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1.
OBJECTIVES: To establish the prevalence of HIV, syphilis, and sexual risk behaviour among three groups of men who have sex with men in Jakarta, Indonesia, and to investigate sexual links between these men and broader heterosexual populations. METHODS: Anonymous, cross sectional surveys among community recruited transgender and male sex workers and self recognised men who have sex with men (MSM) were undertaken in mid-2002 in Jakarta, Indonesia. Places where transgender and male sex workers sell sex and where men go to meet non-commercial male sex partners were mapped. Probability samples were selected for the sex worker populations, while a mixed probability and convenience sample was drawn for self recognised MSM. Blood was drawn for HIV and syphilis serology and community interviewers administered a standardised questionnaire. RESULTS: HIV prevalence was 22% among transgender sex workers, 3.6% among male sex workers, and 2.5% among self recognised MSM, and syphilis prevalence was 19.3%, 2.0% and 1.1% respectively. 59.3% of transgender sex workers and 64.8% of male sex workers reported recent unprotected anal intercourse with clients, and 53.1% of other MSM reported unprotected anal sex with male partners. Some 54.4% of male sex workers and 18.3% of other MSM reported female partners in the preceding year. CONCLUSION: HIV has reached substantial levels among transgender sex workers, and is not negligible in other MSM groups. Risk behaviour is high in all subpopulations, and bisexual behaviour is common, meaning the threat of a wider epidemic is substantial. Prevention programmes targeting male-male sex are needed to reduce this threat.  相似文献   

2.
OBJECTIVES: This study investigated the prevalence of bisexual behaviors and marital status among Chinese men who have sex with men (MSM) and the associations between MSM's condom use and their heterosexual behaviors. METHODOLOGY: Eight hundred ninety-six adult males in Yunnan Province, China, who reported to ever have engaged in MSM behaviors were interviewed. Data were acquired through the China-UK HIV/AIDS Prevention and Care Project from 2003 to 2006. RESULTS: Of all respondents, one-third had ever been married, 59% had ever engaged in bisexual behaviors, and 31% had done so in the past 6 months. High prevalence of inconsistent condom use was reported in heterosexual behaviors (71.9%), as well as with those who had engaged in MSM sexual behaviors in the past 6 months (30.8% with commercial sex workers and 54.7% with noncommercial sex partners) in the past 6 months. Those who did not use condoms with MSM partners were also more likely than others to not use condoms with their female sex partners (FSP). Those who had voluntary counseling and testing services were more likely than others to have used a condom in the last episode of sex with their FSP (multivariate odds ratio = 1.66). CONCLUSIONS: The clustering of unprotected sexual behaviors with male and FSP among bisexual MSM is revealed. The bridging effects of the risk for human immunodeficiency virus transmission from the MSM population to the female population are evident.  相似文献   

3.
BACKGROUND: Little is known about risk of HIV and other STDs among men who have sex with men (MSM) in China. OBJECTIVE: To survey the prevalence and risk factors of HIV and syphilis and evaluate correlation of two infections among MSM in the Chinese capital city. METHODS: A community-based sample of 526 MSM was recruited in 2005 through Internet advertising, community outreach, and peer referring. Interviewer-administered interviews were conducted to collect information on demographics and sexual and other risk behaviors, and blood samples were collected to test for syphilis and HIV infections. RESULTS: Seventeen (3.2%) participants were HIV seropositive and 59 (11.2%) syphilis seropositive. Sixty-four percent of participants were migrants who did not have Beijing residence. Forty percent had >10 lifetime male sex partners and 28.8% reported having ever had sex with women. Consistent condom use with primary male sex partners ranged from 21% to 24%, with nonprimary male sex partners from 35% to 42%, and with female partners around 33%. Illicit drug use was not common; only 2.5% reported using Ecstasy or ketamine in the past 6 months. Multivariate logistic regression analyses demonstrated that >10 lifetime male sex partners were independently associated with seropositivity of both syphilis (OR, 1.9; 95% CI, 1.1-3.4) and HIV (OR, 4.3; 95% CI, 1.4-13.6). In addition, HIV infection is significantly associated with syphilis seropositivity (OR, 3.8; 95% CI, 1.3-10.8). CONCLUSIONS: High mobility, multiple sexual partners, and high prevalence of unprotected sex behaviors and syphilis infection suggest a potential rapid spread of HIV in Chinese MSM.  相似文献   

