Cultures of sexual adventurism as markers of HIV seroconversion: a case control study in a cohort of Sydney gay men
Cultures of sexual adventurism as markers of HIV seroconversion: a case control study in a cohort of Sydney gay men
复制标题
DOI：
10.1080/09540129848307
复制
发表时间：
1998-12-01
影响因子：
1.7
通讯作者：
Kinder, P
中科院分区：
文献类型：
--
作者：
Kippax, S;Campbell, D;Kinder, P
一项正在进行的队列研究中的病例对照分析被用来检查血清转换者和艾滋病毒仍然阴性的男性之间的差异。这些病例在血清转换前1至13个月内接受了面谈。他们对结构化问卷的回答与来自同一时期和同一纵向研究--悉尼男性与性健康--的HIV阴性对照组的回答进行了比较。从病例和对照中收集的数据包括：人口和背景变量、艾滋病毒传播知识、性行为、药物和酒精使用以及态度因素。其目的是比较男性在艾滋病毒血清转换之前的性行为，以及这种行为的社会和文化背景，以及没有血清转换的男性。队列中有23名男子进行了血清转换。病例是通过艾滋病毒抗体阳性检测或在之前的艾滋病毒阴性检测后自我报告艾滋病毒阳性状态来确定的。根据1994年面谈时艾滋病毒呈阴性，并在随后至少进行了一次经医学确认的艾滋病毒抗体阴性试验，选择了369名对照。血清转换的单变量预测因素是：与已知的HIV阳性伴侣有规律的关系，吸毒，以及从事一系列肛门和神秘的性行为。通常用于增强性快感的行为，如群交、观看和被观看做爱、使用性玩具和打扮/幻想，更多地被血清转换者从事。参与这些神秘的性行为与吸毒、参与同性恋社区和参与广泛的肛交行为高度相关。在多变量分析中，血清转换的独立预测因素是：年龄较小；与已知的艾滋病毒阳性伴侣保持定期关系；认为停药对艾滋病毒传播是安全的；以及一系列深奥的做法。这些结果表明了特定性行为的社会和文化背景以及由此导致的艾滋病毒传播的重要性。性爱冒险的男性感染艾滋病毒的风险可能会增加，因为他们在特定的亚文化中寻求性行为。
A case control analysis within an ongoing cohort study was used to examine differences between seroconverters and men who remained HIV-negative. The cases were interviewed within one to 13 months prior to their seroconversion. Their responses to a structured questionnaire were compared with those of HIV-negative controls drawn from the same time period and from the same longitudinal study, Sydney Men and Sexual Health. Data collected from both cases and controls included: demographic and contextual variables, knowledge of HIV transmission, sexual practices, drug and alcohol use and attitudinal factors. The aim was to compare the sexual behaviours, and the social and cultural contexts of such behaviours, of men prior to their HIV seroconversion with men who did not seroconvert. Twenty-three men had seroconverted within the cohort. Cases were identified by a positive HIV antibody test or self-report of positive HIV status following a previous negative HIV test. Three-hundred-and-sixty-nine controls were selected on the basis of being HIV negative at interview in 1994, and having at least one subsequent medically-confirmed negative HIV antibody test. Univariate predictors of seroconversion were: being in a regular relationship with a known HIV-positive partner, drug use, and engaging in a range of anal and esoteric sexual practices. Practices commonly used to enhance sexual pleasure, such as group sex, watching and being watched having sex, the use of sex toys and dressing up/fantasy, were engaged in more frequently by seroconverters. Engaging in these esoteric sexual practices was highly correlated with drug use, involvement in the gay community and engagement in a wide range of anal practices. In the multivariate analysis independent predictors of seroconversion were: younger age; being in a regular relationship with a known HIV-positive partner; believing withdrawal to be safe with regard to HIV transmission; and range of esoteric practices. These results indicate the importance of the social and cultural contexts of particular sexual practices and consequent HIV transmission. Sexually adventurous men may be at increased risk for HIV because the seek sex within particular sub-cultures.