Level of AIDS and HIV knowledge and sexual practices among sexually transmitted disease patients in China

BACKGROUND: Little is known about sex practices that increase the risk of contracting HIV infection or the level of HIV and AIDS knowledge among sexually transmitted disease (STD) patients in China. OBJECTIVE: To describe AIDS and HIV knowledge, sexual practices, and factors associated with never using condoms among patients at an STD clinic in Jinan, China. STUDY DESIGN: Clinic patients (n = 498) were randomly sampled to answer AIDS and HIV knowledge questions and to report sexual practices, including condom use. RESULTS: Patients had low levels of AIDS and HIV knowledge and engaged in high-risk sex behaviors. The majority of patients reported having had multiple sex partners. When having sex, few men and no women reported always using condoms. Gender, age, residence, AIDS and HIV knowledge, and having multiple sex partners were significantly associated with never using condoms. CONCLUSION: STD clinic patients report having engaged in high-risk sex behaviors. More research is needed to better understand the factors relevant to developing risk-reduction interventions for these patients in China.     

270名暗娼性病／艾滋病现状调查与分析

目的了解某市收容教育所卖淫女学员的社会人口学特征、艾滋病相关知识，行为和态度及性传播疾病感染情况，为商业性性服务小姐的干预工作提供指导依据。方法对该市收容教育所270名卖淫女学员进行一对一问卷调查，同时进行性传播疾病感染检测。结果收容所暗娼艾滋病相关知识知晓率为64．07％。入所前商业性性行为中“最近一次”安全套使用率为81．1％，“最近一个月”每次使用安全套的比例为63％，从未使用的比例为5．6％。入所前最后一个交易日接客数最多10个，平均1．56个。性传播疾病阳性率为51，1％，其中HIV抗体阳性率为3．3％。不同场所的暗娼在社会人口学、商业性性行为、安全套使用方面存在差异。结论不同场所问HIV／AIDS和STD感染无差异，不同类型场所均是艾滋病干预的重点。“街头”暗娼更易受到性病、艾滋病威胁。     

Men who have sex with men and human immunodeficiency virus/sexually transmitted disease control in China

OBJECTIVES: To address the role of men who have sex with men (MSM) in the human immunodeficiency virus (HIV)/sexually transmitted disease (STD) epidemic in China. GOAL: To explore the prevalence of risky sexual behaviors and the existing prevention efforts among men who have sex with men (MSM) in China. STUDY DESIGN: Review of behavioral and STD/HIV prevention studies addressing MSM in China. RESULTS: Sexual risk behaviors including unprotected group sex, anal sex, casual sex, and commercial sex were prevalent among Chinese MSM. Many Chinese MSM also engaged in unprotected sex with both men and women. Most MSM either did not perceive that they were at risk of HIV/AIDS or underestimated their risk of infection. Surveillance and intervention research among these men are still in the preliminary stages. CONCLUSIONS: Chinese MSM are at risk for HIV/STD infection and potential transmission of HIV to the general population. In addition to sexual risk reduction among MSM, reduction of homosexuality- related stigma should be part of effective intervention efforts. Volunteers from the MSM community and health care workers in primary health care system may serve as valuable resources for HIV/STD prevention and control among MSM.     

Knowledge, attitude, belief and practice (K.A.B.P) study on AIDS among senior secondary students

A cross-sectional survey was done among students of four senior secondary schools including two boys and two girls schools of rural Delhi to know the knowledge, attitude, belief and practices regarding AIDS. A large majority (83.0%) of students though had heard about AIDS, yet majority of them did not know the possible methods for prevention of AIDS. There were only 27.1% girls who knew about regular condom usage. Half of them had permissible attitude for pre-maritial sex, while sexual activity was observed in one-fourth students. Students were less reluctant to discuss about AIDS than sex, and teachers were preferred as compared to parents in this regard. School is an ideal setting to educate adolescents regarding HIV/AIDS transmission and safer sex behaviour.     