4.
BACKGROUND: Herpes simplex virus type 2 is common among MSM and is a risk factor for transmission of HIV. The findings of studies investigating the relationship between infection with HSV-2 and number of sex partners among MSM are inconsistent and rarely distinguish between male and female partners. GOAL: To determine the prevalence and risk factors for infection with HSV-2, including the number and gender of sex partners, in a group of MSM in Baltimore, MD. STUDY: This was a cross-sectional study among young MSM in Baltimore. RESULTS: Of the blood samples from 824 participants, 19.3% had HSV-2 antibodies. After adjusting for known HSV-2 correlates, independent predictors of HSV-2 seropositivity included HIV seropositivity, black race, older age, number of lifetime female sex partners, recent unprotected receptive anal intercourse with a man. CONCLUSIONS: This study suggests that female sex partners may be an important source of HSV-2 infection among young bisexual MSM. After adjusting for known HSV-2 correlates, the number of lifetime female but not male sex partners was independently associated with HSV-2. These results highlight the need for HSV-2 prevention and treatment efforts targeting MSM who also have sex with women. Future investigations of HSV-2 and sexual behavior among MSM need to distinguish between male and female sex partners.  相似文献   

5.
OBJECTIVES: Contact tracing may be less effective in populations with casual sex partners such as male syphilis patients who report sex with men; this opinion is widely held, but few quantitative comparisons are available. GOAL: The goal of this study was to compare contact-tracing outcomes among male syphilis patients reporting sex with men (MSM) or with women only (MSWO). STUDY DESIGN: The authors conducted a record review of cases of early syphilis among MSM and MSWO comparing contact-tracing outcomes. RESULTS: Interviews of MSM case-patients resulted in higher mean numbers of contacts named and located per case than interviews of MSWO. Mean numbers of contacts of MSM and MSWO diagnosed with syphilis per case were not significantly different. The mean number of unlocatable sex partners per case was slightly higher for MSM than MSWO. CONCLUSION: This study comparing contact tracing by the same trained health department personnel demonstrated that outcomes of contact tracing were similar for MSM and MSWO.  相似文献   

6.
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.  相似文献   

7.
OBJECTIVE: To provide insight into the role of commercial sex venues in the spread of syphilis and HIV among men who have sex with men (MSM). Study: A cross sectional study of 1351 MSM who were diagnosed with early syphilis who did and did not encounter sexual partners at commercial sex venues. RESULTS: Overall, 26% MSM diagnosed with syphilis had sexual encounters at commercial sex venues. Of these, 74% were HIV positive, 94% reported anonymous sex, and 66% did not use a condom. Compared to those who did not have a sexual encounter at these venues, they were twice as likely to be HIV positive (OR = 1.91, 95% CI 1.36 to 2.68), six times more likely to have anonymous sex (OR = 6.18, 95% CI 3.37 to 11.32), twice as likely not to use condom (OR = 2.02, 95% CI 1.71 to 2.38), and twice as likely to use non-injecting drugs (OR = 1.65, 95% CI 1.21 to 2.37). CONCLUSIONS: MSM diagnosed with syphilis who frequent commercial sex venues are engaging in high risk behaviours for syphilis and HIV transmission and acquisition. Thus commercial sex venues are one of the focal points of syphilis and HIV transmission and acquisition.  相似文献   

