ACQUIRED-IMMUNODEFICIENCY-SYNDROME HUMAN-IMMUNODEFICIENCY-VIRUS RISK BEHAVIOR AMONG GAY MEN IN SMALL CITIES - FINDINGS OF A 16-CITY NATIONAL SAMPLE
ACQUIRED-IMMUNODEFICIENCY-SYNDROME HUMAN-IMMUNODEFICIENCY-VIRUS RISK BEHAVIOR AMONG GAY MEN IN SMALL CITIES - FINDINGS OF A 16-CITY NATIONAL SAMPLE
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DOI：
10.1001/archinte.152.11.2293
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发表时间：
1992-11-01
影响因子：
--
通讯作者：
YAFFE, DM
中科院分区：
文献类型：
--
作者：
KELLY, JA;MURPHY, DA;YAFFE, DM
背景-关于获得性免疫缺陷综合征的大多数研究都是在该国几个最大的城市进行的，对其他地理区域的男同性恋者目前承担的人类免疫缺陷病毒风险水平知之甚少。这项研究的目的是确定较小社区中男同性恋者的风险行为频率。方法：对来自美国四个不同地区的六个州的16个中小城市光顾Py酒吧的男性进行大样本调查，以确定高风险行为的频率和影响风险承担的因素。在所有城市的酒吧里，85%的男性完成了所有调查。社区样本为1991名男性，平均年龄31.3岁，平均受教育程度10.6年；90%为白人，10%为其他种族。所有参与者都提供了关于他们在过去两个月中的性行为的详细信息，并完成了评估他们感知的同伴规范的措施，这些规范涉及更安全的性行为和风险规避、规避风险的意图、个人风险估计、获得性免疫缺陷综合征风险知识、获得性免疫缺陷综合征/人类免疫缺陷病毒的感知威胁以及血清学检测历史。结果：在这些较小的城市，高危模式在这些小城市的男性中仍然很常见；近三分之一的男性在过去两个月中平均进行了8次无保护的肛交，通常是在一夫一妻制的关系之外。高危行为与认为安全的性行为不会被同龄人很好地接受、使用避孕套的意愿薄弱、低估了个人对获得性免疫缺陷综合征的易感性、年龄较小以及总体性行为水平较高的信念最密切相关。在接受测试的男性中，9%的人表示他们的血清呈阳性。结论--不断增长的人类免疫缺陷病毒流行率和持续高危行为的比率表明，在同性恋活跃的男性中预防人类免疫缺陷病毒的新“一线”已经转移到该国的小城市。迫切需要在这些地区开展社区预防工作，以避免未来该人群中人类免疫缺陷病毒感染的急剧增加。
Background.-Most research on acquired immunodeficiency syndrome has been conducted in several of the country's largest cities, and little is known about the current level of human immunodeficiency virus risk taking among gay men in other geographical areas. The purpose of this study was to determine the frequency of risk behavior practices among gay men in smaller communities.Methods.-A large sample of men who patronized py bars in 16 small and moderate-size cities drawn from six states in four different regions of the country was surveyed to determine the frequency of high-risk behavior and factors influencing risk taking. Eighty-five percent of men in all cities' bars completed all survey measures. The community samples were 1991 men, mean age, 31.3 years, mean education, 10.6 years; 90% were white and 10% were of other ethnicities. All participants provided detailed information on their sexual behavior practices over the preceding 2 months and completed measures assessing their perceived peer norms concerning safer sex practices and risk avoidance, intentions to avoid risk, personal risk estimation, acquired immunodeficiency syndrome risk knowledge, perceived threat of acquired immunodeficiency syndrome/human immunodeficiency virus, and serostatus testing history.Results.-High-risk patterns were still common among py men in these smaller cities; nearly one third of all men had engaged in unprotected anal intercourse an average of eight times in the past 2 months, usually outside monogamous relationships. High-risk behavior was most strongly associated with beliefs that safer sex practices would not be well accepted by peers, weak intentions to use condoms, underestimation of personal vulnerability to the acquired immunodeficiency syndrome, younger age, and higher levels of overall sexual activity. Nine percent of men tested said they were seropositive.Conclusions.-Growing human immunodeficiency virus prevalence and continued high rates of risk behavior indicate that a new "front line" for human immunodeficiency virus prevention among homosexually active men has shifted to the country's smaller cities. Community prevention efforts in these areas are urgently needed to avert sharp increases in future human immunodeficiency virus infections in this population.