HIV-positive men's sexual practices in the context of self-disclosure of HIV status
HIV-positive men's sexual practices in the context of self-disclosure of HIV status
复制标题
DOI：
10.1097/00126334-200105010-00013
复制
发表时间：
2001-05-01
期刊：
影响因子：
--
通讯作者：
Crepaz, N
中科院分区：
文献类型：
--
作者：
Marks, G;Crepaz, N
目的：研究向有感染艾滋病毒风险的性伴侣披露艾滋病毒阳性状态是否与安全性行为有关，并研究特定披露/性行为模式的流行率和相关性。方法：206例HIV阳性男性的横断面评估（41%同性恋，35%双性恋，24%异性恋）在洛杉矶的一家艾滋病门诊诊所随机抽样，报告其最近的性伴侣为HIV阴性或血清状态未知。不安全的性行为被定义为无保护的肛门或阴道性交与partner.Results：25%的男性从事不安全的性行为，和48%的总样本隐瞒披露从合作伙伴。安全性行为的发生率在吸烟者中并不显著高于非吸烟者（未校正的比值比= 1.29; 95%置信区间：0.69-2.45），并且在研究中检查的25个人口统计学或伴侣亚组中，披露与安全性行为没有显著相关性。在全部样本中，40%的男性披露并从事安全性行为（知情保护），35%的男性拒绝披露并从事安全性行为（不知情保护），12%的男性告知其伴侣并从事不安全的性行为（知情暴露），13%的男性拒绝披露并从事不安全的性行为（不知情暴露）。危险的行为模式与性行为前使用酒精/药物，有一个艾滋病毒未知的合作伙伴，情感参与与一个人的合作伙伴，并测试血清阳性在过去3 years.Conclusions：干预血清阳性的男性，主要集中在增加披露的血清状态的性伴侣可能不会减少不安全性行为的患病率。需要采取干预措施，以解决引起艾滋病毒感染者危险行为模式的社会和心理过程。也可能需要改善药物滥用咨询。
Objective: To examine whether disclosure of HIV-positive status to sex partners at risk for HIV infection is associated with safer sex practices and to examine the prevalence and correlates of specific disclosure/sexual behavior patterns.Methods: Cross-sectional assessment of 206 HIV-positive men (41% homosexual, 35% bisexual, 24% heterosexual) sampled randomly at an outpatient HIV clinic in Los Angeles, who reported that their most recent sex partner was HIV-negative or of unknown serostatus. Unsafe sex was defined as unprotected anal or vaginal intercourse with that partner.Results: Twenty-five percent of the men engaged in unsafe sex, and 48% of the total sample withheld disclosure from the partner. The prevalence of safer sex was not significantly higher among disclosers than among nondisclosers (unadjusted odds ratio = 1.29; 95% confidence interval: 0.69-2.45), and disclosure was not significantly associated with safer sex in any of 25 demographic or partner subgroups examined in the study. In the full sample, 40% of the men disclosed and engaged in safer sex (informed protection), 35% withheld disclosure and engaged in safer sex (uninformed protection), 12% informed their partner and engaged in unsafe sexual behavior (informed exposure), and 13% withheld disclosure and engaged in unsafe sex (uninformed exposure). Risky behavior patterns were associated with using alcohol/drugs before sex, having an HIV-unknown partner, being less emotionally involved with one's partner, and testing seropositive in the previous 3 years.Conclusions: Interventions for seropositive men that focus primarily on increasing disclosure of serostatus to sex partners may not reduce the prevalence of unsafe sex. Interventions are needed to address the social and psychologic processes that give rise to risky behavior patterns in HIV-infected men. Improved substance abuse counseling also may be needed.