HIV-1 infection in high risk men who have sex with men in Mombasa, Kenya
HIV-1 infection in high risk men who have sex with men in Mombasa, Kenya
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DOI：
10.1097/qad.0b013e3282f2704a
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发表时间：
2007-11-30
期刊：
影响因子：
3.8
通讯作者：
Smith, Adrian D.
中科院分区：
文献类型：
--
作者：
Sanders, Eduard J.;Graham, Susan M.;Smith, Adrian D.
背景：同性恋和肛交行为在非洲HIV-1流行病中的作用尚未得到很好的描述。我们旨在评估男男性行为者（MSM）中流行HIV-1感染的危险因素，以指导HIV-1预防工作。方法：在一项疫苗准备队列研究中，对285名男男性接触者的社会行为特征、性传播疾病（STD）体征和症状以及HIV-1的血清学证据进行了测定。我们使用多变量逻辑回归来评估流行HIV-1感染的危险因素。结果：仅与男性发生性行为（MSME）的男性HIV-1患病率为43.0%[49/114,95%可信区间（CI）， 34-52%]，与男性和女性同时发生性行为（MSMW）的男性HIV-1患病率为12.3% （21/171,95% CI, 7-17%）。86名（75%）MSME和69名（40%）MSME报告最近有接受性肛交。在上周性活跃的174名男男性接触者中，44%的人报告在与临时伴侣发生性关系时没有使用安全套。在过去的3个月里，210名MSM（74%）报告了性交易，大多数客户（93%）是当地居民。流行的HIV-1感染与近期接受性肛交相关[优势比（OR）， 6.1；（95% CI, 2.4-16），只与男性发生性关系（OR, 6.3; 95% CI, 2.3-17）；年龄增加（OR， 1.1 /年；95% CI, 1.04-1.12）。只有四名男男性接触者报告使用注射毒品。结论：肯尼亚男男性接触者中HIV-1的高流行率可能归因于无保护的接受性肛交。肯尼亚迫切需要艾滋病毒-1预防规划，向男男性行为者提供有针对性的降低风险干预措施和性病服务。(C) 2007年威科集团健康垂直条Lippincott Williams & Wilkins。
Background: The role of homosexuality and anal sex practices in the African HIV-1 epidemic is not well described. We aimed to assess the risk factors for prevalent HIV-1 infection among men who have sex with men (MSM) to guide HIV-1 prevention efforts.Methods: Socio-behavioural characteristics, signs and symptoms of sexually transmitted diseases (STD), and serological evidence of HIV-1 were determined for 285 MSM at enrolment into a vaccine preparedness cohort study. We used multivariate logistic regression to assess risk factors for prevalent HIV-1 infection.Results: HIV-1 prevalence was 43.0% [49/114, 95% confidence interval (CI), 34-52%] for men who reported sex with men exclusively (MSME), and 12.3% (21/171, 95% CI, 7-17%) for men who reported sex with both men and women (MSMW). Eighty-six (75%) MSME and 69 (40%) MSMW reported recent receptive anal sex. Among 174 MSM sexually active in the last week, 44% reported no use of condoms with casual partners. In the previous 3 months, 210 MSM (74%) reported payment for sex, and most clients (93%) were local residents. Prevalent HIV-1 infection was associated with recent receptive anal sex [odds ratio (OR), 6.1; 95% CI, 2.4-16], exclusive sex with men (OR, 6.3; 95% CI, 2.3-17); and increasing age (OR, 1.1 per year; 95% CI, 1.04-1.12). Only four MSM reported injecting drug use.Conclusions: The high prevalence of HIV-1 in Kenyan MSM is probably attributable to unprotected receptive anal sex. There is an urgent need for HIV-1 prevention programmes to deliver targeted risk-reduction interventions and STD services to MSM in Kenya. (C) 2007 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.