HIV serostatus disclosure is not associated with safer sexual behavior among HIV-positive men who have sex with men (MSM) and their partners at risk for infection in Bangkok, Thailand.
HIV serostatus disclosure is not associated with safer sexual behavior among HIV-positive men who have sex with men (MSM) and their partners at risk for infection in Bangkok, Thailand.
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DOI：
10.1186/1742-6405-9-38
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发表时间：
2012-12-23
影响因子：
2.2
通讯作者：
Ananworanich J
中科院分区：
文献类型：
--
作者：
Edwards-Jackson N;Phanuphak N;Van Tieu H;Chomchey N;Teeratakulpisarn N;Sathienthammawit W;Pakam C;Pharachetsakul N;Sobieszczyk ME;Phanuphak P;Ananworanich J
在不同的研究中，艾滋病毒血清状态披露和性行为风险之间的关系是不一致的。由于男男性行为者(MSM)正在成为泰国曼谷的主要受影响人群，据报道艾滋病毒流行率为30%，我们评估了艾滋病毒披露是否与这一人群的保护性行为有关。使用音频计算机辅助自我访谈(ACASI)对曼谷200名HIV阳性男男性行为者进行了危险行为问卷调查，以确定HIV血清状态披露是否与保护性行为有关。评估了在性行为之前或发生性行为时向最近的性伴侣披露的艾滋病毒血清状况。受保护的性行为被定义为在最近的性行为中使用避孕套进行插入式或接受性肛交。平均年龄为30.2岁，CD4为353个/mm~3，三分之一接受抗逆转录病毒治疗。在最近一次性行为中，艾滋病毒血清状态的披露比率很低(26%)；60.5%的受试者根本没有讨论过他们的血清状态，而5.5%的人没有透露他们的真实血清状态。17%的人报告说没有保护措施的肛交，大约一半的人与他们的主要伴侣发生了性关系。最近性伴的血清状况为HIV阳性的占19.2%，阴性的占26.4%，未知的占54.4%。披露与保护性行为之间没有关联，48名脱节者中有41人(85.4%)报告了保护性行为，而非脱节者中有104人(82.5%)报告了保护性行为(p = .65)。与HIV阴性(85.4%)或未知(41/45，91.1%)伴侣的受试者(p = .001)相比，有艾滋病毒阳性伴侣的受试者总体上报告保护性行为的可能性较低(20/33，60.6%)。在多因素分析中，年龄(27-32岁比≤26岁，p = .008)、主要伴侣状态(p<；.001)和性伴侣艾滋病毒阳性血清状态(p <； .001)与信息披露显著相关。曼谷艾滋病毒阳性男男性行为者向性伴侣披露艾滋病毒的比率很低。尽管HIV血清状态披露率很低，但大多数HIV阳性男男性接触者报告说，他们与有感染风险的伴侣发生了保护性行为。未来的研究应该侧重于了解泰国男男性接触者的披露障碍和风险行为的驱动因素。
The relationship between HIV serostatus disclosure and sexual risk behavior is inconsistent across studies. As men who have sex with men (MSM) are emerging as the key affected population in Bangkok, Thailand with reported HIV prevalence of 30%, we assessed whether HIV disclosure is associated with protected sex in this population. A risk behavior questionnaire was administered using Audio Computer-Assisted Self-Interviewing (ACASI) to determine whether HIV serostatus disclosure was associated with protected sex in 200 HIV-positive MSM in Bangkok. HIV serostatus disclosure to the most recent sexual partner prior to or at the time of the sexual encounter was assessed. Protected sex was defined as insertive or receptive anal intercourse with a condom at the most recent sexual encounter. The mean age was 30.2 years, CD4 was 353 cells/mm3, and one-third was on antiretroviral therapy. At the most recent sexual encounter, HIV serostatus disclosure rate was low (26%); 60.5% of subjects had not discussed their serostatus at all, while 5.5% had not revealed their true serostatus. Seventeen percent reported unprotected anal intercourse and about half had sex with their primary partners. The serostatus of the most recent sexual partner was HIV-positive in 19.2%, HIV-negative in 26.4%, and unknown in 54.4% of subjects. There was no association between disclosure and protected sex, with 41 of 48 (85.4%) disclosers and 104 of 126 (82.5%) of non-disclosers reported protected sex (p = .65). Subjects with HIV-positive partners were less likely to report protected sex overall (20 of 33, 60.6%) compared to those with HIV negative (82 of 96, 85.4%) or unknown (41 of 45, 91.1%) partners (p = .001). Age (27-32 years vs. ≤26 years, p = .008), primary partner status (p < .001), and HIV-positive serostatus of sexual partner (p < .001) were significantly associated with disclosure in the multivariate analyses. Rates of HIV disclosure to sexual partners by HIV-positive MSM in Bangkok are low. Despite low rates of HIV serostatus disclosure, most HIV-positive MSM reported protected sex with their partners at risk for infection. Future studies should focus on understanding barriers to disclosure and factors driving risk behavior amongst MSM in Thailand.
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影响因子：
4.2
作者：
Kalichman, SC;Nachimson, D
通讯作者：
Nachimson, D
DOI：
10.1097/00126334-200105010-00013
发表时间：
2001-05-01
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
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作者：
Marks, G;Crepaz, N
通讯作者：
Crepaz, N
DOI：
10.1080/09540129308258609
发表时间：
1993-01-01
影响因子：
1.7
作者：
SITTITRAI, W;BROWN, T;SAKONDHAVAT, C
通讯作者：
SAKONDHAVAT, C
DOI：
10.1080/09540120701767265
发表时间：
2008-09
影响因子：
1.7
作者：
Rosser, B. R. Simon;Horvath, K. J.;Hatfield, L. A.;Peterson, J. L.;Jacoby, S.;Stately, A.
通讯作者：
Stately, A.
DOI：
10.1080/09540120600983971
发表时间：
2007-07-01
影响因子：
1.7
作者：
Klitzman, R.;Exner, T.;Charlebois, E.
通讯作者：
Charlebois, E.