8.
OBJECTIVES: To examine sex partner meeting venues and out-of-state sex partners among men who have sex with men (MSM) with syphilis in Connecticut, a state with moderate syphilis prevalence. GOAL: To better understand transmission dynamics in the current syphilis epidemic. STUDY DESIGN: Review of health department records. RESULTS: A total of 185 MSM were diagnosed with early syphilis in Connecticut from 2000 to 2005 (mean age, 36 years; 56% white, 37% HIV-positive). Fifty-two percent of cases reported meeting sex partners at venues that facilitate multiple and/or anonymous sexual encounters including gay clubs or bars (22%), Internet (18%), and adult bookstores (12%). Meeting sex partners in venues increased over time and was associated with nonmetropolitan residence of the case. Forty-three percent of cases had an out-of-state sex partner during the time in which they likely acquired their infection. Having out-of-state sex partners decreased during the study period. Throughout 2000-2005, having out-of-state sex partners was positively associated with bathhouse use and negatively associated with use of adult bookstores. CONCLUSIONS: The observed pattern of increased meeting sex partners in venues located within the state and decreased out-of-state sex partners over time is suggestive of increasing transmission within the state of Connecticut.  相似文献   

9.
青岛市男男性行为人群艾滋病高危性行为调查   总被引:1,自引:0,他引:1       下载免费PDF全文
目的:了解男男性行为人群(MSM)的高危性行为,为制定预防控制策略提供依据。方法:采用同伴推动抽样法对MSM人群进行问卷调查。结果:累计调查1849人,年龄中位数26岁,与男性发生过肛交者占98.37%;最近3个月男性性伴在2人以上者占46.29%,有女性性伴者占11.14%;最近一次与男性肛交时安全套使用率为57.92%,最近3个月与男性肛交时每次都使用安全套的比例为35.37%。结论:MSM人群普遍存在多性伴、无保护的性行为,传播性病艾滋病的风险较大。  相似文献   

10.
OBJECTIVES: To estimate the percentage of men who have sex with men (MSM) who have used the Internet to look for sex partners and to examine the prevalence of risky sex among MSM who have and have not sought partners online. METHODS: Meta-analyses were conducted on findings from published English-language studies. High-risk sex was self-reported unprotected anal intercourse (UAI). Analyses were stratified by method of study recruitment (online versus offline venues) and participants' human immunodeficiency virus (HIV) status. RESULTS: In studies that recruited MSM offline, a weighted mean, based on 15 findings, indicated that 40% (95% confidence interval [CI], 35.2%-45.2%) of MSM had used the Internet to look for sex partners. In 3 findings from offline studies that stratified by participant HIV status, the weighted-mean percentage was higher among HIV-positive (49.6%; 95% CI, 44.9%-54.3%) than HIV-negative/unknown MSM (41.2%; 95% CI, 36.8%-45.6%). UAI with male sex partners was more likely among MSM who sought partners online than MSM who did not (odds ratio, 1.68; 95% CI, 1.18-2.40; k = 11). This group difference was observed for UAI with HIV-serodiscordant as well as HIV-seroconcordant partners, particularly among HIV-positive study participants. HIV-serodiscordant UAI was not more prevalent with partners met online than offline. CONCLUSIONS: A substantial percentage of MSM use the Internet to look for sex partners, and those who do are more likely to engage in unprotected sex. Additional research is needed to determine whether the Internet may increase risk behavior beyond that which occurs when men meet partners at offline venues.  相似文献   

