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王慧豪, 俞斌, 袁靓, 刘昕, 官越, 翟萌曦, 李佳钰, 燕虹. 年轻男男性行为者性伴数量轨迹与早期负性经历关系[J]. 中国公共卫生, 2023, 39(12): 1520-1525. DOI: 10.11847/zgggws1140517
引用本文: 王慧豪, 俞斌, 袁靓, 刘昕, 官越, 翟萌曦, 李佳钰, 燕虹. 年轻男男性行为者性伴数量轨迹与早期负性经历关系[J]. 中国公共卫生, 2023, 39(12): 1520-1525. DOI: 10.11847/zgggws1140517
WANG Huihao, YU Bin, YUAN Liang, LIU Xin, GUAN Yue, ZHAI Mengxi, LI Jiayu, YAN Hong. Relationship between trajectory of changing in sexual partner numbers and early negative experiences among young men who have sex with men: a follow-up study[J]. Chinese Journal of Public Health, 2023, 39(12): 1520-1525. DOI: 10.11847/zgggws1140517
Citation: WANG Huihao, YU Bin, YUAN Liang, LIU Xin, GUAN Yue, ZHAI Mengxi, LI Jiayu, YAN Hong. Relationship between trajectory of changing in sexual partner numbers and early negative experiences among young men who have sex with men: a follow-up study[J]. Chinese Journal of Public Health, 2023, 39(12): 1520-1525. DOI: 10.11847/zgggws1140517

年轻男男性行为者性伴数量轨迹与早期负性经历关系

Relationship between trajectory of changing in sexual partner numbers and early negative experiences among young men who have sex with men: a follow-up study

  • 摘要:
    目的 了解年轻男男性行为者(YMSM)性伴数量变化情况及与早期负性经历(童年期不良经历、首次同性性行为年龄)之间的关系。
    方法 采用纵向研究设计,于2017年9月 — 2018年1月在武汉、长沙和南昌地区的男同组织的协助下招募16~24岁YMSM作为研究对象,并于2018年7月 — 2020年12月随访3次,共423名YMSM纳入研究。通过R LCTMtools程序确定YMSM性伴数量轨迹亚组,使用无序多分类logistic回归模型分析YMSM性伴数量轨迹与早期负性经历的关系。
    结果  YMSM性伴数量变化可以分为3个不同亚组,持续低水平组、缓慢下降组、持续上升组,分别占调查人数的46.81%(198/423)、35.70%(151/423)、17.49%(74/423)。29.79%(126/423)的YMSM首次同性性行为年龄 < 18岁,56.26%(238/423)的YMSM经历过童年期不良经历(ACE),其中有虐待、忽视、家庭功能障碍经历者分别占38.53%(163/423)、22.46%(95/423)、27.66%(117/423)。无序多分类logistic回归在控制了年龄、文化程度、职业、性取向等混杂因素后,以持续低水平组为参照,首次同性性行为年龄 < 18岁的YMSM性伴数量缓慢下降(aOR = 2.469,95%CI = 1.468~4.151,P < 0.001)和快速上升(aOR = 2.565,95%CI = 1.360~4.838,P = 0.004)的可能性均更高。有躯体虐待(aOR = 1.943,95%CI = 1.003~3.765,P = 0.049)和性虐待(aOR = 1.854,95%CI = 1.053~3.265,P = 0.033)经历的YMSM出现性伴数量缓慢下降的可能性更高,有躯体虐待(aOR = 2.386,95%CI = 1.114~5.108,P = 0.025)经历的YMSM出现性伴数量快速上升的可能性也更高。
    结论  YMSM人群早期负性经历报告率高,且多性伴数量轨迹与早期负性经历存在关联,需关注YMSM早期负性经历并进行早期干预。

     

    Abstract:
    Objective To examine changes in the number of sexual partners among young men who have sex with men (YMSM) and their associations with early negative experiences (including adverse childhood experience ACE and the age of having first homosexual behavior).
    Methods Totally 423 YMSM at ages of 16 – 24 years were recruited with accidental sampling and respondent-driven sampling during September 2017 – January 2018 with the assistance of gay men′s organizations in three cities (Wuhan, Changsha and Nanchang) and were followed up three times from July 2018 to December 2020. Three subgroups of YMSM with different trajectories of changing in the number of sexual partners were discriminated through latent class trajectory modeling with the R LCTMtools program and the relationship between early negative experiences and the trajectory of changing number of sexual partners among the YMSM was explored using unordered multinomial logistic regression analysis.
    Results The three types of trajectory of changing in the number of sexual partners discriminated among the YMSM were less fluctuation with small number, slow downward, and rapid upward and the proportion (number) of the YMSM assigned into the three trajectory subgroups were 46.81% (198), 35.70% (151), and 17.49% (74), respectively. Among the YMSM, 29.79% (126) reported the first homosexual behavior at the age of less than 18 years and 56.26% (238) reported ACE. The experiences of abuse, neglect, and family dysfunction were reported by 38.53% (163), 22.46% (95), and 27.66% (117) of the YMSM. Unordered multinomial logistic regression analysis revealed that after adjusting for potential confounders (age, education, occupation and sexual orientation) and compared to the YMSM of the subgroup with the trajectory of less fluctuation of small sexual partner number, the YMSM having first homosexual behavior under age of 18 years were more likely to have a slow downward trajectory (adjusted odds ratio aOR = 2.469, 95% confidence interval 95%CI: 1.468 – 4.151) and a rapid upward trajectory (aOR = 2.565, 95%CI: 1.360 – 4.838) of sexual partner number; the YMSM ever experiencing physical abuse and sexual abuse were more likely to have a slow downward trajectory, with the aORs (95%CI) of 1.943 (1.003 – 3.765) and 1.854 (1.053 – 3.265); and the YMSM ever experiencing physical abuse were more likely to have a rapid upward trajectory (aOR = 2.386, 95%CI: 1.114 – 5.108).
    Conclusion The self-reported early negative experience is high among YMSM recruited in three China cities and the trajectory of change in sexual partner number of the YMSM is associated with early negative experiences. The results suggest that attention should be paid to early negative experiences of YMSM for implementing relevant interventions.

     

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