Path analysis on unprotected anal intercourse with regular sexual partners in men who have sex with men in Qingdao

ObjectiveTo understand the effects of AIDS related knowledge awareness, self-identity and social support on unprotected anal intercourse (UAI) with regular male sexual partners in men who have sex with men (MSM) in Qingdao.MethodsMSM were recruited in a snowball way. A face-to-face interview was conducted to collect the information about their AIDS related knowledge awareness and sexual behavior characteristics. The Short Recreation to Homosexuality Scale and Social Support Rating Scale were used to evaluate their self-identity and social support status respectively. Quantitative and qualitative variables were compared by using Student’s t-test and χ2 test respectively. Pearson correlation and multiple linear regression analysis were used to identify the correlation and related factors of quantitative variables. In the process of path analysis, parameters were estimated by mean and variance-adjusted weighted least square (WLSMV), mediation effect was tested by bootstrapping.ResultsA total of 529 MSM were recruited, among them, 66.54% had ≥2 regular partners. The proportion of MSM having UAI with single regular male partner and with ≥2 regular male partners were 88.92% and 51.98% (P＜0.001). MSM having UAI with single regular male partner reported lower mean scores for AIDS related knowledge awareness (t＝－2.780) and self-identity score (t＝－2.000), higher mean scores for social support (t＝2.670, P＜0.05). MSM having UAI with ≥2 regular male partner reported lower mean scores for AIDS related knowledge awareness (t＝－3.550, P＜0.001). The path analysis showed that social support and risk sexual situation had direct effects on UAI (social support: Bstd＝0.24, risk sexual situation: Bstd＝0.45) in MSM with single regular male partner. For MSM with ≥2 regular male partners, AIDS related knowledge awareness score had direct effects on UAI with regular male partners (Bstd＝－0.42). Meantime, AIDS related knowledge awareness score can influence UAI with regular partners indirectly through risk sexual situation in MSM. (Bstd＝0.04, P＜0.05). ConclusionThe prevalence of unprotected anal intercourse with regular male sexual partners was high in MSM in Qingdao. Lacking AIDS related knowledge and having higher social support scores can result in high risk of having unprotected anal intercourse.