Web-based behavioral surveillance among men who have sex with men: A comparison of online and offline samples in London, UK
Web-based behavioral surveillance among men who have sex with men: A comparison of online and offline samples in London, UK
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DOI：
10.1097/00126334-200404010-00012
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发表时间：
2004-04-01
影响因子：
3.6
通讯作者：
Hart, G
中科院分区：
文献类型：
--
作者：
Elford, J;Bolding, G;Hart, G
目标：比较男性与男性发生性关系（MSM）调查的特点在线（通过同性恋互联网聊天室和配置文件）和离线（在社区场地）在伦敦，UK.Methods：在2002年2月和3月，879 MSM完成了自我管理的笔和纸的问卷分布在中央伦敦健身房（离线样本）。2002年5月和6月，1218名伦敦男男性接触者通过互联网聊天室和gay.com上的个人资料完成了一份在线自填问卷。结果：与线下接受调查的男性相比，那些在线接受调查的男性只与男性发生性关系的可能性明显降低（89对94%），与男性有关系（44对52%），或接受过艾滋病毒检测（68对80%）（P < 0.001）。在线招募的男性也更年轻（平均年龄34岁对36岁），接受高等教育的可能性更低（67%对79%）（P < 0.001）。然而，在线和离线样本之间的差异对于艾滋病毒阳性男性来说不太明显，而对于艾滋病毒阴性男性和从未接受过艾滋病毒检测的人来说则更为明显。无论艾滋病毒感染状况如何，在网上招募的男性更有可能报告高风险的性行为（即，与艾滋病病毒感染状况未知或不一致的伴侣进行无保护肛交的男性（32%对22%，P < 0.001）。在网上招募的男性也更有可能使用互联网寻找性行为（85%对45%，P < 0.001）;对于艾滋病毒阳性和阴性男性，在互联网上寻找性行为与高危性行为有关（P < 0.01）。在多变量分析中，在控制了混杂因素后，对于HIV阴性和从未接受过检测的男性，在线调查与高危性行为独立相关（HIV阴性男性，在线与离线样本的调整优势比，1.73; 95% CI，1.23，2.42; P < 0.01;从未测试过的男性调整优势比2.45; 95%CI，1.40，4.29; P < 0.01）。这是不是艾滋病毒阳性的男性（调整后的比值比在线与离线样本，1.32; 95%CI，0.69，2.50; P = 0.4）。结论：互联网提供了宝贵的机会，进行行为监测男男性接触者，因为它达到了一些男人谁可能不容易在社区访问，但谁是艾滋病毒和性传播疾病的高风险。然而，在线和离线样本的社会，人口统计学和行为特征的比较必须考虑到艾滋病毒状况和在互联网上寻求性行为的混杂影响。
Objective: To compare the characteristics of men who have sex with men (MSM) surveyed online (through gay Internet chat rooms and profiles) and offline (in community venues) in London, UK.Methods: In February and March 2002, 879 MSM completed a self-administered pen-and-paper questionnaire distributed in central London gyms (offline sample). In May and June 2002, 1218 London MSM completed a self-administered questionnaire online, accessed through Internet chat rooms and profiles on gaydar and gay.com.Results: Compared with men surveyed offline, those surveyed online were significantly less likely to only have sex with men (89 vs. 94%), to be in a relationship with a man (44 vs. 52%), or to have been tested for HIV (68 vs. 80%) (P < 0.001). Men recruited online were also younger (mean age, 34 vs. 36 years) and less likely to have had a higher education (67 vs. 79%) (P < 0.001). However, differences between online and offline samples were less pronounced for HIV-positive men and more pronounced for HIV-negative men and those who had never been tested for HIV. Regardless of HIV status, men recruited online were more likely to report high-risk sexual behavior (i.e., unprotected anal intercourse with a partner of unknown or discordant HIV status) than men surveyed offline (32 vs. 22%, P < 0.001). Men recruited online were also significantly more likely to have used the Internet to look for sex (85 vs. 45%, P < 0.001); for HIV-positive and negative men, seeking sex on the Internet was associated with high-risk sexual behavior (P < 0.01). In multivariate analysis, after controlling for confounding factors, being surveyed online was independently associated with high-risk sexual behavior for HIV-negative and never-tested men (HIV-negative men, adjusted odds ratio for online vs. offline samples, 1.73; 95% CI, 1.23, 2.42; P < 0.01; never-tested men adjusted odds ratio 2.45; 95% CI, 1.40, 4.29; P < 0.01). This was not the case for HIV-positive men (adjusted odds ratio for online vs. offline samples, 1.32; 95% CI, 0.69, 2.50; P = 0.4).Conclusion: The Internet offers valuable opportunities for conducting behavioral surveillance among MSM because it reaches some men who may not be easily accessed in the community yet who are at high risk for HIV and sexually transmitted diseases. Comparisons of the social, demographic, and behavioral characteristics of online and offline samples must, however, take into account the confounding effects of HIV status and seeking sex on the Internet.