Social contexts as mediator of risk behaviors in Rwandan men who have sex with men (MSM): Implications for HIV and STI transmission
Social contexts as mediator of risk behaviors in Rwandan men who have sex with men (MSM): Implications for HIV and STI transmission
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DOI：
10.1371/journal.pone.0211099
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发表时间：
2019-01-18
期刊：
影响因子：
3.7
通讯作者：
Anastos, Kathryn M.
中科院分区：
文献类型：
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作者：
Adedimeji, Adebola;Sinayobye, Jean d'Amour;Anastos, Kathryn M.
男男性行为者（MSM）因危险的性行为而受到艾滋病毒/艾滋病的影响。已知社会和背景因素介导风险行为，但关于卢旺达男男性接触者危险性行为的流行情况以及伴随的社会背景决定因素的信息有限，因此难以评估在这一关键人群中预防艾滋病毒/性传播疾病传播的影响。我们获得了关于危险性行为流行率的社会背景信息，并评估了对艾滋病毒/艾滋病的影响。性传播感染的传播和男男性行为者为改善性健康和幸福而采取的预防措施。招募30名男男性行为者参加深入访谈，采用基加利LGBT协会的受访者驱动抽样。数据进行了分析，使用标准的定性数据分析procedure. ResultsResponses的年龄在18-40岁之间，所有完成小学教育，大多是低社会经济地位。危险的性行为很常见，但因特殊的个人和环境因素而有所不同。年长的男男性行为者经常报告偶尔与妇女发生性关系，以避免怀疑和社会耻辱。年轻的男男性接触者的危险性行为大多是交易性的，并以社会接受和支持的需要为中介。对性传播感染的知识贫乏，但感染率，特别是HPV感染率很高。改善性健康的选择是有限的，大多是secondary. ConclusionRisk-sexual行为的卢旺达男男性接触者的HIV/STI传播的重大影响。社会上的严重耻辱和孤立使人们很难获得改善性健康的信息或服务。迫切需要采取有效的干预措施，解决风险和获得保健服务的个人和背景决定因素，以限制男男性行为者作为艾滋病毒向一般人群传播的桥梁的后果。
IntroductionMen who have sex with men (MSM) are disproportionately impacted by HIV/AIDS resulting from risky sexual behaviors. Social and contextual factors are known to mediate risk behaviors, but there is limited information about the prevalence of risky sexual practices of Rwandan MSM and the concomitant socio-contextual determinants making it difficult to assess implications for preventing HIV/STI transmission in this key population.MethodsUsing exploratory qualitative design, we obtained socio-contextual information regarding prevalence of risky sexual behavior and assessed implications for HIV/STIs transmission and preventive measures taken by MSM to improve sexual health and wellbeing. Thirty MSM were recruited to participate in in-depth interviews using respondent-driven sampling from LGBT associations in Kigali. Data were analyzed using standard qualitative data analysis procedures.ResultsRespondents' were between 18-40 years old; all completed primary education and are mostly low-socioeconomic status. Risky sexual practices were common, but differed by peculiar individual and contextual factors. Older MSM often reported occasional sexual relations with women to avoid suspicion and social stigma. Younger MSM's risky sexual practices are mostly transactional and mediated by the need for social acceptance and support. Knowledge of STIs was poor, but prevalence, especially of HPV was high. The options for improving sexual wellbeing are limited and mostly clandestine.ConclusionRisky sexual behavior of Rwandan MSM has major implications for HIV/STI transmission. An environment of intense social stigma and social isolation makes it difficult to obtain information or services to improve sexual health. Effective interventions that address individual and contextual determinants of risk and access to health services are urgently needed to limit the consequence of MSM as a bridge for HIV transmission to the general population.