建筑工地男性农民工艾滋病防治知识及性行为调查

目的：了解贵阳市2011年至2013年建筑工地男性农民工艾滋病防治知识、性行为情况及HIV、HCV和梅毒感染率。方法：采用整群随机抽样的方法对建筑工地1203名男性农民工进行问卷调查及HIV、HCV和梅毒检测。结果：2011年至2013年艾滋病知晓率分别为29.1%、42.1%、52.5%。年龄20～39岁、未婚、高文化程度者知晓率较高。感染HIV高危行为发生普遍,最近1年与暗娼每次都用安全套的分别为22.2%、16.7%、64.0%;最近1年与临时性伴每次用安全套的分别为27.3%、22.2%、17.9%;梅毒感染率2.5%、0.7%、1.0%;HCV感染率0.2%、0.5%、0.3%,2011年发现1例HIV阳性。结论：贵阳市建筑工地男性农民工知晓率和安全套使用率较低,今后要加强该人群宣传、干预及监测力度。     

Risk factors for sexually transmitted diseases in northern Thai adolescents: an audio-computer-assisted self-interview with noninvasive specimen collection

BACKGROUND: Previous studies of sexual behavior and sexually transmitted diseases (STDs) in Thai adolescents may have been limited by participation bias and underreporting of stigmatized behaviors. GOAL: The goal was to increase knowledge about risk behaviors and STDs among youths in Thailand. STUDY DESIGN: Students aged 15 to 21 years completed an audio-computer-assisted self-interview. Oral fluid was tested for HIV antibodies and urine was tested for Chlamydia trachomatis and Neisseria gonorrhoeae nucleic acids with polymerase chain reaction. RESULTS: Of 1736 invited students, 1725 (99.4%) agreed to participate. Overall, C trachomatis infection was detected in 49 (2.8%), and there were five cases (0.3%) each of infection with N gonorrhoeae and HIV. Among those who reported sexual intercourse, the prevalence of chlamydial infection was 3.7% among men and 6.1% among women. Logistic regression analysis showed age-adjusted factors associated with chlamydial infection among men to be parents' occupation in agriculture, having sold sex, having a sex partner who had been pregnant, and the number of casual sex partners during lifetime. Among women, age-adjusted factors were parents' occupation in agriculture, number of casual partners during lifetime, having an older sex partner, and perception of higher HIV infection risk. CONCLUSION: These adolescents had high rates of unprotected intercourse and are at risk for STDs. Prevention programs should emphasize use of effective contraceptive methods, including condom use; reducing the number of sex partners (stressing the risk a partner of older age may pose to female adolescents); and reducing engagement in commercial sex.     

青岛市吸毒者性行为特征及梅毒和艾滋病感染状况调查

目的:了解青岛市新型毒品吸食者的性行为特征并调查梅毒和艾滋病感染状况。方法:问卷调查新型毒品吸食者的性行为特征,并检测HIV和梅毒抗体。结果:共调查吸毒者564名,98.22%以吸食冰毒为主,54.09%最近1年有过临时性伴,55.14%最近1年发生过商业性性行为,15.60%最近1年提供过性服务;最近1个月有过性行为的人最近1次性行为安全套使用率为32.42%;HIV抗体阳性检出率为0.36%,梅毒阳性率为13.19%。结论:该人群以吸食新型毒品为主,梅毒流行率较高,应加强对该人群的宣传教育和行为干预,减少梅毒和艾滋病的发生率。     

Simultaneous use of multiple condoms among male Cambodian military personnel visiting female sex workers

