Sexual Networks, Dyadic Characteristics, and HIV Acquisition and Transmission Behaviors Among Black Men Who Have Sex With Men in 6 US Cities
Sexual Networks, Dyadic Characteristics, and HIV Acquisition and Transmission Behaviors Among Black Men Who Have Sex With Men in 6 US Cities
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DOI：
10.1093/aje/kww144
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发表时间：
2017-05-01
影响因子：
5
通讯作者：
Mayer, Kenneth H.
中科院分区：
文献类型：
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作者：
Hickson, DeMarc A.;Mena, Leandro A.;Mayer, Kenneth H.
人们对性网络在男男性行为黑人 (MSM) 中人类免疫缺陷病毒 (HIV) 流行病学中的作用知之甚少。我们使用美国 BROTHERS 研究（2009-2010）中 1,306 名黑人 MSM 的数据，研究了多重性二元特征与血清不一致/血清状态未知的无套性行为 (SDCS) 之间的关系。 HIV感染者在至少每周发生性行为（比值比（OR）= 2.41，95%置信区间（CI）：1.37，4.23）或每月发生性行为（OR = 1.94，95% CI：1.17，3.24）时，与每年发生一到几次性行为相比，发生SDCS的几率更高。与在线见面的伴侣相比，未感染 HIV 的参与者在以性为中心的场所线下见面时发生 SDCS 的几率更高（OR = 1.79，95% CI：1.15，2.78）。此外，与第一次见面时没有发生性关系相比，初次见面时发生性行为与 SDCS 发生率较高相关（OR = 1.49，95% CI：1.21，1.83），而与性伴侣生活/持续交流则与 SDCS 发生率较低相关（每周：OR = 0.64，95% CI：0.47，0.85；每月：OR = 0.60， 95% CI：0.44，0.81；每年：OR = 0.58，95% CI：0.39，0.85）与中断通信相比。无论 HIV 血清状态如何，拥有主要/稳定非主要伴侣的人与商业伴侣相比，SDCS 的几率较低。这表明需要针对黑人男男性接触者采取与文化相关的艾滋病毒预防工作，以促进与性伴侣的沟通，特别是关于降低风险策略的沟通，包括暴露前预防。
The role of sexual networks in the epidemiology of human immunodeficiency virus (HIV) among black men who have sex with men (MSM) is poorly understood. Using data from 1,306 black MSM in the BROTHERS Study (2009-2010) in the United States, we examined the relationships between multiple sexual dyadic characteristics and serodiscordant/serostatus-unknown condomless sex (SDCS). HIV-infected participants had higher odds of SDCS when having sex at least weekly (odds ratio (OR) = 2.41, 95% confidence interval (CI): 1.37, 4.23) or monthly (OR = 1.94, 95% CI: 1.17, 3.24) versus once to a few times a year. HIV-uninfected participants had higher odds of SDCS with partners met offline at sex-focused venues (OR = 1.79, 95% CI: 1.15, 2.78) versus partners met online. In addition, having sex upon first meeting was associated with higher odds of SDCS (OR = 1.49, 95% CI: 1.21, 1.83) than was not having sex on first meeting, while living/continued communication with sexual partner (s) was associated with lower odds of SDCS (weekly: OR = 0.64, 95% CI: 0.47, 0.85; monthly: OR = 0.60, 95% CI: 0.44, 0.81; yearly: OR = 0.58, 95% CI: 0.39, 0.85) versus discontinued communication. Persons with primary/steady nonprimary partners versus commercial partners had lower odds of SDCS regardless of HIV serostatus. This suggests the need for culturally relevant HIV prevention efforts for black MSM that facilitate communication with sexual partners especially about risk reduction strategies, including preexposure prophylaxis.