It's not just what you say: Relationships of HIV dislosure and risk reduction among MSM in the post-HAART era
It's not just what you say: Relationships of HIV dislosure and risk reduction among MSM in the post-HAART era
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DOI：
10.1080/09540120600983971
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发表时间：
2007-07-01
影响因子：
1.7
通讯作者：
Charlebois, E.
中科院分区：
文献类型：
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作者：
Klitzman, R.;Exner, T.;Charlebois, E.
在后haart时代，出现了一些关键问题，如什么因素影响披露决定，以及这些决定如何与高风险行为和伙伴变量等因素相关联。我们采访了1828名艾滋病毒阳性的男男性行为者（MSM），其中46%的人向所有伴侣透露了情况。在有临时伴侣的男性中，41.8%的人向所有这些伴侣透露了自己的秘密，21.5%的人不向任何伴侣透露。信息披露与关系类型、伴侣艾滋病毒感染状况和性行为有关。总体而言，36.5%的受访者与艾滋病毒呈阴性/未知状态的伴侣进行无保护肛交。在那些只有临时伴侣的人中，80.4%的人有100次UAS行为，其中58%的人没有向所有伴侣透露。这58%的人更有可能自认为是同性恋（而不是双性恋），知道自己的身份不足5年，并且有更多的伴侣。在接受HAART治疗时，病毒载量和症状数量与信息披露无关。这项研究是迄今为止在MSM中进行的最大规模的披露研究，也是在haart后进行的为数不多的研究之一，它表明，几乎有五分之一的人报告了与临时伴侣发生的无披露性行为，突出了公共卫生挑战。需要在关系类型、伴侣状况和更广泛的降低风险战略的背景下处理披露问题。
In the post-HAART era, critical questions arise as to what factors affect disclosure decisions and how these decisions are associated with factors such as high-risk behaviors and partner variables. We interviewed 1,828 HIV-positive men who have sex with men (MSM), of whom 46% disclosed to all partners. Among men with casual partners, 41.8% disclosed to all of these partners and 21.5% to none. Disclosure was associated with relationship type, perceived partner HIV status and sexual behaviors. Overall, 36.5% of respondents had unprotected anal sex (UAS) with partners of negative/unknown HIV status. Of those with only casual partners, 80.4% had > 1 act of UAS and 58% of these did not disclose to all partners. This 58% were more likely to self-identify as gay (versus bisexual), be aware of their status for < 5 years and have more partners. Being on HAART, viral load and number of symptoms were not associated with disclosure. This study-the largest conducted to date of disclosure among MSM and one of the few conducted post-HAART-indicates that almost 1/5th reported UAS with casual partners without disclosure, highlighting a public health challenge. Disclosure needs to be addressed in the context of relationship type, partner status and broader risk-reduction strategies.