【摘要】 目的 了解成都市异性性传播HIV/AIDS患者中男性病例确诊前，与配偶/固定性伴、商业性性伴、非婚非商业性伴和男男同性性伴4种常见性伴之间的性行为特征。方法 采用横断面调查，对成都市三个区（市）县的经异性性传播感染的男性HIV/AIDS患者进行问卷调查，收集其社会人口学资料及确诊前性伴及性行为等信息，采用率或者占比、χ2检验和二分类非条件Logistic回归模型对确诊前性行为特征进行分析。结果 共计调查576名HIV/AIDS患者，确诊前47.05%(271/576)有配偶/固定性伴，70.49%(406/576)有过商业性性行为，22.57%(130/576)有过非婚非商业性性行为，5.90%(34/576)有过男男同性性行为；与性伴间发生性行为每次均使用安全套的占比低于15.00%；未每次都使用安全套的原因70%以上由于“无使用习惯”。25～49岁（OR=5.056,95%CI:1.951～13.106）和≥50岁（OR=4.830,95%CI:1.877～12.432）年龄段、居住在近郊区（OR=2.653,95%CI:1.661～4.236）和远郊区（OR=1.821,95%CI:1.165～2.845）、在婚（OR=1.751,95%CI:1.181～2.596）是发生商业性性行为的危险因素；19～24岁（OR=3.655,95%CI:1.504～8.884）和25～49岁（OR=2.026,95%CI:1.293～3.176）年龄段、居住在主城区（OR=2.855,95%CI:1.669～4.885）、非婚状态（OR=2.984,95%CI:1.866～4.773）和外出务工（OR=1.685,95%CI:1.039～2.732）是发生非婚非商业性行为的危险因素；19～24岁（OR=5.913,95%CI:1.657～21.096）；高中/中专（OR=5.332,95%CI:2.06～13.799）和大专及以上（OR=2.800,95%CI:1.039～7.543）文化程度、非婚状态（OR=3.511,95%CI:1.258～9.798）是发生男男同性性行为的危险因素。结论 成都市报告传播途径为异性性传播的男性HIV/AIDS患者在确诊前，不同年龄、地区及婚姻状态者在发生商业性性行为、非婚非商业性性行为及男男同性性行为三种非婚性接触方面存在差异，且安全套使用比例较低。不同区域须根据人群特征进行差异化健康教育和行为干预，安全套推广工作须进一步加强。更多还原

【Abstract】 Objective To investigate the characteristics of pre-confirmation sexual behavior of men HIV/AIDS infected by heterosexual transmission, that respectively with spouses, commercial heterosexual partners, non-marital and non-commercial heterosexual partners, and MSM partners in Chengdu. Methods A cross-sectional survey was conducted, and the questionnaires were collected among men HIV/AIDS infected by heterosexual transmission in three counties in Chengdu. The data of socio-demography, as well as pre-confirmation sexual behavior characteristics and sexual partners were collected. The rate or percentage, chi-square test and a binary unconditional logistic regression model were used to analyze the pre-confirmation characteristics of sexual behavior. Results A total of 576 patients were surveyed. Out of them, 47.05%(271/576) had a spouse/regular sexual partner, 70.49%(406/576) had commercial sexual contacts, 22.57%(130/576) had non-marital and non-commercial heterosexual contact, and 5.90%(34/576) had men homosexual behavior before infection. The proportion of individuals used condoms every time is less than 15.00%, and more than 70% of the reasons for not using condoms every time were ’no usage habits’. Multivariate logistic regression analysis showed that 25-49 and ≥50 years old(OR=5.056, 95%CI: 1.951-13.106; OR=4.830, 95%CI: 1.877-12.432), living in suburbs and outer suburbs(OR=2.653, 95%CI: 1.661-4.236, OR=1.821, 95%CI: 1.165-2.845), and married(OR=1.751, 95%CI: 1.181-2.596) were risk factors for commercial heterosexual behavior; 19-24 and 25-49 years old(OR=3.655, 95%CI: 1.504-8.884; OR=2.026, 95%CI: 1.293-3.176), living in downtown(OR=2.855, 95%CI: 1.669-4.885), being unmarried(OR=2.984, 95%CI: 1.866-4.773), migrant workers(OR=1.685, 95%CI: 1.039-2.732) were risk factors for non-marital and non-commercial heterosexual behavior; 19-24 years old(OR=5.913, 95%CI: 1.657～21.096) high school or technical secondary education and college degree or above(OR=5.332, 95%CI: 2.06-13.799;OR=2.800,95%CI: 1.039-7.543), being unmarried(OR=3.511, 95%CI: 1.258-9.798) were risk factors for men homosexual behavior. Conclusions Before confirmed diagnosis in Chengdu, there were differences in three kinds of non-marital sexual contact among men HIV/AIDS in terms of different ages, regions and marriages, including commercial heterosexual behavior, non-marital and non-commercial heterosexual behavior, and men homosexual behavior. The habit of using condoms with sexual partners is poor. Differentiated health education and behavioral intervention should be carried out in different regions according to the sexual behavior characteristics of the population. Condom promotion should be further strengthened.更多还原