Bisexual concurrency, bisexual partnerships, and HIV among Southern African men who have sex with men
Bisexual concurrency, bisexual partnerships, and HIV among Southern African men who have sex with men
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DOI：
10.1136/sti.2009.040162
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发表时间：
2010-08-01
影响因子：
3.6
通讯作者：
Baral, Stefan
中科院分区：
文献类型：
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作者：
Beyrer, Chris;Trapence, Gift;Baral, Stefan
在非洲南部，对男男性行为（MSM）的研究很少。我们在此提供了马拉维、纳米比亚和博茨瓦纳男男性行为者中双性恋伴侣和双性恋并发性行为的第一批数据。方法采用结构化调查仪和HIV快速检测试剂盒，对537例曾报告肛交的男性进行横断面探查。结果34.1%的男男性接触者已婚或有稳定的女性伴侣，53.7%的男男性接触者在过去6个月内既有男性也有女性性伴侣。双性恋并发性很常见，16.6%的MSM同时与男性和女性发生关系。在双变量分析中，任何双性恋伴侣都与以下因素相关：受教育程度较低（OR 1.6, 95% CI 1.1至2.3）、安全套使用率较高（OR 6.6, 95% CI 3.2至13.9）、接受过HIV检测的可能性较低（OR 1.6, 95% CI 1.1至2.3）、向家人透露性取向的可能性较低（OR 0.47, 95% CI 0.32至0.67）以及接受随意性行为金钱的可能性较高（OR 1.9, 95% CI 1.3至2.7）。双性恋并发性与较高的自我报告安全套使用（OR 1.7, 95% CI 1.0至3.1）、受雇（OR 1.8, 95% CI 1.2至2.9）、较低的向家人透露性取向的可能性（OR 0.37, 95% CI 0.22至0.65）以及与男性发生性行为（OR 2.0, 95% CI 1.2至3.2）相关。本研究中的大多数MSM报告在过去6个月内有过双性恋伴侣关系。与两种性别的性伴侣同时发生是很常见的。令人鼓舞的是，报告同时有双性恋活动的男性更有可能报告与性伴侣使用避孕套，这些男性感染艾滋病毒的可能性并不比只报告男性伴侣的男性高。在非洲着重减少同时性伴侣的艾滋病毒预防规划也应针对男男性行为者中的双性恋同时性行为。同性性行为的非刑事化将促进针对男男性行为者的循证艾滋病预防规划。
Objectives The sexual behaviour of men who have sex with men (MSM) in southern Africa has been little studied. We present here the first data on bisexual partnerships and bisexual concurrency among MSM in Malawi, Namibia and Botswana.Methods A cross-sectional probe of a convenience sample of 537 men who have ever reported anal sex with another man using a structured survey instrument and rapid-kit HIV screening.Results 34.1% of MSM were married or had a stable female partner, and 53.7% reported both male and female sexual partners in the past 6 months. Bisexual concurrency was common, with 16.6% of MSM having concurrent relationships with both a man and a woman. In bivariate analyses, any bisexual partnerships were associated with lower education (OR 1.6, 95% CI 1.1 to 2.3), higher condom use (OR 6.6, 95% CI 3.2 to 13.9), less likelihood of having ever tested for HIV (OR 1.6, 95% CI 1.1 to 2.3), less likelihood of having disclosed sexual orientation to family (OR 0.47, 95% CI 0.32 to 0.67) and being more likely to have received money for casual sex (OR 1.9, 95% CI 1.3 to 2.7). Bisexual concurrency was associated with a higher self-reported condom use (OR 1.7, 95% CI 1.0 to 3.1), being employed (OR 1.8, 95% CI 1.2 to 2.9), lower likelihood of disclosure of sexual orientation to family (OR 0.37, 95% CI 0.22 to 0.65) and having paid for sex with men (OR 2.0, 95% CI 1.2 to 3.2).Conclusions The majority of MSM in this study report some bisexual partnerships in the previous 6 months. Concurrency with sexual partners of both genders is common. Encouragingly, men reporting any concurrent bisexual activity were more likely to report condom use with sexual partners, and these men were not more likely to have HIV infection than men reporting only male partners. HIV-prevention programmes focussing on decreasing concurrent sexual partners in the African context should also target bisexual concurrency among MSM. Decriminalisation of same-sex practices will potentiate evidence-based HIV-prevention programmes targeting MSM.