ปัจจัยทำนายพฤติกรรมการป้องกันการติดเชื้อ HIV ของเยาวชนกลุ่มชายรักชาย ในเขตกรุงเทพมหานคร
คำสำคัญ:
พฤติกรรมการป้องกันการติดเชื้อ HIV, กรอบแนวคิดโมเดลเชิงนิเวศวิทยา, เยาวชนชายรักชายบทคัดย่อ
การวิจัยนี้เป็นรูปแบบการวิจัยเชิงสำรวจแบบภาคตัดขวาง มีวัตถุประสงค์เพื่อศึกษาปัจจัยทำนายพฤติกรรมการป้องกันการติดเชื้อเอชไอวีของเยาวชนกลุ่มชายรักชายในเขตกรุงเทพมหานคร โดยประยุกต์ใช้กรอบแนวคิดโมเดลเชิงนิเวศวิทยา (McLeroy และคณะ, 1988) กลุ่มตัวอย่างเป็นเยาวชนชายรักชายที่พักอาศัยหรือทำงานในเขตกรุงเทพมหานคร อายุ 18-24 ปี โดยวิธีการสุ่มตัวอย่างแบบลูกโซ่ จำนวน 386 คน เก็บข้อมูลตั้งแต่เดือนพฤศจิกายน - เดือนธันวาคม พ.ศ. 2562 ด้วยวิธีการตอบแบบสอบถามด้วยตนเองในรูปแบบออนไลน์ วิเคราะห์ข้อมูลโดยใช้สถิติพรรณนา และการวิเคราะห์ถดถอยพหุคูณแบบขั้นตอน กำหนดระดับนัยสำคัญทางสถิติที่ระดับ .05
ผลการวิจัย พบว่า กลุ่มตัวอย่างส่วนใหญ่มีค่าคะแนนพฤติกรรมการป้องกันการติดเชื้อ HIV
อยู่ในระดับที่มีความเสี่ยง ร้อยละ 91.5 และพบปัจจัยทำนายพฤติกรรมป้องกันการติดเชื้อ HIV ในเยาวชนกลุ่มชายรักชาย ดังนี้ การเข้าถึงข้อมูลและนโยบายเกี่ยวกับการป้องกันการติดเชื้อ HIV ในกลุ่มชายรักชาย (β = .163, p < .05) การไม่ทราบสถานการณ์ติดเชื้อโรคติดต่อทางเพศสัมพันธ์ของคู่นอน (β = .138,
p < .05) การดื่มแอลกอฮอล์ (β = -.127, p < .05) การเปิดเผยเพศภาวะต่อสังคม (β = .154, p < .05) และความรู้เกี่ยวกับพฤติกรรมป้องกันการติดเชื้อ HIV (β = .136, p < .05) สามารถทำนายพฤติกรรมการป้องกันการติดเชื้อ HIV ในเยาวชนกลุ่มชายรักชายได้ร้อยละ 21.2 (R2 = .212, p < .001)
ผลการวิจัยแสดงให้เห็นถึงความสำคัญของการเกิดพฤติกรรมการป้องกันการติดเชื้อ HIV ของเยาวชนกลุ่มชายรักชาย ควรมุ่งเน้นการป้องกันอย่างครอบคลุมความหลากหลายระดับปัจจัย โดยเฉพาะปัจจัยระดับนโยบายสาธารณะ ในเรื่องการเข้าถึงข้อมูลและนโยบายเกี่ยวกับการป้องกันการติดเชื้อ HIV ในกลุ่มชายรักชายและการป้องกันความเสี่ยงระดับบุคคลของกลุ่มชายรักชาย
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References
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13. Lachowsky NJ, Milhausen RR. The positive impact of technology on young gay men's dating and sexual relationships in Canada: Results from a focus group study. Journal of LGBT Youth 2015;12(1):19-38.
14. Hu Y, Zhong X, Peng B, Zhang Y, Liang H, Dai J, et al. Comparison of depression and anxiety between HIV-negative men who have sex with men and women (MSMW) and men who have sex with men only (MSMO): a cross-sectional study in Western China. BMJ Open 2019;9(1):1-11.
15. Sithole B. HIV prevention needs for men who have sex with men in Swaziland. Afr J AIDS Res 2017;16(4):315-20.
16. Jumpa W. Influences towards target group's decision making of health care service using at Caremat Health Center. Thai AIDS Journal 2017;29(2):56-70. (in Thai)
17. Mor Z, Turner D, Livnat Y, Levy I. HIV infected men who have sex with men in Israel: knowledge, attitudes and sexual behavior. BMC Infect Dis [Internet]. 2017 [cited 2019 April 28];17:679-9. Available from: https://bmcinfectdis.biomedcentral.com /articles/10.1186 /s12879-017-2782-1
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19. Upacha N, Prasertchai A, Boromtanarat C. The Development of Friendly Service Men Who Have Sex with Men in Center for Youth Friendly Health Service Chonburi Province. EAU 2017;11(2):239-52. (in Thai)
