HIV Prevention Interventions in Chennai, India: Are Men Who Have Sex with Men Being Reached?
HIV Prevention Interventions in Chennai, India: Are Men Who Have Sex with Men Being Reached?
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DOI：
10.1089/apc.2009.0092
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发表时间：
2009-11-01
影响因子：
4.9
通讯作者：
Safren, Steven A.
中科院分区：
文献类型：
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作者：
Thomas, Beena;Mimiaga, Matthew J.;Safren, Steven A.
印度是亚洲艾滋病毒感染人数最多的国家，也是全球感染人数第三多的国家。印度政府的国家艾滋病控制组织（纳科）认为男男性行为者（MSM）是需要艾滋病毒预防工作的艾滋病毒“核心风险群体”。然而，关于印度男男性行为者参与艾滋病毒预防干预措施的频率以及随后的艾滋病毒风险和其他相关因素的信息缺乏。通过同伴外展工作者，口碑和雪球抽样技术招募，金奈的210名男男性行为者完成了面试官管理的评估，包括过去一年参与任何艾滋病毒预防干预措施的问题，性风险承担，人口统计学，男男性行为者身份和其他心理社会变量。采用双变量和多变量logistic回归分析方法，研究行为和人口统计学与艾滋病预防干预参与的相关性。超过四分之一（26%）的样本报告在参与研究前一年参与了艾滋病毒预防干预。在研究入组前3个月内报告参与无保护肛交（UAS;比值比[OR] = 0.28; p = 0.01）的参与者在过去一年中参与艾滋病毒预防计划的可能性较小。年龄较大的MSM（OR = 1.04; p = 0.05），kothis（女性的表演/出现和主要接受性伴侣在肛交）相比，panthis（男性出现，主要是插入伴侣; OR = 5.52，p = 0.0004），文化程度高者（OR = 1.48，p = 0.01），“不愿”与其他男性发生性关系（OR = 4.03，p = 0.0001），和男男性接触者报告曾被支付以换取性（OR = 2.92，p = 0.001）更有可能在前一年报告参与艾滋病毒预防干预。在多变量模型中，在前3个月报告UAS的MSM不太可能参与艾滋病毒预防干预（AOR = 0.34，p = 0.04）。年龄较大的MSM（AOR = 1.05，p = 0.05），受教育程度较高的MSM（AOR = 1.92，p = 0.0009），以及对与其他男性发生性关系“出局”的MSM（AOR = 2.71，p = 0.04）更有可能报告参加了艾滋病毒预防计划。研究结果表明，暴露于艾滋病毒预防干预措施可能对从事UAS在印度的一些男男性行为者的保护。了解参与艾滋病毒预防干预的预测因子有助于确定印度男男性接触者可能没有接触到艾滋病毒预防信息和技能建设，从而使研究人员和预防工作者能够将工作重点放在最需要的个人身上。
India has the greatest number of HIV infections in Asia and the third highest total number of infected persons globally. Men who have sex with men (MSM) are considered by the Government of India's National AIDS Control Organization (NACO) a "core risk group" for HIV in need of HIV prevention efforts. However there is a dearth of information on the frequency of participation in HIV prevention interventions and subsequent HIV risk and other correlates among MSM in India. Recruited through peer outreach workers, word of mouth and snowball sampling techniques, 210 MSM in Chennai completed an interviewer-administered assessment, including questions about participating in any HIV prevention interventions in the past year, sexual risk taking, demographics, MSM identities, and other psychosocial variables. Bivariate and multivariable logistic regression procedures were used to examine behavioral and demographic correlates with HIV prevention intervention participation. More than a quarter (26%) of the sample reported participating in an HIV prevention intervention in the year prior to study participation. Participants who reported engaging in unprotected anal sex (UAS; odds ratio [OR] = 0.28; p = 0.01) in the 3 months prior to study enrollment were less likely to have participated in an HIV prevention program in the past year. MSM who were older (OR = 1.04; p = 0.05), kothis (feminine acting/appearing and predominantly receptive partners in anal sex) compared to panthis (masculine appearing, predominantly insertive partners; OR = 5.52, p = 0.0004), those with higher educational attainment (OR = 1.48, p = 0.01), being "out" about having sex with other men (OR = 4.03, p = 0.0001), and MSM who reported ever having been paid in exchange for sex (OR = 2.92, p = 0.001) were more likely to have reported participation in an HIV prevention intervention in the preceding year. In a multivariable model, MSM reporting UAS in the prior 3 months were less likely to have participated in an HIV prevention intervention (AOR = 0.34, p = 0.04). MSM who were older (AOR = 1.05, p = 0.05), those with higher educational attainment (AOR = 1.92, p = 0.0009), and MSM who were "out" about having sex with other men (AOR = 2.71, p = 0.04) were more likely to have reported participating in an HIV prevention program. Findings suggest that exposure to HIV prevention interventions may be protective against engaging in UAS for some MSM in India. Understanding predictors of participation in an HIV prevention intervention is helpful for identifying Indian MSM who might have had no exposure to HIV prevention information and skills building, hence allowing researchers and prevention workers to focus efforts on individuals at greatest need.