Unsafe sexual behavior and correlates of risk in a probability sample of men who have sex with men in the era of highly active antiretroviral therapy
Unsafe sexual behavior and correlates of risk in a probability sample of men who have sex with men in the era of highly active antiretroviral therapy
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DOI：
10.1097/01.olq.0000194595.90487.ed
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发表时间：
2006-04-01
影响因子：
3.1
通讯作者：
Handsfield, HH
中科院分区：
文献类型：
--
作者：
Brewer, DD;Golden, MR;Handsfield, HH
目的：评估当代以社区为基础的男男性行为者（MSM）的HIV潜在暴露和传播水平及其相关因素。方法：2003年，在西雅图MSM高发地区，对311名性行为活跃的MSM进行了随机数字拨号电话调查。主要结果是潜在的艾滋病毒暴露和传播，定义为在过去12个月内与艾滋病毒感染情况相反或未知的男性进行无保护的肛交。结果：14%的答复者报告为艾滋病毒阳性，77%报告为艾滋病毒阴性，8%未接受检测。在241名HIV阴性的男男性行为者中，25人（10%；95%可信区间[CI]， 7-15%）可能暴露于HIV；在45名hiv阳性的MSM中，14名（31%;95% CI, 20-46%）是潜在的hiv传播者。在HIV阴性男性中，与潜在HIV暴露最相关的双变量因素是近期细菌性传播疾病（比值比[OR]， 5.8）、近期男性性伴侣数量（比值比，1.01 /伴侣）、近期澡房性行为（比值比，9.1）以及近期使用西地那非（比值比，4.4）、亚硝酸盐戊酯（比值比，6.2）和甲基苯丙胺（比值比，8.0）。在感染艾滋病毒的男性中，与潜在艾滋病毒传播最相关的因素是最近使用亚硝酸盐戊酯（OR, 3.1）、最近有男性性伴侣的数量（OR，每名伴侣1.07）以及有男性配偶或家庭伴侣（OR, 0.3）。结论：大多数男男性接触者了解自己的艾滋病毒感染状况，并采取更安全的性行为，以降低感染或传播艾滋病毒的风险。然而，10%的艾滋病毒阴性男男性行为者和31%的艾滋病毒阳性男男性行为者最近从事使他们处于感染或传播艾滋病毒高风险的行为。
Objective: To assess the levels and correlates of potential exposure to and transmission of HIV in a contemporary, community-based probability sample of men who have sex with men (MSM).Methods: In 2003, 311 sexually active MSM participated in a random-digit dial telephone survey in Seattle neighborhoods with a high prevalence of MSM. The primary outcomes were potential exposure to and transmission of HIV, defined as unprotected anal intercourse with a man of opposite or unknown HIV status in the preceding 12 months.Results: Fourteen percent of respondents reported being HIV-positive, 77% reported being HIV-negative, and 8% had not been tested. Of 241 HIV-negative MSM, 25 (10%; 95% confidence interval [CI], 7-15%) were potentially exposed to HIV; among 45 HIV-positive MSM, 14 (31%; 95% CI, 20-46%) were potential HIV-transmitters. Among HIV-negative men, the strongest bivariate correlates of potential exposure to HIV were recent bacterial sexually transmitted disease (odds ratio [OR], 5.8), number of recent male sexual partners (OR, 1.01 per partner), recent sex at a bathhouse (OR, 9.1), and recent use of sildenafil (OR, 4.4), amyl nitrite (OR, 6.2), and methamphetamine (OR, 8.0). Among HIV-infected men, the strongest correlates of potential HIV transmission were recent use of amyl nitrite (OR, 3.1), number of recent male sex partners (OR, 1.07 per partner), and having a male spouse or domestic partner (OR, 0.3).Conclusions: Most MSM knew their HIV status and adopted safer sexual behaviors to reduce their risk of HIV acquisition or transmission. However, 10% of HIV-negative MSM and 31% of HIV-positive MSM recently engaged in behaviors that placed them at high risk for acquiring or transmitting HIV.