Assessing motivations to engage in intentional condomless anal intercourse in HIV risk contexts ("Bareback Sex") among men who have sex with men.

Assessing motivations to engage in intentional condomless anal intercourse in HIV risk contexts ("Bareback Sex") among men who have sex with men.
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DOI:
10.1521/aeap.2009.21.2.156
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发表时间:
2009-04
期刊:
AIDS education and prevention : official publication of the International Society for AIDS Education
影响因子:
--
通讯作者:
Dolezal C
Dolezal C
中科院分区:
其他
文献类型:
--
作者:
Bauermeister JA;Carballo-Diéguez A;Ventuneac A;Dolezal C

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虽然使用避孕套是防止艾滋病毒传播的有效屏障,但一些男男性行为者(MSM)从事无背带性行为(在危险环境中没有保护措施的肛交),并增加了他们感染艾滋病毒(再次)的风险。了解男男性接触者不戴安全套(相对于使用避孕套)的决定,对于为这一人群制定有效的艾滋病毒/艾滋病预防计划至关重要。不戴马具的男性(n=120)的种族多样性样本完全是在互联网上招募的,并分层包括三分之二的人,他们既报告了乌拉伊,也报告了没有感染艾滋病毒。我们使用探索性因素分析来探索DBB量表中的领域,并检验DBB与危险性行为之间的关联。HIV阳性男男性接触者(n=31)报告与使用避孕套相关的成本/损失高于HIV阴性男性(n=89)。我们在DBB量表中发现了两个潜在因素:应对社交弱点子量表(8个条目,α=.89)和快乐与情感联系子量表(5个条目,α=.92)。我们发现在过去的3个月中,DBB(即与无马鞍性行为相关的更大收益)与Urai场合、伴侣数量以及有一个或多个血清不一致的伴侣之间存在正相关。男男性接触者可能会避免使用避孕套,以应对心理社会脆弱性,并与其他男男性接触者建立亲密关系。这一人群可以受益于避孕套的替代品,如暴露前/暴露后预防和直肠杀微生物剂。
While condom use is an effective barrier against HIV transmission, some men who have sex with men (MSM) engage in bareback sex (unprotected anal sex in risky contexts) and increase their risk for HIV (re)infection. Understanding MSM's decision to bareback (vis-à-vis condom use) is essential to develop effective HIV/AIDS prevention programs for this population. An ethnically diverse sample of men who bareback (n=120) was recruited exclusively on the Internet and stratified to include two-thirds who reported both URAI and being HIV-uninfected. We use exploratory factor analysis to explore the domains within the DBB scale, and test the association between DBB and risky sexual behaviors. HIV-positive MSM (n=31) reported higher costs/losses associated with condom use than HIV-negative men (n=89). We found two underlying factors in the DBB scale: a Coping with Social Vulnerabilities subscale (8 items; α = .89) and a Pleasure & Emotional Connection subscale (5 items; α = .92). We found a positive association between DBB (i.e. greater gains associated with bareback sex) and URAI occasions, number of partners, and having one or more serodiscordant partners in the past 3 months. MSM may avoid using condoms in order to cope with psychosocial vulnerabilities and create intimacy with other MSM. This population could benefit from alternatives to condoms such as pre/post exposure prophylaxis and rectal microbicides.
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