11.
OBJECTIVES: To assess the prevalence of syphilis infections among men who have sex with men (MSM) accessing the Brisbane Sexual Health Clinic during the period 1997 up to May 2003, data were collated through three clinical programmes conducted by the service-a large inner city mainstream sexual health clinic and two small outreach sessional clinics conducted on the site of male sex on premises venues (SOPV). Data analysis also provided the opportunity to evaluate the effectiveness of the smaller outreach clinics to access populations of MSM less likely to attend or identify at the larger mainstream clinic, and therefore enhance the detection of previously undiagnosed sexually transmissible infections. METHODS: Computerised records from 1997-2003 were collated for a statistical analysis of syphilis and other STI pathology results for all MSM accessing the mainstream clinic, and two outreach clinics. RESULTS: A review of client charts showed that 16 new syphilis diagnoses were made over the previous 5 years, but only two of these infections (both through the mainstream clinic) were early syphilis and therefore transmissible. All other cases were latent infections. A higher proportion of bisexual men was identified with positive syphilis serology but this was just below significance (p=0.06). Significantly, almost a third of syphilis diagnoses (all latent) were made at SOPV outreach clinics, despite the much lower proportion of clients seen overall through the SOPV clinics. For other sexually transmissible infections, the mainstream clinic demonstrated greater efficiency at case detection. CONCLUSION: Outreach clinics located in male saunas may serve an effective function in syphilis screening by facilitating access for a particular subpopulation of MSM (bisexual, married men). These outreach clinics may provide important outlets for education and opportunistic screening of asymptomatic MSM and foster a greater willingness for men to honestly self identify. However, larger, mainstream clinics serve a more anonymous venue for the testing of symptomatic men.  相似文献   

12.
目的 了解中国6个省(自治区、直辖市)的16个城区的男男性行为人群(MSM)的梅毒感染情况及其影响因素。方法 于2007年在开展绘制MSM活动场所地理分布图及人群规模估计的基础上,用分类的非概率抽样方法在MSM中开展横断面调查;通过问卷调查收集人口学、危险行为以及梅毒感染等信息。用SPSS软件对数据进行单因素及多因素Logistic回归分析。结果 2007年共收集4211份有效问卷。所调查的MSM平均年龄为28岁,自报为同性恋占66.7%,未婚占72.5%,高中及其以上教育程度占76.4%。近6个月MSM的性行为调查结果显示:8.7%有10个以上的男性性伴,5.6%曾买男性性服务,11.3%曾为男性提供商业性服务,18.9%曾与女性发生过性关系,与男性肛交性行为中的安全套坚持使用率仅为36.3%。所调查MSM的梅毒感染率为10.6%。多因素Logistic回归分析结果显示:年龄 > 25岁[调整OR(AOR) = 1.7,95% CI:1.3 ~ 2.0]、本市户籍(AOR = 1.3,95% CI:1.0 ~ 1.7)、调查地区、酒吧/公园招募对象(AOR = 1.3,95% CI:1.1 ~ 1.7)、买男性性服务(AOR = 1.5,95% CI:1.0 ~ 2.1)、男男肛交行为中不坚持使用安全套(AOR = 1.2,95% CI:1.0 ~ 1.5)和自报性病史(AOR = 1.3,95% CI:1.0 ~ 1.7)是梅毒感染的独立相关变量。结论 16个城区MSM的梅毒感染率已达一定水平、男男商业性服务及不安全性行为的流行率较高,亟待加强MSM的梅毒防治工作,包括梅毒和HIV筛查、推广使用安全套等综合干预措施。  相似文献   

13.
OBJECTIVE: To study factors associated with HIV serostatus discussions among men who have sex with men (MSM). DESIGN: The authors conducted a cross-sectional survey among MSM visiting an urban sexually transmitted infection (STI) clinic. METHODS: MSM were asked about sex partner recruitment, serostatus of partners, condom use, drugs use, and HIV serostatus discussions with sex partners. RESULTS: Among 1,400 MSM reporting occasional sex partners, serostatus discussion with 100% of partners was reported by 509 (36.3%), with 50% to 99% of partners by 263 (18.8%), and with <50% of partners by 628 (44.9%). Factors associated with serostatus discussion included lower number of sex partners, anal sex with an occasional partner, and sex partner recruitment through the Internet. Partner recruitment in bathhouses and having sex with both men and women were negatively associated. CONCLUSIONS: Discussion of HIV serostatus was common among MSM studied. Although this strategy has limitations, interventions should address HIV status discussions. Because the Internet may facilitate these discussions, web-based interventions should be evaluated.  相似文献   

