男男性行为人群性取向告知与艾滋病病毒检测:社会规范与自我效能的链式中介作用

doi:10.6040/j.issn.1671-7554.0.2020.1586

摘要/Abstract

摘要： 目的分析男男性行为人群(MSM)中性取向告知、艾滋病病毒(HIV)检测社会规范、HIV检测自我效能和HIV检测的关系。方法 2019年8月至12月在山东省11个城市招募MSM并开展网络匿名调查,采用偏差校正的非参数百分位Bootstrap法进行链式中介效应分析。结果在调查的924名MSM中,37.1%(343/924)将自己的性取向告知医务工作者,83.8%(774/924)进行过HIV检测。Spearman秩相关分析表明,性取向告知、HIV检测社会规范、HIV检测自我效能和HIV检测之间两两呈正相关(P<0.05)。Bootstrap链式中介效应检验表明,性取向告知与HIV检测的关系中,HIV检测自我效能的中介作用大小为0.163(95%CI:0.075~0.283),HIV检测社会规范和自我效能的链式中介作用大小为0.022(95%CI:0.006~0.052)。结论艾滋病防治工作需要开展MSM人群性取向告知干预措施,并提高HIV检测社会规范和自我效能,以提高我国MSM人群HIV检测率。

关键词: 性取向告知, 艾滋病病毒检测社会规范, 艾滋病病毒检测自我效能, 艾滋病病毒检测, 男男性行为人群

Abstract: Objective To explore the relationship among sexual orientation disclosure, social norms, self-efficacy and uptake of human immunodeficiency virus(HIV)testing among men who have sex with men(MSM). Methods Participants were recruited in 11 cities of Shandong Province during Aug. and Dec., 2019, and were investigated with an anonymous online survey. The chain mediating effect was analyzed with non-parametric bootstrap method with bias correction. Results Among 924 participants, 37.1%(343/924)disclosed their sexual orientation to health professionals and 83.8%(774/924)had received HIV testing. Spearman correlation analysis showed that there was significantly positive correlation between sexual orientation disclosure, HIV testing social norms, HIV testing self-efficacy and HIV testing uptake(P<0.05). Bootstrap test showed that between sexual orientation disclosure and HIV testing uptake, the mediating effect of HIV testing self-efficacy was 0.163(95%CI: 0.075-0.283), and the chain mediating effect of HIV testing social norms and self-efficacy was 0.022(95%CI: 0.006-0.052). Conclusion It is necessary to carry out MSM sexual orientation disclosure intervention and improve HIV testing social norms and self-efficacy to promote HIV testing uptake among MSM in China.

Key words: Sexual orientation disclosure, HIV testing social norms, HIV testing self-efficacy, HIV testing, Men who have sex with men

中图分类号:

R181.3

林玉玺,李传玺,王霖,马伟. 男男性行为人群性取向告知与艾滋病病毒检测:社会规范与自我效能的链式中介作用[J]. 山东大学学报 (医学版), 2021, 59(3): 113-119.

LIN Yuxi, LI Chuanxi, WANG Lin, MA Wei. Sexual orientation disclosure and HIV testing uptake among men who have sex with men: chain mediating effect of HIV testing social norms and self-efficacy[J]. Journal of Shandong University (Health Sciences), 2021, 59(3): 113-119.

