台北都會區慣用菸酒之年輕成人的初次性經驗早晚與高危險性行為的關係

Early sexual initiation and risky sexual practices among alcohol- and tobacco-using young adults in the Taipei metropolitan area

胡達亮(Tat Leong Wu)

指導教授 ： 陳為堅

國立臺灣大學/公共衛生學院/流行病學與預防醫學研究所/碩士(2018年)

https://doi.org/10.6342/NTU201801655

摘要

背景：早發性行為在過去的研究被指出與不良的健康後果相關，但目前大部分的研究均在西方族群進行，亦未有探討非法藥物在兩者之間的潛在效應。本研究旨在探討台灣人口的早發性行為與危險性行為的相關性，及性行為前用藥於兩者之間的中介效果。
方法：透過「回應者引介抽樣法」於台北都會區，招募慣用菸酒的1115位年輕成人（18至50歲）參與研究。每位參與者接受電腦輔助式訪談，內容涵蓋各種物質使用與性經驗，以及其他題項。其中有性經驗的916位參與者被用於本分析。多變項邏輯迴歸模型分析了早發性行為（16歲前有初次性經驗）與四個危險性行為的相關性 – 分別為多重性伴侶（終生累積8個或以上）、一夜情、群交以及不規則保險套使用（有時候/很少/從來沒有）。此外，模型中早發性行為與性別的交互作用項探討了男性性別對早發性行為與危險性行為之相關性的調節作用。因果式中介分析則探討了性行為前用藥（終生有或沒有）是否能夠中介前述的相關性及其中介的程度。
結果：慣用菸酒的年輕成人中約9%有早發性行為的經驗，而危險性行為的盛行率為7%（群交）至47%（不規則保險套使用）。早發性行為與多重性伴侶、一夜情及群交皆呈現正向相關性；而與男性相比，女性早發性行為與多重性伴侶及一夜情的勝算比較高。上述的相關性均被性行為前用藥顯著地中介，中介的比率17%至22%不等。
結論：慣用菸酒的年輕成人中有早發性行為者，會比較傾向參與危險性行為，而性行為前用藥解釋了它們之間部分的關係。對於台灣及整個東亞而言，這部分人口的性健康需要更多的關注。

關鍵字

早發性行為 ； 危險性行為 ； 性行為前用藥 ； 物質使用 ； 性健康 ； 回應者引介抽樣法

並列摘要

Background. Previous studies showed that early sexual initiation was associated with negative sexual health outcomes. However, most studies were conducted in Western populations and did not examine the role of illicit drugs in the pathway. This study aims to (1) examine the associations between early sexual initiation and risky sexual practices in Taiwan and (2) the mediation effects through drugs before sex in the above associations.

Methods. Participants were recruited from regular alcohol- and tobacco-using young adults (aged 18-50) in the Taipei metropolitan area through respondent-driven sampling (N = 1115). Respondents completed a computer-assisted self-interview covering a variety of questions on substance use and sexual experiences, among others. We analyzed a sexually experienced subsample of 916 participants. Multivariable logistic regression analyses examined the associations between early sexual initiation (before age 16) and four risky sexual practices, respectively – multiple sexual partners (≥ 8 partners in lifetime), casual sex, group sex, and inconsistent condom use (sometimes/seldom/never). Interaction terms of early sexual initiation and gender were applied to the logistic regression models to examine moderation effects of being male on the associations between early sexual initiation and the four risky sexual practices. Causal mediation analyses examined if and to what extent drugs before sex (yes/no in lifetime) mediated these associations.

Results. Around 9% reported early sexual initiation and the prevalence of risky sexual practices ranged from 7% (group sex) to 47% (inconsistent condom use). Early sexual initiation was positively associated with multiple sexual partners, casual sex, and group sex. The odds ratio of early sexual initiation with multiple sexual partners or casual sex was greater for females than males. Significant mediation effects through drugs before sex were found between early sexual initiation and the three risky sexual practices, with the proportions mediated ranging from 17% to 22%.

Conclusions. Early sexual initiators among alcohol- and tobacco-using young adults were more likely to engage in risky sexual practices and drugs before sex partially explained this relationship. Attention should be given to the sexual health of this population in Taiwan and more generally in East Asia.

並列關鍵字

early sexual initiation ； risky sexual practices ； drugs before sex ； substance use ； sexual health ； respondent-driven sampling

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