis,the goodness of fit evaluation of the integrated IMB model was better than the traditional IMB model,and the effect of explaining safety behavior was higher than the traditional IMB model(92.7% and 59.9%,respectively).Conclusions:1.Guangzhou MSM population,whom searching for sexual partners mainly through the Internet,has a high level of sexual activity.It is common to have multiple partners,and the phenomenon of drinking alcohol and using club drug before sexual activity were worthy of caution.2.Condom using have a low percentage among MSM population whose marriage status is divorced or widowed,student,low-income,low-educated,looking for a partner mainly through a physical location,has not received HIV prevention services in the past year,has depressive symptoms,experienced intimate partner violence,and childhood sexual abuse.More attentions should be paid for this MSM population.3.The integrated IMB model was better than the traditional IMB model.There should focus on strengthening the behavior skills on safe sexual behavior of MSM population,learning and mastering more ability to reject high-risk sexual behavior and promote safe sex.In the implementation of interventions,it is necessary to specifically integrate social demographic characteristics,sexual behavior-related characteristics,social psychological characteristics,and AIDS prevention services to conduct effective interventions.