14.
OBJECTIVE: This study was conducted in order to determine the prevalence of men having sex with men (MSM) and their HIV related behaviours and attitudes among Chinese men in Hong Kong. METHODS: A large scale, random, population based, anonymous telephone survey of 14 963 men between the ages of 18-60 was conducted. The overall response rate was approximately 57%. RESULTS: Of the respondents, 4.6% had ever engaged in MSM activity. In the 6 months preceding the survey, 2.0% had engaged in MSM behaviours (active MSM) and 0.5% reported having engaged in anal sex MSM behaviours. Among anal sex MSM, consistent condom use was 42.9% with male non-commercial sex partners and even lower with male commercial sex partners (35.7%). Approximately 11% of anal sex MSM and 4.1% of the non-anal sex MSM had contracted an STD in the last 6 months. The prevalence of HIV testing was only 20.6% among anal sex MSM and 11.9% among non-anal sex MSM. CONCLUSIONS: Active MSM in Hong Kong are at high risk of HIV infection. The belief of low vulnerability to HIV is prevalent among active MSM in Hong Kong with only 2.0% believing that their chances of HIV infection as being "very likely."  相似文献   

15.
目的:了解深圳地区男男性接触者性病艾滋病高危行为状况,为高危人群行为干预提供科学依据。方法:知情同意原则下填写调查问卷,收集整理资料后进行分析。结果:203例男男性接触者中,年龄最小15岁,最大57岁,平均年龄26岁。学历以高中/中专为主(38.9%),婚姻状况以未婚为主(86.7%),主要居住在罗湖(47.78%)、福田(23.65%)。首次性行为年龄最小12岁,最大30岁,52.2%的男男性接触者第一个性伴为男性,平均性伴数31个;双性恋占47.3%,同性恋占43.8%,异性恋占2.0%;过去6个月与男性肛交每次都用安全套仅41.4%;14.3%回答曾经与外国人发生性接触;12.3%回答曾有医生护士或保健人员告之得了某种性病;54.2%做过HIV检测。结论:男男性接触者普遍多性伴,安全套使用率相对较低,加强对MSM的性病艾滋病防治已刻不容缓。  相似文献   

16.
目的:了解深圳市近6个月内发生过同性临时性行为的MSM人群梅毒合并HIV感染状况及其相关影响因素。方法:运用滚雪球法和同伴推动抽样法招募MSM进行问卷调查和血清学检测,采用χ2检验和Logistic回归分析梅毒HIV合并感染的相关影响因素。结果:共调查434例MSM,梅毒和HIV感染率分别为16.4%和12.2%,梅毒合并HIV感染率为7.3%。年龄越大(OR=4.0,P=0.0007)、高中/中专文化者(OR=6.5,P=0.0081)、性角色以被动方为主者(OR=12.1,P=0.0017)、多个同性肛交性伴者(OR=1.5,P=0.0455)、不能坚持每次使用安全套者(OR=2.9,P=0.0236),其梅毒合并HIV感染风险越高。结论:需要采取更大努力来应对该人群的梅毒和HIV双重感染问题。  相似文献   

17.
OBJECTIVES: We investigated if a rise in rectal gonorrhoea and early syphilis among men who have sex with men (MSM) in Amsterdam coincided with the introduction of highly active antiretroviral therapies (HAART) in July 1996 and determined risk factors for these sexually transmitted infections (STI). METHODS: Subjects were patients of the STI clinic of the municipal health service in Amsterdam. Surveillance data (1994-9) represented consultations (n=11 240) of MSM (n=6103). For analyses we used logistic regression. RESULTS: Comparing the periods before and after the introduction of HAART, the infection rate for rectal gonorrhoea increased from 4% to 5.4% (p=.001) and for syphilis, from 0.5% to 0.8% (p = 0.050). Independent risk factors for rectal gonorrhoea (younger age, western nationality, and concurrent infection with another STI) and for early syphilis (non-western nationality and concurrent infection with rectal gonorrhoea) did not change after HAART became available. For rectal gonorrhoea, however, the infection rate increased only among men who had exclusively homosexual contacts (OR 1.38, p<0.01), compared with bisexual men. For early syphilis, the infection rate increased only among men of western nationality (OR 3.38, p<0.01) compared to men of non-western nationality. CONCLUSIONS: Infection rates of rectal gonorrhoea and early syphilis increased, indicating a change in sexual behaviour, possibly as a result of the introduction of HAART. For now, it is important to find out how sexual behaviour is changing and to keep monitoring trends in STIs (including HIV) among MSM in Amsterdam.  相似文献   