OBJECTIVES: To estimate the prevalence of simultaneous use of multiple condoms (SUMC) and identify the characteristics of the multiple condoms users. STUDY DESIGN: Cross-sectional survey among military men from a purposively selected Cambodian military region. Military men were interviewed face to face. RESULTS: From the 1638 respondents, 40% never had sex with female sex workers (FSWs), 55% had used condom(s), and 5% had unprotected sex at their last encounter with a FSW. Among those reporting sex with FSWs, 21% had used multiple condoms simultaneously at their last sex with a FSW. CONCLUSION: Compared with single condom users, multiple condom users were younger, had lower rank, had first sex more recently, had lower knowledge of HIV transmission, had received less HIV peer-education sessions, were more likely to have visited multiple FSWs, and were more likely to have sought their HIV serostatus. As it is unknown if SUMC increases or decreases condom effectiveness, more research is needed to investigate the effect of SUMC on condom failure rates.     

Casual sexual experience abroad in patients attending an STD clinic and at high risk for HIV infection.

OBJECTIVE--To study possible "import" routes of HIV infection to Norway (by obtaining information on casual sexual contacts abroad from patients attending an STD clinic), and to assess their behavioural risk factors (such as alcohol intake, use of condom) for HIV infection. DESIGN AND SETTING--Patients visiting the clinic for sexually transmitted diseases (STD), April-June 1989, received a questionnaire. SUBJECTS--606 consecutive persons of whom 599 agreed (98.8%) to participate. We grouped the patients in four categories. 1: Sex with a prostitute during the last 5 years, 2: Homosexuals/bisexuals, 3: prostitutes/intravenous drug abusers (IVDUs) and 4: Other heterosexuals. RESULTS--245 patients (41%) reported having a casual sex partner abroad (M: 182, F: 63), mainly in Europe, particularly in Spain, Denmark and Greece. Outside Europe such contacts were most frequently reported from USA, Brazil and Thailand. Among men who had had sex with a prostitute, 93.5% reported such sex abroad (homosexuals/bisexuals: 63.6%, prostitutes/IVDUs: 66.7%, "other heterosexuals: 32.1%). Homosexual/bisexual men with casual partner(s) abroad used a condom more frequently than did others. CONCLUSION--245 of 599 persons reported casual sex abroad during 1985-1989, and the different "risk groups" reported countries where most HIV infected persons belonged to their own "risk group". We have reason to believe that alcohol intake increased the likelihood of casual sexual activity and decreased the use of condom. Norwegian travellers need more information on the risks of casual sex abroad, the use of condoms and the combination of alcohol intake and casual sex.     

Trends in sexual behaviour among London homosexual men 1998-2003: implications for HIV prevention and sexual health promotion

OBJECTIVES: To examine changes in sexual behaviour among London homosexual men between 1998 and 2003 by type and HIV status of partner. METHODS: Homosexual men (n=4264) using London gyms were surveyed annually between 1998 and 2003 (range 498-834 per year). Information was collected on HIV status, unprotected anal intercourse (UAI) in the previous 3 months, and type of partner for UAI. High risk sexual behaviour was defined as UAI with a partner of unknown or discordant HIV status. RESULTS: Between 1998 and 2003, the percentage of men reporting high risk sexual behaviour with a casual partner increased from 6.7% to 16.1% (adjusted odds ratio (AOR) 1.36 per year, 95% confidence interval (CI) 1.26 to 1.46, p <0.001). There was no significant change in the percentage of men reporting high risk sexual behaviour with a main partner alone (7.8%, 5.6%, p=0.7). These patterns were seen for HIV positive, negative and never tested men alike regardless of age. The percentage of HIV positive men reporting UAI with a casual partner who was also HIV positive increased from 6.8% to 10.3% (AOR 1.27, 95% CI 1.01 to 1.58, p <0.05). CONCLUSION: The increase in high risk sexual behaviour among London homosexual men between 1998 and 2003 was seen only with casual and not with main partners. STI/HIV prevention campaigns among London homosexual men should target high risk practices with casual partners since these appear to account entirely for the recent increase in high risk behaviour.     

