An Epidemiological Survey On Hepatitis C Knowl Edge Practice And Health Education Among Men Who Have Sex With Men In Three Areas Of Southwest China

Objective: To investigate the awareness of hepatitis C related knowledge among the men who had sex with men(MSM)in three areas of Southwest China,so as to facilitate the fishing expedition for carrying out knowledge propaganda and health education in the high-risk population.2.To understand the current status of hepatitis C related risk behaviors among the MSM in those areas and hepatitis C detection,and to search for the influence factors.3.To dig out the self-identification,hepatitis C related knowledge,current status of behavior,and view on health education among the MSM through qualitative interview.Methods: Quantitative research: From August 2016 to December2016,the MSM populations were recruited from three areas of Southwest China(including Chongqing City,Chengdu City and Kunming City)according to the snowball sampling.The self-designed questionnaire was adopted to investigate the basic information,hepatitis C related knowledge level,behavior features and influence factors of the subjects.In addition,Epidata V3.1 was utilized to construct the database;whereas the SPSS V22.0 software chi-square and multivariate Logistic regression methods were employed to analyze the knowledge level,condom use and influence factors of hepatitis C detection.Qualitative research: From May 2018 to August 2018,in-depth individual interview was conducted in 20 MSM using the pre-designed interview outline.Subsequently,the MAXqda2 software was employed to analyze the data according to the main body framework method.Results : Quantitative research: a total of 399 subjects had the age of<35 years,accounting for 88.6%;94.9%(n=427)subjects had senior high school or above secondary vocational school level;the income level of the subjects concentrated on ?3000-8999(n=235,57.7%).The subjects had poor awareness on the prevention and treatment of hepatitis C.The knowledge score of each subject was divided into qualified and unqualified;upon calculation,138(30.6%)subjects had qualified score,with the average score of 3.46±2.16.Multivariate Logistic regression analysis results suggested that,income was the influence factor of the hepatitis C related knowledge score among the MSM.The probability of qualified score among the subjects with the per capita monthly income of ?6000-9999 was 3.587-fold higher of that in subjects with the income of < ? 3000;while that in subjects with the per capita monthly income of ??10000 was 17.519-fold of that in subjects with the income of < ? 3000.The major pathway for the subjects to obtain the hepatitis knowledge was doctors,which accounted for 41.9%(n=189),followed by network and television,accounting for 34.8%(n=157).Additionally,15.7%(n=71)subjects declared no way to obtain hepatitis related knowledge.Hepatitis C related behaviors: with regard to high-risk sexual behavior,6.4%(n=29)subjects never used condom when having sexual relationship with their sex partners.Only 64.1%(n=277)subjects persisted in usingcondom when having sexual relationship with their sex partners.In terms of hepatitis C detection,only 15.1%(n=68)subjects had once received hepatitis C antibody detection,while the major cause of not receiving hepatitis C detection was the unawareness of that examination(43.2%).Results of multivariate Logistic regression analysis suggested that,the detection rate among subjects with the per capita monthly income of ??10000 was 6.745-fold of that among subjects with the income level of <?3000(95%CI:1.937-23.491);and that in subjects with qualified hepatitis C knowledge was 9.454-fold of that in subjects with unqualified hepatitis C knowledge(95%CI:4.633-19.290).Qualitative research: A total of 20 interviewees were recruited altogether.Most interviewees had the age of <30 years(80.0%),with the education of bachelor degree or above(90%);meanwhile,students had accounted for a high proportion(40%)in terms of occupation.Nearly a half of subjects were once bothered with their own sexual orientation,but they could gradually accept with the increase in age.Most subjects were at the semi-coming out status,and their intimate friends and colleagues were aware of their sexual orientation.No subject was bullied or unfairly treated due to their sexual orientation.The subjects had lower awareness of hepatitis C than of AIDS,and some of them might speculate hepatitis C related knowledge through hepatitis B and other common sense.Most subjects would not determine their physical conditions before having sexual relationship with their homosexual partner.The initiative hepatitis C detection was poor among the subjects,most of them only received hepatitis C related detection in entrance and employment check-up,and were not aware of the detection results.The tolerance level to homosexuality in the Chinese society was increasingly enhanced,but mostsubjects held antagonistic attitude towards sexual health education.For the existing health education,empathy was the important influence factor for MSM to participate in health education.Conclusions: The hepatitis C knowledge level among the MSM population in three areas of Southwest China is relatively low,and there are mistakes in the knowledge.Typically,the initiative detection awareness of hepatitis C is poor.Discrimination and tagging may be the obstacles that blocking the MSM to receive health intervention.When carrying out intervention in the stigmatized areas of homosexuality,the psychological need of MSM should be taken into sufficient consideration.Weakening the subject sexual orientation and de-differentiation can be adopted when carrying out heath education,so as to enhance the acceptability of the MSM.