18.
BACKGROUND AND OBJECTIVES: To obtain patients' perspectives on why only some partners are notified in partner-notification programs, the cornerstone of sexually transmitted disease (STD) control, although low proportions of partners are located and evaluated. GOALS: To describe patterns of partner notification reported by persons with STD infection. STUDY DESIGN: In-depth interviews conducted in Seattle with 60 heterosexual men and women with gonorrhea, chlamydial infection, or nongonoccocal urethritis, and 19 men with gonorrhea reporting sex with men (MSM) were tape recorded, transcribed verbatim, and content analyzed. RESULTS: The typical notification pattern was to notify a main partner but not others. Least likely to be notified were partners perceived as transmitters, contacts preceding the onset of symptoms, the oral sex and anonymous contacts of MSM, one-time partners of men, and incarcerated and former partners of women. Fears among young heterosexual participants included gossip and violence (women). Fears among MSM included rejection. CONCLUSIONS: Partner-notification programs should develop innovative approaches for partners perceived as transmitters, oral-sex only contacts of MSM, and contacts preceding symptom onset.  相似文献   

19.
BACKGROUND: Prevention interventions have had little impact on syphilis outbreaks among men who have sex with men (MSM) and diagnosis rates continue to rise rapidly. Detailed studies of the determinants of syphilis transmission are needed to inform new prevention interventions. OBJECTIVE: To investigate factors associated with recent syphilis diagnosis and recommend strategies for improved prevention interventions. METHODS: A case-control study of MSM attending genitourinary medicine (GUM) and HIV outpatient clinics. Cases were MSM testing positive for early syphilis, based on either laboratory or microscopy results, with those testing negative being controls. All participants completed the same anonymous questionnaire covering demographics, lifestyle, sexual behaviour, and sexual partnerships. RESULTS: 50 cases and 108 controls returned questionnaires. Syphilis diagnosis was significantly associated with sexually transmitted infection history, recent recreational drug use, receptive anal sex practices, but not insertive ones, higher numbers of oral sex partners, but not specific oral sex practices. Overall, there were no differences between HIV positive and HIV negative/untested men in reporting of sexual behaviours or partnership combinations. The use of public sex settings (backrooms, saunas, "cruising grounds," etc) was reported by 68% of all participants and not significantly associated with syphilis diagnosis. CONCLUSIONS: Many key behavioural and partnership risk factors for syphilis are also risk behaviours for HIV transmission and point to the need for integrated strategies that tackle the two infections together. Simplified procedures for syphilis screening should be available in GUM clinical settings, along with targeted community outreach prevention interventions.  相似文献   

20.
目的了解兰州市男男性接触者(MSM)艾滋病知识知晓率及性行为危险性。方法采用全球基金艾滋病项目统一设计的调查问卷,对263名MSM进行匿名调查。结果最近6个月内,有201例(76.43%)与男性发生过性行为,74例(28.14%)与女性发生过性关系。除了与女性发生性行为时安全套使用率较高外,其余使用率都很低。调查者中H IV阳性2例,梅毒阳性9例。结论MSM是艾滋病传播的高危人群,应加大对这一人群的健康教育,采取适宜且实用的措施进行干预,以有效控制艾滋病、性病在这一人群中的传播与流行。  相似文献   

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