参考文献

[1] Wu ZY, Chen JF, Scott SR, et al. History of the HIV epidemic in China [J]. Curr HIV/AIDS Rep, 2019, 16(6): 458-466.
[2] Platteau T, van Lankveld J, Apers L, et al. HIV testing for key populations in Europe: a decade of technological innovation and patient empowerment complement the role of health care professionals [J]. HIV Med, 2018, 19(Suppl 1): 71-76.
[3] Petroll AE, Mosack KE. Physician awareness of sexual orientation and preventive health recommendations to men who have sex with men [J]. Sex Transm Dis, 2011, 38(1): 63-67.
[4] Tang WM, Mao J, Tang SY, et al. Disclosure of sexual orientation to health professionals in China: results from an online cross-sectional study [J]. J Int AIDS Soc, 2017, 20(1): 21416.
[5] Metheny N, Stephenson R. Disclosure of sexual orientation and uptake of HIV testing and hepatitis vaccination for rural men who have sex with men [J]. Ann Fam Med, 2016, 14(2): 155-158.
[6] Ahmed AK, Weatherburn P, Reid D, et al. Social norms related to combining drugs and sex(“chemsex”)among gay men in South London [J]. Int J Drug Policy, 2016, 38: 29-35. doi: 10.1016/j.drugpo.2016.10.007.
[7] 郭沁. 健康行为的社会规范性影响和从众心[J]. 浙江大学学报(人文社会科学版), 2019, 49(1): 80-92. GUO Qin. Normative Influence on Health Behaviors and Group Psychology [J]. Journal of Zhejiang University(Humanities and Social Sciences), 2019, 49(1): 80-92.
[8] Perkins JM, Nyakato VN, Kakuhikire B, et al. Actual versus perceived HIV testing norms, and personal HIV testing uptake: a cross-sectional, population-based study in rural Uganda [J]. AIDS Behav, 2018, 22(2): 616-628.
[9] Zhao PZ, Liu L, Zhang Y, et al. The interaction between HIV testing social norms and self-efficacy on HIV testing among Chinese men who have sex with men: results from an online cross-sectional study [J]. BMC Infect Dis, 2018, 18(1): 541.
[10] Safiri S. Knowledge, attitude, self-efficacy and estimation of frequency of condom use among Iranian students based on a crosswise model: more explanation is needed for the crosswise model [J]. Int J of Adolesc Med Health, 2017, 29(2): /j/ijamh.2017.29.issue-2/ijamh-2016-0110/ijamh-2016-0110.xml.
[11] 刘士雨, 刘洋. 试论培养和提高学生自我效能感的意义和策略[J]. 教育教学论坛, 2020(6): 288-289. LIU Shiyu, LIU Yang. The meaning and strategy on train and improve self-efficacy of the students [J]. Education Teaching Forum, 2020(6): 288-289.
[12] Bandura A. Social foundations of thought and action: a social cognitive theory [M]. Englewood Cliffs: Prentice-Hall, 1986.
[13] 薛莉. HIV检测自我效能和预期污名量表信效度分析及对MSM人群HIV检测影响[D]. 济南:山东大学, 2018.
[14] 马仲慧, 杨彦玲, 邢文革. WHO推荐艾滋病自我检测[J]. 中国艾滋病性病, 2018, 24(2): 211-212. MA Zhonghui, YANG Yanling, XING Wenge. WHO recommends HIV self-testing [J]. Chinese Journal of AIDS & STD, 2018, 24(2): 211-212.
[15] 陈瑞, 郑毓煌, 刘文静. 中介效应分析:原理、程序、Bootstrap方法及其应用[J]. 营销科学学报, 2013, 9(4): 120-135. CHEN Rui, ZHENG Yuhuang, LIU Wenjing. Mediation analysis: principle, procedure and the application of Bootstrap method [J]. Journal of Marketing Science, 2013, 9(4): 120-135.
[16] Hayes AF. An introduction to mediation, moderation, and conditional process analysis: a regression-based approach [M]. New York: Guilford Press, 2013.
[17] 邓稳根, 黎小瑜, 陈勃, 等. 国内心理学文献中共同方法偏差检验的现状[J]. 江西师范大学学报(自然科学版), 2018,42(5): 447-453. DENG Wengen, LI Xiaoyu, CHEN Bo, et al. Analysis on application of common methods bias test to psychological studies during recent five years in China [J]. Journal of Jiangxi Normal University(Natural Sciences Edition), 2018, 42(5): 447-453.
[18] Granich R, Williams B, Montaner J, et al. 90-90-90 and ending AIDS: necessary and feasible [J]. Lancet, 2017, 390(10092): 341-343.
[19] 王雁, 辛颖, 魏贝贝, 等. 非支持性环境、性取向自我认同、秘密隐藏对性少数大学生心理健康的影响[J]. 中国健康心理学杂志, 2020, 28(10): 1572-1576. WANG Yan, XIN Ying, WEI Beibei, et al. Influence of non-support environment, sexual identity, secret concealment on mental health of sex minority college students [J]. China Journal of Health Psycholoy, 2020, 28(10): 1572-1576.
[20] 何慧婧. 影响男性同性性行为人群艾滋病传播的社会文化因素定性研究[D]. 北京:中国疾病预防控制中心, 2017.
[21] Coleman TA, Bauer GR, Pugh D, et al. Sexual orientation disclosure in primary care settings by gay, bisexual, and other men who have sex with men in a Canadian city [J]. LGBT Health, 2017, 4(1): 42-54.
[22] Durso LE, Meyer IH. Patterns and predictors of disclosure of sexual orientation to healthcare providers among lesbians, gay men, and bisexuals [J]. Sex Res Social Policy, 2013, 10(1): 35-42.
[23] Brooks H, Llewellyn CD, Nadarzynski T, et al. Sexual orientation disclosure in health care: a systematic review [J]. Br J Gen Pract, 2018, 68(668): e187-e196.
[24] El-Bassel N, Jemmott JB 3rd, Bellamy SL, et al. Mediation analysis of the efficacy of the Eban HIV/STD risk-reduction intervention for African American HIV serodiscordant couples [J]. AIDS Behav, 2016, 20(6): 1197-1207.
[25] Jamil MS, Guy RJ, Bavinton BR, et al. HIV testing self-efficacy is associated with higher HIV testing frequency and perceived likelihood to self-test among gay and bisexual men[J]. Sexual health, 2017, 14(2): 170-178.
[26] Prati G, Breveglieri M, Lelleri R, et al. Psychosocial correlates of HIV testing among men who have sex with men in Italy: a cross-sectional study [J]. Int J STD AIDS, 2014, 25(7): 496-503.
[27] Pham MD, Aung PP, Agius PA, et al. Relationship between self-efficacy and HIV testing uptake among young men who have sex with men in Myanmar: a cross-sectional analysis[J]. Int J STD AIDS, 2019, 30(1): 20-28.
[28] 潘珊珊. 不同任务情境中描述性社会规范对风险决策的影响[D]. 杭州:浙江大学, 2018.
[29] 范雄智, 刘仲琦, 程伟彬, 等. 男男性行为人群同伴社会网络规范对其HIV检测行为的影响[J]. 中华疾病控制杂志, 2018, 22(1): 38-41. FAN Xiongzhi, LIU Zhongqi, CHENG Weibin, et al. Association between social norms of egocentric social network and HIV testing behaviors among men who have sex with men [J]. Chinese Journal Disease Control & Prevention, 2018, 22(1): 38-41.
[30] 温忠麟, 叶宝娟. 中介效应分析: 方法和模型发展[J]. 心理科学进展, 2014, 22(5): 731-745. WEN Zhonglin, YE Baojuan. Analyses of mediating effects: the development of methods and models [J]. Advances in Psychological Science, 2014, 22(5): 731-745.

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