Sexual patterning and condom use among a group of HIV vulnerable men in Thika, Kenya

Background/aim: A composite sample of 37 peer educators and 215 members of self help groups of male informal sector workers in Thika, Kenya, targeting HIV/AIDS prevention, were interviewed about their sexual behaviour, using a customised template, as part of a broader survey on gender attitudes and peer pressure. METHOD: Details on each sexual partner reported by each man over a 12 month recall period included type of partner, months during which sexual relations took place, and condom use. RESULTS: The men reported 471 sexual partners over the recall period, with a range of 0-16 partners, and an average of just under two partners. 8% of men had had no sexual partner, half were monogamous, and 3% had multiple partners with whom they used condoms exclusively, leaving 39% at varying degrees of risk. Condom use increased significantly with reduced intimacy of partner. 16% of men reported having at least one liaison with a female sex worker and two thirds of such liaisons were exclusively protected by condom use. Younger, single men had significantly more partners, but were more likely to use condoms. Duration of membership in self help groups was strongly associated with exclusive use of condoms with casual or FSW partners. Recorded attitudes corresponded somewhat with practice, but the data showed large gaps between the two, and low levels of gender sensitivity. CONCLUSION: There is some evidence that group membership has resulted in increased condom use and partner reduction, but there are doubts as to the extent to which the "ABC" strategy can be successful in stemming the HIV/AIDS epidemic. It may be necessary for interventions to target contextual issues, particularly gender relations, if the approach is to be more successful.     

Homosexual men's HIV related sexual risk behaviour in Scotland

OBJECTIVE: To date, the epidemic of HIV infection in Scotland has been primarily associated with injecting drug use. However, the epidemiology of HIV in Scotland changed in the late 1980s, with homosexual men becoming the largest group at risk of HIV infection and AIDS. Our aim was to describe homosexual men's sexual risk behaviours for HIV infection in a sample of men in Scotland's two largest cities. DESIGN/SETTING: Trained sessional research staff administered a short self completed questionnaire, to homosexual men present in all of Glasgow's and Edinburgh's "gay bars," during a 1 month period. SUBJECTS: A total of 2276 homosexual men participated, with a response rate of 78.5%. Of these, 1245 were contacted in Glasgow and 1031 in Edinburgh. MAIN OUTCOME MEASURES: Sociodemographic data, recent (past year) sexual behaviour, information on last occasion of anal intercourse with and without condoms, and sexual health service use. RESULTS: Anal intercourse is a common behaviour; 75% of men have had anal intercourse in the past year. A third of our sample report anal intercourse with one partner in the past year, but 42% have had anal intercourse with multiple partners. Over two thirds of the total population have not had any unprotected anal intercourse (UAI) in the past year and a quarter of the sample have had UAI with one partner only. 8% report UAI with two or more partners. More men in Edinburgh (17% v 10%) reported unprotected sex with casual partners only, but more men in Glasgow (29% v 20%) reported UAI with both casual and regular partners (chi 2 = 12.183 p < 0.02). Multiple logistical regression found that odds of UAI are 30% lower for men with degree level education and 40% lower for men who claim to know their own HIV status, whereas they are 40% higher for those who have been tested for HIV and 48% higher for infrequent visitors to the "gay scene". Men who have had an STI in the past year are 2.4 times more likely to report UAI than those who have not. Men with a regular partner were significantly more likely to report UAI, as were those who had known their partner for longer, and who claimed to know their partner's antibody status. CONCLUSION: On the basis of current sexual risk taking, the epidemic of HIV among homosexual men in Scotland will continue in future years. The data reported here will prove useful both for surveillance of sexual risk taking, and the effectiveness of Scotland-wide and UK-wide HIV prevention efforts among homosexual men.     

