Condom use problems during anal sex among men who have sex with men (MSM): findings from the Safe in the City study.
Condom use problems during anal sex among men who have sex with men (MSM): findings from the Safe in the City study.
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DOI：
10.1080/09540121.2012.668285
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发表时间：
2012
期刊：
影响因子：
1.7
通讯作者：
Safe City Study Group
中科院分区：
文献类型：
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作者：
D'Anna LH;Margolis AD;Warner L;Korosteleva OA;O'Donnell L;Rietmeijer CA;Klausner JD;Nomura W;Malotte CK;Safe City Study Group
我们的研究目的是：1)评估在美国城市性病诊所寻求服务的男男性行为者（MSM）中两种安全套使用问题的流行程度：破损或滑脱和部分使用（延迟使用或过早取出）；2)检查这些安全套使用问题与参与者、伴侣和伙伴关系特征之间的关系。分析仅限于艾滋病毒阴性的男男性行为者，他们报告在前3个月内至少有一次肛交，并完成了基线和3个月的随访评估。采用GEE方法拟合两个模型。共有263名男男性行为者（年龄中位数为32岁）报告了990次伴侣关系。不使用安全套的性伙伴422例（42.6%）被排除在外。因此，包括207名男男性行为者和568名伙伴关系。在安全套使用者中，454名伴侣（79.9%）报告100%使用安全套，114名伴侣（20.1%）报告100%使用安全套，21名（3.7%）报告两种安全套使用问题，25名（4.4%）报告仅破损，67名（11.8%）报告仅部分使用安全套，455名（80.1%）报告无错误。每个安全套的破损或滑脱率和部分使用率分别为3.4%和11.2%。在非主要合伙企业中，破裂率或滑移率明显较高。与避孕套破损或滑脱几率增加相关的特征是：受教育程度较低（or =2.78; CI: 1.1-7.5），非主要伴侣状态（or =4.1; CI: 1.5-11.7），性行为中醉酒或吸毒（or =2.0; CI: 1.1-3.8），部分使用：受教育程度较低（or =2.6; CI: 1.0-6.6），感知伴侣性传播感染风险（or =2.4; CI:1.3-4.2），不一致使用避孕套（or =3.7; CI:2.0-6.6）。高比例的男男性接触者伴侣报告没有使用安全套，而在安全套使用者中，相当大比例的人没有持续或正确使用安全套。男男性接触者可以从旨在提高安全套使用熟练程度的干预措施中受益，特别关注不一致和部分使用安全套的行为。
Our research aims were to: 1) assess the prevalence of two condom use problems: breakage or slippage and partial use (delayed application or early removal) among men who have sex with men (MSM) seeking services in urban U.S. STD clinics; and 2) examine the association between these condom use problems and participant, partner and partnership characteristics. Analysis is restricted to HIV-negative MSM who reported having anal sex at least once in the preceding 3 months and who completed both the baseline and 3-month follow-up assessments. Two models were fitted using the GEE approach. A total of 263 MSM (median age=32 years) reported 990 partnerships. Partnerships with no condom use 422 (42.6%) were excluded. Thus, 207 MSM and 568 partnerships were included. Among condom users, 100% use was reported within 454 partnerships (79.9%) and <100% within 114 (20.1%), and 21(3.7%) reported both condom use problems, 25 (4.4%) reported only breakage, 67 (11.8%) reported only partial use, and 455 (80.1%) reported no errors. The breakage or slippage and partial use rates per condom used were 3.4% and 11.2%, respectively. A significantly higher rate of breakage or slippage occurred among non-main partnerships. Characteristics associated with increased odds for condom breakage or slippage were: lower education level (OR=2.78; CI: 1.1-7.5), non-main partner status (OR=4.1; CI: 1.5-11.7), and drunk or high during sex (OR=2.0; CI: 1.1-3.8), and for partial use: lower education level (OR=2.6; CI: 1.0-6.6), perceived partner STI risk (OR=2.4; CI:1.3-4.2), and inconsistent condom use (OR=3.7; CI:2.0-6.6). A high percentage of MSM partnerships reported no condom use and among condom users, a sizable proportion did not use them consistently or correctly. MSM may benefit from interventions designed to increase proficiency for condom use with a particular focus on the behaviors of inconsistent and partial condom use.