Sex Practices by HIV Awareness and Engagement in the Continuum of Care Among MSM: A National HIV Behavioral Surveillance Analysis in 21 U.S. Cities.
Sex Practices by HIV Awareness and Engagement in the Continuum of Care Among MSM: A National HIV Behavioral Surveillance Analysis in 21 U.S. Cities.
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DOI：
10.1007/s10461-017-1966-4
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发表时间：
2018-03
影响因子：
4.4
通讯作者：
NHBS Study Group
中科院分区：
文献类型：
--
作者：
Whitham HK;Sansom SL;Wejnert C;Finlayson T;Huang YA;An Q;Paz-Bailey G;NHBS Study Group
利用美国 21 个大都市区的国家艾滋病毒行为监测 (NHBS) 横断面调查和艾滋病毒检测数据，我们确定了性活跃男性男男性行为者 (MSM) 的性行为与以下因素相关：(1) 对艾滋病毒状况的认识，以及 (2) 参与艾滋病毒护理连续体。汇总 2008 年、2011 年和 2014 年的数据，得出 5079 名性活跃的艾滋病病毒感染者男男性行为者 (MLWH) 样本。参与者被分为艾滋病毒状况类别：（1）不知道； (2) 知晓且不在意； (3) 知晓并接受护理，未接受抗逆转录病毒治疗 (ART)； (4) 意识到并接受 ART。根据艾滋病毒状况对性行为（例如无套性行为、不一致的无套性行为和性伴侣数量）进行了分析。大约 30%、5%、10% 和 55% 的样本分别被分类为不知情、知情且不接受 ART、知晓并接受 ART 护理、以及知晓并接受 ART。不知情的 MLWH 比知晓的 MLWH (18.0%，p 值 < 0.0001) 更有可能报告与艾滋病毒状况不一致或未知的最后一个男性伴侣进行无套肛交 (25.9%)。不知情的 MLWH 在过去 12 个月内报告女性性伴侣的可能性是知晓 MLWH 的 3 倍（17.3% 和 5.6%，p 值 < 0.0001）。在检查整个护理过程中的趋势时，过去一年与男性伴侣进行无安全套肛交的报告（范围为 65.0% 至 70.0%）、与 HIV 状况不一致或未知的男性伴侣进行无安全套肛交的报告（范围为 17.7% 至 21.3%），以及男性和女性性伴侣的中位数数量相似。总之，对艾滋病毒的认识和参与护理并不总是与保护性性行为相关，这凸显了持续预防工作的必要性。
Using National HIV Behavioral Surveillance (NHBS) cross-sectional survey and HIV testing data in 21 U.S. metropolitan areas, we identify sex practices among sexually active men who have sex with men (MSM) associated with: (1) awareness of HIV status, and (2) engagement in the HIV care continuum. Data from 2008, 2011, and 2014 were aggregated, yielding a sample of 5079 sexually active MSM living with HIV (MLWH). Participants were classified into HIV status categories: (1) unaware; (2) aware and out of care; (3) aware and in care without antiretroviral therapy (ART); and (4) aware and on ART. Analyses were conducted examining sex practices (e.g. condomless sex, discordant condomless sex, and number of sex partners) by HIV status. Approximately 30, 5, 10 and 55% of the sample was classified as unaware, aware and out of care, aware and in care without ART, and aware and on ART, respectively. Unaware MLWH were more likely to report condomless anal sex with a last male partner of discordant or unknown HIV status (25.9%) than aware MLWH (18.0%, p value < 0.0001). Unaware MLWH were 3 times as likely to report a female sex partner in the prior 12 months as aware MLWH (17.3 and 5.6%, p-value < 0.0001). When examining trends across the continuum of care, reports of any condom-less anal sex with a male partner in the past year (ranging from 65.0 to 70.0%), condomless anal sex with a male partner of discordant or unknown HIV status (ranging from 17.7 to 21.3%), and median number of both male and female sex partners were similar. In conclusion, awareness of HIV and engagement in care was not consistently associated with protective sex practices, highlighting the need for continued prevention efforts.
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DOI：
10.1016/j.jana.2008.10.005
发表时间：
2009-01
影响因子：
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影响因子：
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