Study on Influencing Factors to HIV Health Services Among MSM: Based on Andersen Behavioral Model

Abstract

Background: We assessed the utilization of HIV health services and its influencing factors on consistent condom use, HIV testing and HIV counseling among men who have sex with men (MSM), so as to provide a theoretical basis for future infectious disease prevention and control strategies and health services policy formulation. Methods: This study is a cross-sectional study. From April 2013 to October 2014, a sample survey was conducted in southwest China including Chongqing, Sichuan, Xinjiang and Guangxi, and an anonymous self-administered questionnaire survey was conducted among MSM who met the requirements and were recruited. Based on Anderson Behavioral Model, the questionnaire divided the influencing factors into predisposing factor, enabling factor and need factor. There were 1727 valid questionnaires. SAS 9.4 was used for univariate analysis and multivariate Logistic regression analysis to explore the factors influencing the utilization of health services. AMOS Graphics 24.0 was used to construct the path diagram through path analysis to explore the effect among various factors. Results: In the survey of HIV health services, 9.96% of respondents consistently used condoms, 78.00% had HIV testing, and 60.63% had HIV counseling. Among the predisposing factor, the older respondents are, the easier it is to be tested for HIV(β=0.078, p＜0.001). Among the enabling factor, urban registration is a factor that promotes HIV testing and counseling(β=0.064,p=0.003 and β=0.072, p=0.002). Among the need factor, HIV knowledge score is also a key point affecting testing and counseling(β=0.157, p＜0.001 and β=0.184, p＜0.001). The diagnosis of STD can promote respondents counseling(β=0.051, p=0.031). Depression is a contributing factor to consistent condom use(β=0.051,p=0.033), but negative to HIV counseling(β=-0.119, p＜0.001). Conclusions: For these groups, MSM with high-risk characteristics should be identified as a priority in the future public health services. HIV knowledge should be promoted in health education, physical and mental health diagnosis and treatment should also be strengthened.