The effect of venue sampling on estimates of HIV prevalence and sexual risk behaviors in men who have sex with men

OBJECTIVE: The objective of this study was to investigate differences in HIV prevalence and sexual risk behaviors among men who have sex with men (MSM) according to their gay venue visit patterns. METHODS: In a cross-sectional survey, a population-based sample of men aged 18 to 64 years who self-identified as gay or bisexual were interviewed by telephone regarding their sexual behaviors, HIV serostatus, and gay venue visit patterns. RESULTS: A total of 398 men were recruited for the study. The results showed that frequent gay venue visitors were more likely to engage in high-risk sexual behaviors. Among gay venue attendees who visited different types of gay venues, men who visited sex clubs/bathhouses reported the highest rates of 5 or more male sexual partners and unprotected anal intercourse (UAI) with secondary partners (62.6% and 34.6%, respectively), gay bar/club attendees and cruisers reported higher rates of having sex with women (8.5% and 14.8%, respectively), and circuit party attendees reported the highest HIV prevalence (40.4%) and serodiscordant UAI (30.2%). CONCLUSIONS: MSM who visited different types of gay venues and with varied visit frequency showed marked differences in sexual risk behaviors, and the differences suggest the importance of weighting procedure to obtain unbiased estimates in venue-based studies.     

Barebacking among HIV-positive gay men in London

OBJECTIVES: The objectives of this study were to examine the extent to which HIV-positive gay men in London intentionally seek unprotected anal intercourse ("barebacking") and the contribution this makes to total sexual risk. STUDY DESIGN: In 2002 to 2003, HIV-positive gay men surveyed in an HIV outpatient clinic or on the Internet were asked whether they had intentionally looked for anal sex without a condom in the previous 12 months. RESULTS: Of 481 men in the clinic, 59 (12.3%) said they had intentionally looked for anal sex without a condom, 34 (7.1%) only with another HIV-positive man and 25 (5.2%) with a man of unknown or discordant HIV status. Overall, 85 men reported unprotected anal intercourse (UAI) with a casual partner of unknown or discordant HIV status; 20 (23.5%) had intentionally looked for UAI with such a partner, whereas the remaining 65 (76.5%) had not. Of 66 men surveyed on the Internet, 32 (48.5%) said they had intentionally looked for anal sex without a condom. CONCLUSION: Although barebackers made a disproportionate contribution to sexual risk, three-fourths of high-risk sex reported by HIV-positive gay men in London was not intentional. The Internet sample overestimated the prevalence of barebacking among HIV-positive gay men because of sampling bias.     

2010-2019年云南省玉溪市男男性行为者艾滋病哨点监测结果及知行分离影响因素分析

目的了解2010-2019年云南省玉溪市MSM人群HIV、梅毒和HCV感染状况及艾滋病知晓情况并分析知行分离的影响因素。方法根据《全国艾滋病哨点监测方案》的要求,以每年4-7月为监测期,采用横断面调查法对玉溪市MSM人群的人口学特征、艾滋病知识知晓情况、行为学和接受艾滋病干预服务等情况进行连续监测,应用Logistic回归分析分析MSM人群知行分离的相关影响因素。结果2010-2019年玉溪市监测MSM共3765人次,98.94%(3725/3765)知晓艾滋病基本知识,25.42%(946/3721)存在知行分离。79.18%(2586/3266)的MSM最近6个月与同性肛交时坚持使用安全套,历年坚持使用安全套比例呈上升趋势(B=3.384,P=0.011)。HIV、梅毒和HCV感染率分别为4.54%(95%CI:3.88%~5.21%)、3.45%(95%CI:2.87%~4.04%)和0.64%(95%CI:0.38%~0.89%)。多因素Logistic回归分析显示,年龄越大、户籍为外省、文化程度为初中及以下、最近6个月与异性发生过性行为、最近1年患有性病和HIV抗体阳性者是知行分离的危险因素,而最近1年接受过艾滋病干预服务是保护因素。结论2010-2019年玉溪市MSM人群HIV感染率基本平稳,但坚持使用安全套的比例不高,存在知行分离现象,应提供精准干预,促进MSM坚持使用安全套。     

Changes in heterosexual university undergraduates'' HIV-related knowledge, attitudes and behaviour: Melbourne, 1989-1994.