20. McLeroy R, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ. Q. 1988;15(4):351-77.
21. Thato R. Nursing research : concepts to application. 3rd ed. Bangkok:Chulabook; 2018. (in Thai)
22. Trangkasombat U, Larbbunsub W, Havanont P. CES-D screening for teen depression. J Psychiatr Assoc Thailand 1997;42(1):2-13. (in Thai)
23. Seeya A, Auemaneekul N, Keawpan W, Powwattana A. Intimate partner violence victims and health problems among men who have sex with men in Bangkok, Thailand[Internet]. 2017 [cited 2019 May 15]. Available from: https://dric.nrct.go.th/index.php?/ Search/Search Detail/295127. (in Thai)
24. International Labour Organization. Gender equality and sexual orientation in Thailand [Internet]. 2015 [cited 2020 January 20]. Available from: https://bit.ly/3d85ofh25. Gios L, Mirandola M, Sherriff N, Toskin I, Blondeel K, Dias S, et al. Being in the Closet. Correlates of outness among MSM in 13 European cities. Journal of Homosexualityv[Internet]. 2019 [cited 2019 April 28]. Available from:https://doi.org /10.1080/00918369.2019.1656033
26. Powwattana A. Preventive Adolescent Alcohol Use. Risk Behaviors Prevention in Adolescence: Concepts and Management in Multilevel Approach. Bangkok: Protexts.com; 2017. 99-117. (in Thai)
27. Kann L, Kinchen S, Shanklin S, Flint K, Hawkins J, Harris W, et al. Youth Risk behavior surveillance-United States, 2013. MMWR [Internet]. 2014 [cited 2019 November 20];63:1-172. Available from: https://www.cdc.gov/mmwr/pdf/ss/ss6304.pdf
28. Latimer R, Vodstrcil L, Fairley C, Cornelisse V, Chow E, Read T, et al. Non-consensual condom removal, reported by patients at a sexual health clinic in Melbourne, Australia. Plosone 2018;14:1-16.
29. Vagenas P, Brown S, Clark J, Konda K, Lama S, Sanchez J, et al. A Qualitative assessment of alcohol consumption and Sexual Risk behaviors among men who have sex with men and transgender women in Peru. HHS Public Access 2018;52(7):831-39.
2. Jantaramanee P, Jantaramanee S. A prevalence survey of HIV and sexually transmitted infection among men who have sex with men (MSM), Thailand: venue day time sampling (VDTS) and respondent driven sampling (RDS). Disease Control Journal 2016;42(4):269-79. (in Thai)
3. Nilsum K, Sattayasomboon Y, Kittipichai W. Acceptability of using HIV self-testing among men who have sex with men in Bangkok, Thailand. Journal of Health Science 2018;27(5): 819-29. (in Thai)
4. World Health Organization. WHO expands recommendation on oral pre-exposure prophylaxis of HIV infection (PrEP) [Internet]. 2015 [cited 2019 November 12]. Available from: https://bit.ly/2x7bHPy
5. Card KG, Lachowsky NJ, Cui Z, Shurgold S, Armstrong, HL, Rich AJ, et al. An event-level analysis of the Interpersonal factors associated with condomless anal sex among gay, bisexual, and other men who have sex with men (MSM) with online-met partners. AIDS Education and Prevention [Internet]. 2017 [cited 2019 April 28];29:154-174. Available from: https://doi.org/10.1521/aeap.2017.29.2.154
6. Chen L, Lian D, Wang B. Factors associated with disclosing men who have sex with men (MSM) sexual behaviors and HIV-positive status: A study based on a social network analysis in Nanjing, China. PLOS ONE[Internet]. 2018 [cited 2019 April 28];13:1-11. Available from: https://journals.plos. org/plosone/article?id=10.1371/journal.pone.0196116
7. Drumright LN, Weir SS, Frost SDW. The role of venues in structuring HIV, sexually transmitted infections, and risk networks among men who have sex with men. BMC Public Health [Internet]. 2018 [cited 2019 April 28];18:225-9. Available from: https://bmcpublic health.biomedcentral.com/ articles/10.1186/s12889-018-5140-3
8. Liu Y, Zhang Y, Ning Z, Zheng H, Ding Y, Gao M, et al. Intimate partner violence victimization and HIV infection among men who have sex with men in Shanghai, China. Biosci Trends 2018;12(2): 142-48.
9. Mao J, Tang W, Liu C, Wong NS, Tang S, Wei C, et al. Sex tourism among Chinese men who have sex with men: a cross-sectional observational study. BMC Public Health [Internet]. 2018 [cited 2019 April 28];18:306-12. Available from: https://bmcpublichealth. biomedcentral.com/articles/10.1186/ s12889-018-5214-2
10. Buapan C, Rutchanagul P, Buaboon N. Factors predicting condom use behavior among men who have sex with men in Bangkok. JHNR 2018;34(2):62-73. (in Thai)
11. Piyaraj P, van Griensven F, Holtz TH, Mock PA, Varangrat A, Wimonsate W, et al. The finding of casual sex partners on the internet, methamphetamine use for sexual pleasure, and incidenceof HIV infection among men who have sex with men in Bangkok, Thailand: an observational cohort study. Lancet HIV 2018;5(7):379-89.
