MSMW: Pathways, Motives and Behaviors

描述(由申请人提供)：最近，人们对与男性和女性发生性关系的男性(MSMW)可能扮演的“桥梁”角色越来越感兴趣，通过他们的同性接触将感染传播给他们的女性伴侣。MSMW中最有可能将女性伴侣置于危险境地的人群是那些对这些女性隐瞒自己的同性性行为、没有同性恋身份、以及与男性和女性都有性行为活跃的人。这些男性并不是之前研究的重点。因此，我们对以下方面知之甚少：这些男性与男性和女性伴侣发生的性行为，包括他们将自己置于感染风险的程度；他们是否采取了降低风险的策略以避免感染或传播感染；他们隐瞒同性的原因和策略；他们是否感到容易感染艾滋病毒；以及他们是否认为有必要进行艾滋病毒检测、教育或预防干预。为了解决这些差距并检查性行为中的种族/民族差异，我们建议对200名MSMW-60名非洲裔美国人、60名拉丁裔和60名非西班牙裔白人进行调查。在这些种族/民族中的每一个群体中，将有20例以前被检测出艾滋病毒呈阳性。我们还将包括20名MSMW，他们是亚洲人、太平洋岛民、美洲印第安人或阿拉斯加原住民。符合资格的男性必须是非同性恋身份，并在过去一年内：与男性发生肛交或口交；与交往至少3个月的女性发生阴道、肛门或口交；对所有女性伴侣隐瞒他们的同性性行为。这项研究的具体目标是：1.确定MSMW与男性和女性的关系满足了哪些心理、社会和性需求；2.调查MSMW向女性伴侣隐瞒其同性行为的原因和动机，以及与此隐瞒相关的社会和心理成本；3.确定MSMW用来与其男女伴侣保持期望的社会身份认同(例如，作为异性恋男性)的各种印象管理策略；4.调查MSMW与其男性和女性伴侣之间的性行为和降低风险策略的潜在差异；5.调查MSMW对他们在不同场所与男性和女性的性行为的理解，以及这些背景和发生在其中的活动如何促进认知逃避。这项研究的发现将提供关于MSMW高危亚群的新的和重要的信息，并将产生重要的信息，可以指导预防措施的发展。

DESCRIPTION (provided by applicant): Recently, interest has grown in the possible role that men who have sex with men and women (MSMW) may play as a "bridge", spreading infection acquired through their same sex contacts to their female partners. The subpopulation of MSMW who may be most likely to place their female partners at risk are ones who hide their same sex behavior from these women, are not gay identified, and are sexually active with both men and women. These men have not been the focus of previous research. Consequently, we know very little about: the sexual behaviors these men engage with male and female partners, including to what extent they place themselves at risk of infection; whether they adopt risk-reduction strategies to avoid acquiring or transmitting infection; their reasons and strategies for concealing their same sex; if they feel vulnerable to acquiring HIV infection; and whether they perceive a need for HIV testing, education or prevention interventions. To address these gaps and examine race/ethnic differences in sexual behavior, we propose an investigation of 200 MSMW - 60 African Americans, 60 Latinos, 60 non-Hispanic Whites. Within each of these racial/ethnic groups, 20 cases will have previously tested HIV-positive. We will also include 20 MSMW who are Asian, Pacific Islanders, American Indians, or Alaskan Natives. Eligible men must be non gay- identified and in the past year: had anal or oral sex with a man; had vaginal, anal or oral sex with a woman to whom they had been in a relationship for at least 3 months; and concealed their same sex behavior from all their female partners. The study's specific aims are: 1. To identify what psychological, social, and sexual needs fulfilled by MSMW's relationships with men and with women; 2. To investigate MSMW's reasons and motives for concealing their same sex behavior from their female partners, and the social and psychological costs associated with this concealment; 3. To identify the various impression management strategies, both active and passive, that MSMW use to maintain their desired social identity (e.g., as a heterosexual man) with their male and female partners; 4. To investigate the potential differences in the sexual behaviors and risk reduction strategies MSMW engage in with their male and female partners; 5. To examine how MSMW's understandings of their sexual behavior with men and women in different venues and, how these contexts and activities that take place within them facilitate cognitive escape. The study's finding will offer novel and important information about a high risk subpopulation of MSMW, and will yield important information that can guide the development of preventive interventions.