Use of Illicit Drugs and Erectile Dysfunction Medications and Subsequent HIV Infection among Gay Men in Sydney, Australia
Use of Illicit Drugs and Erectile Dysfunction Medications and Subsequent HIV Infection among Gay Men in Sydney, Australia
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DOI：
10.1111/j.1743-6109.2009.01323.x
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发表时间：
2009-08-01
影响因子：
3.5
通讯作者：
Grulich, Andrew
中科院分区：
文献类型：
--
作者：
Prestage, Garrett;Jin, Fengyi;Grulich, Andrew
介绍.非法药物和口服勃起功能障碍药物（OEM）的使用与男同性恋者的危险行为有关.目的.确定非法药物和OEM作为艾滋病毒血清转化的危险因素在澳大利亚悉尼的一个以社区为基础的艾滋病毒阴性同性性行为活跃男性队列中的作用.主要结果测量.在过去6个月和最近的性接触中使用药物;最近的场合无保护和保护肛交; HIV阳性diagnosis.Methods.从2001年6月至2007年6月，参与者随访6个月的详细行为访谈和每年的HIV检测。收集了有关性、吸毒和其他行为的详细信息。结果：在1,427名参与者中，截至2007年6月，确定了53名HIV血清转换者。基线时，62.7%的人报告在过去6个月内使用非法药物，其中10.7%的人报告至少每周使用一次。非法药物的使用与无保护的肛门性交的临时合作伙伴（P < 0.001）。在单变量水平上，使用非法药物与艾滋病毒感染风险增加相关，并且这种风险随着使用频率的增加而增加。OEM的使用也是如此。使用每种非法药物都包括在多变量分析中，在控制了性风险行为后，只有使用OEM仍然是HIV感染的显著预测因素（风险比[HR] = 1.75，CI = 1.31-2.33，P < 0.001），尽管亚硝酸戊酯具有临界显著性（HR = 1.26，CI = 0.98-1.62，P = 0.074）。结论：吸毒与HIV感染风险增加之间的关系在用于提高性快感的药物中最强，尤其是OEM。当同时使用OEM和甲基苯丙胺时，感染的风险大大增加。在更“冒险”的同性恋社区亚文化中，性行为和吸毒的相互联系可能是理解艾滋病毒风险的关键，也是该人群艾滋病毒预防工作的适当优先事项。Prestage G，Jin F，Kippax S，Zablotska I，Imrie J，and Grulich A.使用非法药物和勃起功能障碍药物和随后的艾滋病毒感染男同性恋者在悉尼，澳大利亚。J Sex Med 2009;6：2311-2320.
Introduction.Use of illicit drugs and oral erectile dysfunction medications (OEM) have been associated with risk behavior among gay men.Aim.To determine the effects of illicit drugs and OEM as risk factors for HIV seroconversion in a community-based cohort of HIV-negative homosexually active men in Sydney, Australia.Main Outcome Measures.Drug use in the previous 6 months and at the most recent sexual encounter; Most recent occasions of unprotected and protected anal intercourse; HIV-positive diagnosis.Methods.From June 2001 to June 2007, participants were followed up with 6-monthly detailed behavioral interviews and annual testing for HIV. Detailed information about sexual, drug-using and other behavior was collected.Results.Among 1,427 participants enrolled, 53 HIV seroconverters were identified by June 2007. At baseline, 62.7% reported using illicit drugs in the previous 6 months, including 10.7% who reported at least weekly use. Illicit drug use was associated with unprotected anal intercourse with casual partners (P < 0.001). Use of illicit drugs was associated with increased risk of HIV infection at a univariate level, and this risk increased with greater frequency of use. This was also true of the use of OEM. Use of each type of illicit drug was included in multivariate analysis, and after controlling for sexual risk behaviors, only use of OEM remained significantly predictive of HIV infection (Hazard ratios [HR] = 1.75, CI = 1.31-2.33, P < 0.001), although amyl nitrite was of borderline significance (HR = 1.26, CI = 0.98-1.62, P = 0.074).Conclusion.The association between drug use and increased risk of HIV infection was strongest for drugs used specifically to enhance sexual pleasure, particularly OEM. The risk of infection was substantially increased when both OEM and methamphetamine were used. Within more "adventurous" gay community subcultures, the interconnectedness of sexual behavior and drug use may be key to understanding HIV risk and is an appropriate priority in HIV-prevention efforts in this population. Prestage G, Jin F, Kippax S, Zablotska I, Imrie J, and Grulich A. Use of illicit drugs and erectile dysfunction medications and subsequent HIV infection among gay men in Sydney, Australia. J Sex Med 2009;6:2311-2320.