OBJECTIVE: To examine differences in the AIDS-related knowledge, attitudes and behaviours of first year university undergraduates in 1989 and 1994. DESIGN: Comparisons were made between cross-sectional surveys, conducted in 1989 and 1994, of first year undergraduates at three Melbourne universities. RESULTS: The 1994 cohort reported more positive attitudes toward, and better knowledge of, safe sex practices and less discrimination against perceived risk groups than did the 1989 cohort; however, this was due primarily to improvement among female undergraduates. Male undergraduates either demonstrated no improvement or a decline in pro-safe sex attitudes. A general increase was found in the proportion of respondents always using condoms for vaginal sex with casual and regular partners and for oral sex with casual and regular partners. CONCLUSIONS: While the extent of sexual behaviour among these young people has remained essentially unchanged over the past five years, the extent of self-reported condom use has increased markedly. The general decline in attitudinal measures among young men contrasts with a marked improvement among young women and suggests the need for education programs targeted specifically at this group.     

梧州市男男同性恋艾滋病相关知识知晓、性行为特征及感染情况

目的：了解梧州市男男同性恋（MSM）艾滋病相关知识、性行为特征及感染情况。方法：对梧州市辖区内的55名MSM进行问卷调查和艾滋病病毒抗体检测。结果：55名MSM艾滋病相关知识知晓率为89．09％;最近6个月与男性性伴发生性行为时均使用安全套的比例为30．9％。HIV抗体阳性检出率为9．09％。结论：为降低HIV感染风险,应在MSM人群中推广100％安全套,提倡正确的安全性行为。     

Risk factors for sexually transmitted diseases and casual sex among Chinese patients attending sexually transmitted disease clinics in Hong Kong

BACKGROUND: The risk factors for sexually transmitted diseases (STDs) and having casual sex among the Chinese people are unknown. GOAL: The goal of the study was to estimate the prevalence of STDs and to develop a profile of risk behavior among patients attending STD clinics in Hong Kong. STUDY DESIGN: In a clinic-based, cross-sectional study, 448 patients attending two government STD clinics were randomly sampled and interviewed by means of a structured questionnaire. RESULTS: The prevalence of STDs was 51% (70% of men and 35% of women). Attendees who had STDs diagnosed were more likely to be male, never married, and smokers and alcohol users (ever) and to have had casual sex or sex during travel with someone not their usual partner. Those who did not always use condoms were more likely to be male and never married. Having had casual sex was reported by 63% of the respondents. Those who reported having had casual sexual encounters were more likely to have the following characteristics: male; never married; no religious belief; ever smoker and alcohol user; current STD; had sex during travel; history of STD; inconsistent condom user; and perception of being at low risk for STD. After adjustment, only male gender was associated with casual sexual encounters. CONCLUSION: The results of this study indicated several risk factors among Chinese patients for the acquisition of STDs, for not using condoms, and for having casual sex. This information is useful in strengthening and evaluating currently available STD prevention and control strategies for the Chinese population in Hong Kong and elsewhere.     

Sexual behaviour in a group of Swedish homosexual men

Using self-administered questionnaires, sexual behaviour was assessed among 181 male homosexuals who were members of a 'gay' organization. Eighty-seven out of 181 (48%) had a regular partner and 14% reported their relationship as monogamous. The number of different sexual partners among the studied men was found to be low. Anal intercourse with non-steady partners in the past year had been practised by 43%, 79% of whom had generally used a condom. Use of condoms during oral intercourse was less common. Most of the men (86%) had made some risk-reducing behavioural changes (since a mean of 2.8 years) because of perceived risk of HIV/AIDS. 73% had had an HIV antibody test performed. Adoption of safer sexual practices seems to have occurred among the gay men studied.