Sexual Mixing Patterns and Partner Characteristics of Black MSM in Massachusetts at Increased Risk for HIV Infection and Transmission
Sexual Mixing Patterns and Partner Characteristics of Black MSM in Massachusetts at Increased Risk for HIV Infection and Transmission
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DOI：
10.1007/s11524-009-9363-6
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发表时间：
2009-07-01
影响因子：
6.6
通讯作者：
Mayer, Kenneth H.
中科院分区：
文献类型：
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作者：
Mimiaga, Matthew J.;Reisner, Sari L.;Mayer, Kenneth H.
在美国，与其他男男性行为者相比，与男男性行为者（MSM）发生性关系的黑人男性感染艾滋病毒的风险增加。本研究的目的是调查黑人男男性接触者的性混合模式和合作伙伴的特点，性风险承担，作为一个可能的解释，这种观察到的艾滋病发病率增加。2008年1月至7月，197名黑人男男性接触者通过修改后的响应者驱动的抽样招募，并完成了可选的测试前和测试后的艾滋病毒血清学检测，咨询，和人口，行为和心理社会评估电池。双变量和多变量逻辑回归程序被用来检查跨合作伙伴类型的危险性行为的预测。总的来说，18%的样本是艾滋病毒感染者; 50%的人报告与男性发生无保护性交，30%与女性发生性交，5%与变性伴侣发生性交。53%的人被认为是双性恋或异性恋，尽管所有人都报告在过去12个月内与另一名男子发生过口交或肛交。参与至少一次以下事件的重要预测因素：（1）在过去12个月内与男性伴侣发生血清不一致的无保护肛交（UAS）：有社会隔离风险的个体（AOR = 4.23; p = 0.03），住房不稳定者（AOR = 4.19; p = 0.03），而那些在性生活中至少每周使用一次爆米花的人（AOR = 5.90; p = 0.05）;（2）过去12个月内与女性伴侣发生UAS和/或无保护阴道性交：那些住房不稳定的人（AOR = 4.85; p = 0.04），那些在性生活中至少每周使用可卡因的人（AOR = 16.78; p = 0.006），HIV感染者（AOR = 0.07; p = 0.02），感觉社会规范有利于使用避孕套（AOR = 0.60; p = 0.05）;（3）参与者最近的非主要男性性伴侣的UAS：参与者在最后一次性行为中使用酒精和药物（AOR = 4.04; p = 0.01），与西班牙裔/拉丁裔男性（AOR = 2.71; p = 0.04）或黑人男性（AOR = 0.50; p = 0.05）发生性关系，与白色男性相比，教育程度较低（AOR = 1.31; p = 0.02）。研究结果表明，黑人男男性接触者的性风险行为不同的合作伙伴类型和他们的性网络的特点，这一亚群的男男性接触者艾滋病毒的获得和传播的风险很高。有效的预防策略需要解决不同的性和行为的风险模式所提出的不同的性伙伴关系报告的黑人男男性接触者。
Black men who have sex with men (MSM) are at increased risk for HIV infection in the United States compared to other MSM. The aim of this study was to investigate Black MSM's sexual mixing patterns and partner characteristics in relation to sexual risk taking, as a possible explanation for this observed increase in HIV incidence. Between January and July 2008, 197 Black MSM were recruited via modified respondent-driven sampling and completed optional pretest and post-test HIV serological testing, counseling, and a demographic, behavioral, and psychosocial assessment battery. Bivariate and multivariable logistic regression procedures were used to examine predictors of risky sex across partner types. Overall, 18% of the sample was HIV-infected; 50% reported unprotected intercourse with men, 30% with women, and 5% with transgender partners. Fifty-three percent identified as bisexual or straight, although all reported oral or anal sex with another man in the prior 12 months. Significant predictors of engaging in at least one episode of: (1) serodiscordant unprotected anal sex (UAS) with a male partner in the past 12 months: individuals at risk for social isolation (AOR = 4.23; p = 0.03), those with unstable housing (AOR = 4.19; p = 0.03), and those who used poppers at least weekly during sex (AOR = 5.90; p = 0.05); (2) UAS and/or unprotected vaginal intercourse with a female partner in the past 12 months: those with unstable housing (AOR = 4.85; p = 0.04), those who used cocaine at least weekly during sex (AOR = 16.78; p = 0.006), being HIV-infected (AOR = 0.07; p = 0.02), and feeling social norms favor condom use (AOR = 0.60; p = 0.05); (3) UAS with the participants' most recent nonmain male sex partner: use of alcohol and drugs during last sex by participant (AOR = 4.04; p = 0.01), having sex with a Hispanic/Latino male (AOR = 2.71; p = 0.04) or a Black male (AOR = 0.50; p = 0.05) compared to a White male, and lower education (AOR = 1.31; p = 0.02). Findings suggest that sexual risk behaviors of Black MSM differ across partner type and by the characteristics of their sexual networks and that this subpopulation of MSM are at high risk for HIV acquisition and transmission. Effective prevention strategies need to address the distinct sexual and behavioral risk patterns presented by different sexual partnerships reported by Black MSM.