Perceptions of HIV Seriousness, Risk, and Threat Among Online Samples of HIV-Negative Men Who Have Sex With Men in Seven Countries.
Perceptions of HIV Seriousness, Risk, and Threat Among Online Samples of HIV-Negative Men Who Have Sex With Men in Seven Countries.
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DOI：
10.2196/publichealth.7546
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发表时间：
2017-06-20
影响因子：
8.5
通讯作者：
Stephenson R
中科院分区：
文献类型：
--
作者：
Chard AN;Metheny N;Stephenson R
全球范围内，男男性行为者（MSM）的新艾滋病毒感染率继续上升。尽管避孕套和暴露前预防（PrEP）等有效的预防策略，但在世界许多地方，这两种方法的使用率很低，阻碍了预防工作。一个人对感染艾滋病毒风险的认识以及他们对血清转化的严重性是冒险行为的重要驱动因素。了解抑制艾滋病毒预防服务的行为因素是制定战略以改善干预措施以应对男男性行为者中持续的艾滋病毒流行的关键一步。本研究旨在探讨跨国艾滋病毒/艾滋病的严重性，风险和威胁的看法，这些看法和社会人口学特征，关系和高风险的性行为之间的关联，男男性行为者。通过Facebook招募了澳大利亚、巴西、加拿大、泰国、南非、英国和美国的参与者进行自我管理调查（N=1908）。受访者被要求从1到10，（不严重）至5（非常严重）感染艾滋病毒，他们的感知风险从1（没有风险）到10根据他们目前的行为，以及他们对艾滋病毒威胁的看法--以他们能够在一生中保持艾滋病毒阴性的信心来衡量--在1（在他的生命结束时不会感染艾滋病毒）到5（在他的生命结束时会感染艾滋病毒）。协变量包括社会人口因素、性行为、HIV检测、药物使用和关系状态。三个有序逻辑回归模型，每个结果变量，适合每个国家。感染艾滋病毒被认为是严重的（平均值=4.1-4.6），但艾滋病毒的风险（平均值=2.7-3.8）和艾滋病毒的威胁（平均值=1.7-2.2）的看法相对较低的国家。在五个国家，年龄较大与感染艾滋病毒的严重性明显降低有关（澳大利亚：比值比，OR 0.97，95% CI 0.94-0.99;巴西：OR 0.95，95% CI 0.91-0.98;加拿大：OR 0.96，95% CI 0.93-0.98;南非：OR 0.96，95% CI 0.94-0.98;联合王国：OR 0.95，95% CI 0.92-0.98）。在四个国家，处于男男性关系与艾滋病毒感知风险显著降低相关（澳大利亚：OR 0.47，95% CI 0.30-0.75;加拿大：OR 0.54，95% CI 0.35-0.86;英国：OR 0.38，95% CI 0.24-0.60;美国：OR 0.5，95% CI 0.31-0.82）。在两个国家，前一年的药物使用与感染艾滋病毒的更大威胁相关（加拿大：OR 1.81，95% CI 1.13-2.91;英国：OR 1.7，95% CI 1.06-2.74）。在各国，很少有行为或性冒险的措施与艾滋病毒的严重性、风险或威胁有显著相关。总体而言，低水平的报告风险被确定，结果表明，在不同社会的男男性行为者之间的风险的理解，可以通过文化量身定制的预防信息来解决的重要差距。
Rates of new HIV infections continue to increase worldwide among men who have sex with men (MSM). Despite effective prevention strategies such as condoms and pre-exposure prophylaxis (PrEP), low usage of both methods in many parts of the world hinder prevention efforts. An individual’s perceptions of the risk of acquiring HIV and the seriousness they afford to seroconversion are important drivers of behavioral risk-taking. Understanding the behavioral factors suppressing the uptake of HIV prevention services is a critical step in informing strategies to improve interventions to combat the ongoing HIV pandemic among MSM. The study aimed to examine cross-national perceptions of HIV/AIDS seriousness, risk, and threat and the association between these perceptions and sociodemographic characteristics, relationships, and high-risk sexual behaviors among MSM. Participants in Australia, Brazil, Canada, Thailand, South Africa, the United Kingdom, and the United States were recruited for a self-administered survey via Facebook (N=1908). Respondents were asked to rate their perceived seriousness from 1 (not at all serious) to 5 (very serious) of contracting HIV, their perceived risk from 1 (no risk) to 10 (very high risk) of contracting HIV based on their current behavior, and their perception of the threat of HIV—measured as their confidence in being able to stay HIV-negative throughout their lifetimes—on a scale from 1 (will not have HIV by the end of his lifetime) to 5 (will have HIV by the end of his lifetime). Covariates included sociodemographic factors, sexual behavior, HIV testing, drug use, and relationship status. Three ordered logistic regression models, one for each outcome variable, were fit for each country. Contracting HIV was perceived as serious (mean=4.1-4.6), but perceptions of HIV risk (mean=2.7-3.8) and threat of HIV (mean=1.7-2.2) were relatively low across countries. Older age was associated with significantly lower perceived seriousness of acquiring HIV in five countries (Australia: odds ratio, OR 0.97, 95% CI 0.94-0.99; Brazil: OR 0.95, 95% CI 0.91-0.98; Canada: OR 0.96, 95% CI 0.93-0.98; South Africa: OR 0.96, 95% CI 0.94-0.98; United Kingdom: OR 0.95, 95% CI 0.92-0.98). Being in a male-male sexual relationship was associated with significantly lower perceived risk of HIV in four countries (Australia: OR 0.47, 95% CI 0.30-0.75; Canada: OR: 0.54, 95% CI 0.35-0.86; United Kingdom: OR 0.38, 95% CI 0.24-0.60; United States: OR 0.5, 95% CI 0.31-0.82). Drug use in the previous year was associated with greater threat of contracting HIV in two countries (Canada: OR 1.81, 95% CI 1.13-2.91; United Kingdom: OR 1.7, 95% CI 1.06-2.74). Few measures of behavioral or sexual risk-taking were significantly associated with perceived HIV seriousness, risk, or threat across countries. Overall, low levels of reported risk were identified, and results illustrate important gaps in the understanding of risk among MSM across societies that could be addressed through culturally-tailored prevention messaging.