Gay men's current practice of HIV seroconcordant unprotected anal intercourse: serosorting or seroguessing?
Gay men's current practice of HIV seroconcordant unprotected anal intercourse: serosorting or seroguessing?
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DOI：
10.1080/09540120802270292
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发表时间：
2009-01-01
影响因子：
1.7
通讯作者：
Kippax, Susan
中科院分区：
文献类型：
--
作者：
Zablotska, Iryna B.;Imrie, John;Kippax, Susan
我们探讨了血清分析（基于 HIV 血清一致性假设的血清分类）和与血清分析相关的随意无保护肛交 (UAIC)。澳大利亚正在进行的积极健康和男性健康队列提供了向性伴侣披露血清一致 UAIC 和 HIV 的趋势数据。在事件水平分析中，我们使用对数二项式回归调整个体内相关性和估计患病率比 (PRR) 和 95% 置信区间 (95% CI)，以了解临时伴侣血清一致性知识与 UAIC 之间的关联。 2001 年至 2006 年期间，UAIC 和 HIV 披露显着增加。 54% 的 HIV 阳性男性知道伴侣血清一致，并在 13% 的性行为中认为伴侣血清一致（HIV 阴性男性中为 42%，17%）。在 HIV 阳性男性中，当伴侣的状况已知（调整后的 PRR = 5.17，95% CI：3.82-7.01）并且由于血清分析而假定血清一致（调整后的 PRR = 3.70，95% CI：2.56-5.35）时，与未知的情况相比，UAIC 的可能性更高。在 HIV 阴性男性中，当伴侣状况已知（调整后 PRR = 1.88，95% CI：1.58-2.24）且假定血清一致（调整后 PRR = 2.12，95% CI：1.72-2.62）时，与未知伴侣相比，UAIC 的可能性也更高。由于 UAIC 水平仍然很高，男性同性恋者越来越多地面临感染艾滋病毒的风险。由于艾滋病毒阳性和艾滋病毒阴性男性都经常性感染，因此教育和预防计划应解决这样一个事实：由于这种做法而参与 UAI 的艾滋病毒阴性男性可能面临感染艾滋病毒的高风险。艾滋病毒预防应考虑到这些当代行为变化，尤其是艾滋病毒阴性男同性恋者。
We explored seroguessing (serosorting based on the assumption of HIV seroconcordance) and casual unprotected anal intercourse (UAIC) associated with seroguessing. The ongoing Positive Health and Health in Men cohorts, Australia, provided data for trends in seroconcordant UAIC and HIV disclosure to sex partners. In event-level analyses, we used log-binomial regression adjusted for within-individual correlation and estimated prevalence rate ratios (PRRs) and 95% confidence intervals (95% CIs) for the association between the knowledge of a casual partner's seroconcordance and UAIC. UAIC and HIV disclosure significantly increased during 2001-2006. HIV-positive men knew partners were seroconcordant in 54% and assumed it in 13% of sex encounters (42 and 17% among HIV-negative men). Among HIV-positive men, the likelihood of UAIC was higher when a partner's status was known (Adjusted PRR = 5.17, 95% CI: 3.82-7.01) and assumed seroconcordant because of seroguessing (Adjusted PRR = 3.70, 95% CI: 2.56-5.35) compared with unknown. Among HIV-negative men, the likelihood of UAIC was also higher when a partner's status was known (Adjusted PRR = 1.88, 95% CI: 1.58-2.24) and assumed seroconcordant (Adjusted PRR = 2.12, 95% CI: 1.72-2.62) compared with unknown. As levels of UAIC remain high, seroguessing increasingly exposes gay men to the risk of HIV infection. Because both HIV-positive and HIV-negative men often seroguess, education and prevention programs should address the fact that HIV-negative men who engage in UAI due to this practice may be at high risk of HIV infection. HIV prevention should take into account these contemporary changes in behaviors, especially among HIV-negative gay men.