When safe sex isn't safe
When safe sex isn't safe
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DOI：
10.1080/713804637
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发表时间：
2003-01-01
影响因子：
2.2
通讯作者：
Kippax, S
中科院分区：
文献类型：
--
作者：
Richters, J;Hendry, O;Kippax, S
1993年至1999年期间，通过医生招募了75名最近发生血清转化的悉尼同性恋和同性恋活动男性，并对他们认为导致他们感染艾滋病毒的事件进行了深入采访。访谈记录进行了分析，主题索引，探讨如何组织和谈判的性行为报告中的偶然性接触，以及如何将安全考虑到他们的性行为。可接受的性行为模式包括以下特征：（1）口交几乎总是在不使用避孕套的情况下进行，（2）在不使用避孕套的情况下轻推或短暂插入阴茎通常不被视为“肛交”，（3）男性的身体或手上经常有精液，（4）通常使用手套进行拳交，但不使用手指。对风险的感知主要集中在可见的东西上（例如血液或精液）。预防性做法受到社会对合理行为的期望的限制，也受到这种期望的推动，例如在场所内发生性行为的场所。因此，即使在一个明确接受“安全性行为”的社区，艾滋病毒传播的空间也很大。预防方案的规划者需要考虑是否明确的信息，即避孕套不是100%的保护将是有益的，并重新考虑他们的沟通方式的想法'体液'。
Seventy-five gay and homosexually active men in Sydney who had recently seroconverted were recruited through their doctors and interviewed in depth between 1993 and 1999 about the event(s) they believed led to their becoming infected with HIV. Interview transcripts were analysed by thematic indexing to explore how the sexual practices reported were organized and negotiated within casual sex encounters, and how men integrated safety considerations into their sexual practice. Accepted patterns of sexual interaction included the following features: (1) oral sex was almost always practised without condoms, (2) nudging or brief anal insertion of the penis without a condom was often not regarded as,anal intercourse', (3) there was often semen on men's bodies or hands, (4) fisting was usually done with gloves, but fingering was not. Perception of risk focused largely on the visible (e.g. blood or semen). Preventive practice was constrained and enabled by social expectation of reasonable behaviour in contexts such as sex-on-premises venues. Thus, even in a community where the practice of 'safe sex' is explicitly accepted, there is considerable room for HIV transmission. Prevention programme planners need to consider whether clear messages that condoms are not 100% protective would be beneficial and to reconsider the way in which they communicate the idea of 'body fluids'.