UNSEEN AND UNHEARD: PREDICTORS OF SEXUAL RISK BEHAVIOR AND HIV INFECTION AMONG MEN WHO HAVE SEX WITH MEN IN CHENNAI, INDIA
UNSEEN AND UNHEARD: PREDICTORS OF SEXUAL RISK BEHAVIOR AND HIV INFECTION AMONG MEN WHO HAVE SEX WITH MEN IN CHENNAI, INDIA
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DOI：
10.1521/aeap.2009.21.4.372
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发表时间：
2009-08-01
影响因子：
1.8
通讯作者：
Safren, Steven A.
中科院分区：
文献类型：
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作者：
Thomas, Beena;Mimiaga, Matthew J.;Safren, Steven A.
在印度，男男性行为者（MSM）被污名化，缺乏研究，感染艾滋病毒的风险很高。了解社会心理问题对艾滋病毒风险行为和艾滋病毒感染的影响可以帮助制定与文化相关的艾滋病毒预防干预措施。同伴外展工作人员在金奈招募了210名男同性恋者，他们完成了由访谈者安排的心理社会评估，并接受了艾滋病毒检测和咨询。超过五分之一（46/210）的人报告在过去3个月内进行了无保护的肛交，8%的人艾滋病毒检测呈阳性，26%的人以前参加过艾滋病毒预防干预。在控制年龄、MSM亚群（kothi、panthi或双层）、婚姻状况和宗教的多变量logistic回归模型中，任何无保护肛交的显著预测因子是受教育程度较低（调整优势比[AOR] = 0.54; P = 0.009）、以前没有参加过艾滋病毒预防计划（AOR = 3.75; P = 0.05）、有临床显著的抑郁症状（AOR = 2.8; P = 0.02）和较低的自我效能感（AOR = 0.40; P < 0.0001）。HIV感染检测呈阳性的显著预测因子为：受教育程度较低(AOR = 0.53；05)且目前未与父母同住（AOR = 3.71; p = 0.05）。鉴于艾滋病毒在男男性行为者中的流行，印度仍然需要努力接触隐藏的男男性行为者亚群。在印度，针对男男性行为者的此类项目可能需要解决与文化相关的共同发生的社会心理问题，以最大限度地降低感染风险。
In India men who have sex with men (MSM) are stigmatized, understudied, and at high risk for HIV. Understanding the impact of psychosocial issues on HIV risk behavior and HIV infection can help shape culturally relevant HIV prevention interventions. Peer outreach workers recruited 210 MSM in Chennai who completed an interviewer-achninistered psychosocial assessment battery and underwent HIV testing and counseling. More than one fifth (46/210) reported unprotected anal intercourse in the past 3 months, 8% tested positive for HIV, and 26% had previously participated in an HIV prevention intervention. In a multivariable logistic-regression model controlling for age, MSM subpopulation (kothi, panthi, or double-decker), marital status, and religion, significant predictors of any unprotected anal intercourse were being less educated (adjusted odds ratio [AOR] = .54; P = .009), not having previously participated in an HIV prevention program (AOR = 3.75; p = .05), having clinically significant depression symptoms (AOR = 2.8; p = .02), and lower self-efficacy (AOR = .40; p < .0001). Significant predictors of testing positive for HIV infection were: being less educated (AOR = .53; .05) and not currently living with parent(s) (AOR = 3.71; p = .05). Given the prevalence of HIV among MSM, efforts to reach hidden subpopulations of MSM in India are still needed. Such programs for MSM in India may need to address culturally-relevant commonly co-occurring psychosocial problems to maximize chances of reducing risk for infection.