Objective: To understand the homosexual behavior and related factors among married MSM in Mianyang city. Methods: Between January and October in 2017, a snowball sampling method was adopted to carry out cross-sectional survey through questionnaires plus HIV testing among those MSM in Mianyang city. Logistic regression model was used to analyze homosexual behaviors and related factors among married MSM under study. Statistical analysis was used by EpiData 3.1 and SPSS 19.0 software. Results: A total of 234 MSM participated in this survey. The overall rate of homosexual behavior in these married MSM appeared as 94.9% (222/234). Rate of having anal sex behavior was 94.4% (221/234) in the past 6 months, with rate of condom use as 57.9% (128/221). HIV positive rate was 8.1% (18/222). As for the motives for homosexual behavior after marriage, 87.8% (195/222) were driven by feelings of love, 12.2% (27/222) due to 'releasing pressure'. Proportion of male sex partners would include occasional sex partners (62.2%, 138/222), stable male sex partners (26.1%, 58/222) and stable boyfriends (11.7%, 26/222). Factors from logistic regression analysis showed that homosexual behaviors were related to the factors including education level of senior high school or above vs. education level of junior middle school or below (OR=3.65, 95%CI: 1.33-9.98); local residency over one year vs. the ones having local residency less than one year (OR=23.28, 95%CI:1.67-324.89); having 10 or more friends in the MSM community vs. having below 10 friends in MSM community (OR=4.15, 95%CI: 1.28-13.43); without sex pleasure with spouse vs. having sex pleasure with spouse (OR=3.25, 95%CI: 1.22-8.62); having 2 or more anal sex partners in the past 6 months vs. having less than 2 anal sex partners in the past 6 months (OR=0.28,95%CI: 0.09-0.81). Conclusions: The rate of homosexual behavior and HIV positive rate were high among MSM in Mianyang city. Homosexual behaviors after marriage were influenced by multiple factors among MSM. The motives of homosexual behavior after marriage were driven by feelings of love, the related factors were education level of senior high school or above, local residency over one year, having 10 or more friends in the MSM community and without sex pleasure with spouse. As for the motives of these behaviors was caused by releasing pressure, the related factors was having more than 2 anal sex partners.
目的： 了解绵阳市MSM婚后同性性行为现状及其相关因素。 方法： 2017年1－10月在绵阳市采用滚雪球法招募MSM开展横断面调查，并进行HIV检测，采用多因素logistic回归分析婚后同性性行为的相关因素。采用EpiData 3.1软件和SPSS 19.0软件进行统计学分析。 结果： 研究对象MSM 234人，婚后同性性行为发生率为94.9%（222/234），最近6个月有同性肛交占94.4%（221/234），最近6个月每次肛交安全套使用率为57.9%（128/221）。HIV感染率为8.1%（18/222）。婚后同性性行为发生主要原因为内心驱使（87.8%，195/222）和压力释放（12.2%，27/222）。性伴主要为临时男性性伴（62.2%，138/222）、固定男性性伴（26.1%，58/222）和固定男朋友（11.7%，26/222）。多因素logistic回归分析结果显示，受内心驱使/压力释放而发生婚后同性性行为的相关因素包括文化程度为高中及以上（与初中及以下相比，OR=3.65，95%CI：1.33~9.98）、本地居住时间>1年（与本地居住≤1年相比，OR=23.28，95%CI：1.67~324.89）、社区朋友数≥10人（与社区朋友数<10人相比，OR=4.15，95%CI：1.28~13.43）、夫妻性生活无快感者（与夫妻性生活有快感者相比，OR=3.25，95%CI：1.22~8.62）、最近6个月肛交人数≥2人（与肛交人数≤1人相比，OR=0.28，95%CI：0.09~0.81）。 结论： 绵阳市MSM婚后同性性行为发生率和HIV感染率均较高，由于内心驱使而发生婚后同性性行为的相关因素包括高中及以上文化程度、本地居住时间>1年、社区朋友数≥10人、夫妻性生活无快感；由于压力释放而发生婚后同性性行为的相关因素为最近6个月肛交人数≥2人。.
Keywords: Homosexual behavior; Marriage; Men who have sex with men; Related factors.