Estimation of Potential HIV Transmission Risk in Recent Anal Intercourse Events among Men Who Have Sex with Men and Transgender Women in Bali, Indonesia.
Estimation of Potential HIV Transmission Risk in Recent Anal Intercourse Events among Men Who Have Sex with Men and Transgender Women in Bali, Indonesia.
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DOI：
10.3390/tropicalmed6030139
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发表时间：
2021-07-22
影响因子：
2.9
通讯作者：
Januraga PP
中科院分区：
文献类型：
--
作者：
Bavinton BR;Mahendra IGAA;Kaldor J;Law M;Grulich AE;Januraga PP
近年来，在印度尼西亚巴厘岛，男男性行为者（MSM）和变性妇女（当地称为“waria”）中的人类免疫缺陷病毒（艾滋病毒）流行率大幅上升。这一人群的行为数据有限。我们于2018年3月至4月在巴厘岛进行了一项MSM/waria行为调查。受访者主要是由艾滋病毒外联工作者招募的。受访者报告了与最后一位男性/瓦里亚浪漫伴侣和/或最后一位男性/瓦里亚临时伴侣发生肛交事件的详细信息（如果相关，受访者可以报告这两种情况）。用广义估计方程检验统计学显著性。在709名参与者中，中位年龄为27岁（四分位距= 24-31），92.1%为男性，7.9%为瓦利亚人。三分之一出生在巴厘岛。总体而言，85.9%的人曾经接受过艾滋病毒检测; 55.1%的人报告为艾滋病毒阴性，15.0%的人为艾滋病毒阳性，30.0%的人血清状态未知。大多数（86.5%）报告在过去6个月内与男性发生性关系，9.5%与瓦利亚发生性关系，20.0%与女性发生性关系。受访者描述了703例肛交事件（397/306例分别与浪漫/休闲伴侣发生; 191例同时报告）。超过一半（56.5%）的事件受到避孕套的保护，7.3%受到生物医学预防的保护（2.6%受到PrEP的保护，4.7%受到艾滋病毒治疗的保护）。因此，36.3%的事件涉及无保护的无避孕套肛交（浪漫/随意伴侣中分别为40.8%/30.4%）。在多变量分析中，无保护的无安全套肛交事件与浪漫伴侣（p < 0.001），出生在巴厘岛（p = 0.002），教育程度较低（p = 0.013），相信射精前撤退是有效的（p < 0.001），喜欢使用撤退（p = 0.021）和不喜欢安全套（p < 0.001）有关。四分之一的事件通过非安全套的风险降低策略可能降低了艾滋病毒传播风险，而11.1%的事件没有潜在的风险降低。在巴厘出生的答卷人报告的艾滋病毒传播潜在风险最高的事件更为普遍。
In recent years, prevalence of Human Immunodeficiency Virus (HIV) has increased substantially in Bali, Indonesia, in men who have sex with men (MSM) and transgender women, known locally as ‘waria’. There are limited behavioural data in this population. We conducted a behavioural survey of MSM/waria in Bali in March–April 2018. Respondents were primarily recruited by HIV outreach workers. Respondents reported details about anal intercourse events with their last male/waria romantic partner and/or last male/waria casual partner (respondents could report on both if relevant). Statistical significance was tested with generalised estimating equations. Among 709 participants, median age was 27 (interquartile range = 24–31), and 92.1% were male and 7.9% were waria. One-third were born in Bali. Overall, 85.9% had ever had an HIV test; 55.1% reported being HIV-negative, 15.0% HIV-positive, and 30.0% had unknown serostatus. Most (86.5%) reported sex with men, 9.5% with waria, and 20.0% with women in the previous 6 months. Respondents described 703 anal intercourse events (397/306 with romantic/casual partners, respectively; 191 reported on both). Over half (56.5%) of the events were protected by condoms and 7.3% by biomedical prevention (2.6% by PrEP in either partner, 4.7% by HIV treatments in either partner). Thus, 36.3% of events involved unprotected condomless anal intercourse (40.8%/30.4% in romantic/casual partners, respectively). In multivariate analysis, unprotected condomless anal intercourse events were associated with romantic partners (p < 0.001), being born in Bali (p = 0.002), lower education (p = 0.013), believing that withdrawal before ejaculation is effective (p < 0.001), liking to use withdrawal (p = 0.021), and not liking condoms (p < 0.001). One-quarter of events had potentially reduced HIV transmission risk through non-condom-based risk reduction strategies, while 11.1% had no potential risk reduction. Events presenting the highest potential risk of HIV transmission were more commonly reported by respondents born in Bali.
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DOI：
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影响因子：
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