12. Semple SJ, Pitpitan EV, Goodman-Meza D, Strathdee SA, Chavarin CV, Rangel G, et al. Correlates of condomless anal sex among men who have sex with men (MSM) in Tijuana, Mexico: The role of public sex venues. PLOS ONE 2017;12(10):1-16.
13. Lachowsky NJ, Milhausen RR. The positive impact of technology on young gay men's dating and sexual relationships in Canada: Results from a focus group study. Journal of LGBT Youth 2015;12(1):19-38.
14. Hu Y, Zhong X, Peng B, Zhang Y, Liang H, Dai J, et al. Comparison of depression and anxiety between HIV-negative men who have sex with men and women (MSMW) and men who have sex with men only (MSMO): a cross-sectional study in Western China. BMJ Open 2019;9(1):1-11.
15. Sithole B. HIV prevention needs for men who have sex with men in Swaziland. Afr J AIDS Res 2017;16(4):315-20.
16. Jumpa W. Influences towards target group's decision making of health care service using at Caremat Health Center. Thai AIDS Journal 2017;29(2):56-70. (in Thai)
17. Mor Z, Turner D, Livnat Y, Levy I. HIV infected men who have sex with men in Israel: knowledge, attitudes and sexual behavior. BMC Infect Dis [Internet]. 2017 [cited 2019 April 28];17:679-9. Available from: https://bmcinfectdis.biomedcentral.com /articles/10.1186 /s12879-017-2782-1
18. Edwards-Jackson N, Phanuphak N, Van TH, Chomchey N, Teeratakulpisarn N, Sathienthammawit W, et al. HIV serostatus disclosure is not associated with safer sexual behavior among HIV-positive men who have sex with men (MSM) and their partners at risk for infection in Bangkok, Thailand. AIDS Research and Therapy 2012;9(1):38-48.
19. Upacha N, Prasertchai A, Boromtanarat C. The Development of Friendly Service Men Who Have Sex with Men in Center for Youth Friendly Health Service Chonburi Province. EAU 2017;11(2):239-52. (in Thai)
20. McLeroy R, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ. Q. 1988;15(4):351-77.
21. Thato R. Nursing research : concepts to application. 3rd ed. Bangkok:Chulabook; 2018. (in Thai)
22. Trangkasombat U, Larbbunsub W, Havanont P. CES-D screening for teen depression. J Psychiatr Assoc Thailand 1997;42(1):2-13. (in Thai)
23. Seeya A, Auemaneekul N, Keawpan W, Powwattana A. Intimate partner violence victims and health problems among men who have sex with men in Bangkok, Thailand[Internet]. 2017 [cited 2019 May 15]. Available from: https://dric.nrct.go.th/index.php?/ Search/Search Detail/295127. (in Thai)
24. International Labour Organization. Gender equality and sexual orientation in Thailand [Internet]. 2015 [cited 2020 January 20]. Available from: https://bit.ly/3d85ofh25. Gios L, Mirandola M, Sherriff N, Toskin I, Blondeel K, Dias S, et al. Being in the Closet. Correlates of outness among MSM in 13 European cities. Journal of Homosexualityv[Internet]. 2019 [cited 2019 April 28]. Available from:https://doi.org /10.1080/00918369.2019.1656033
26. Powwattana A. Preventive Adolescent Alcohol Use. Risk Behaviors Prevention in Adolescence: Concepts and Management in Multilevel Approach. Bangkok: Protexts.com; 2017. 99-117. (in Thai)
27. Kann L, Kinchen S, Shanklin S, Flint K, Hawkins J, Harris W, et al. Youth Risk behavior surveillance-United States, 2013. MMWR [Internet]. 2014 [cited 2019 November 20];63:1-172. Available from: https://www.cdc.gov/mmwr/pdf/ss/ss6304.pdf
28. Latimer R, Vodstrcil L, Fairley C, Cornelisse V, Chow E, Read T, et al. Non-consensual condom removal, reported by patients at a sexual health clinic in Melbourne, Australia. Plosone 2018;14:1-16.
29. Vagenas P, Brown S, Clark J, Konda K, Lama S, Sanchez J, et al. A Qualitative assessment of alcohol consumption and Sexual Risk behaviors among men who have sex with men and transgender women in Peru. HHS Public Access 2018;52(7):831-39.
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2020-08-02
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บทความที่ได้รับการตีพิมพ์ เป็นลิขสิทธิ์ของวารสารวิจัยสุขภาพและการพยาบาล (วิทยาลัยพยาบาลบรมราชชนนี กรุงเทพ) ไม่สามารถนำไปตีพิมพ์ซ้ำในวารสารฉบับอื่น
