男男性接触者HIV感染危险因素调查分析

男男性接触(MSM)人群的多性伴和性行为的多样性,使他们处于HIV感染的危险中.为了解白银市MSM人群HIV感染和危险因素现状,2006年8～12月,通过深入该人群活动场所和滚雪球法对112例MSM者进行了调查.     

玉溪市MSM人群同伴教育骨干感染或传播HIV的风险研究

目的通过对在MSM人群实施同伴教育(Peer-education)的同伴骨干(Peer educator)的调查,分析他们在MSM人群HIV流行快速增长中的作用,为找到解决的措施提供参考。方法采用定性、定量研究方法,分析玉溪市MSM人群同伴教育骨干的HIV感染情况、HIV相关行为学、性伴数、曾患性病病史,推算可能感染HIV或传播的风险。结果 (2008-2014)年,玉溪市累计招募28名同伴教育骨干,其中农村户籍17例;28名同伴骨干中,8例(28.6%)为HIV感染者,其中4例为发现感染HIV后招募为同伴骨干,4例为招募为同伴骨干后才感染。与非同伴骨干HIV感染者相比,感染HIV的8名同伴骨干的性伴数偏多、易发生HIV高危行为、并发性病比例偏高。结论在MSM人群艾滋病防治工作中开展的同伴教育是一把双刃剑,既是MSM人群预防艾滋病感染或传播的重要防治措施,也可能是MSM人群HIV流行扩大原因之一,需要进行深入研究。     

广州市男男性接触者肛肠尖锐湿疣HPV感染型别分析

目的:分析2012~2014年我院门诊就诊的患有肛肠尖锐湿疣的男男性接触者(MSM)的人口学资料及肛肠部HPV感染型别分布,为进一步的预防干预提供理论依据。方法:对已确诊的MSM患者进行人口学资料、性行为方式等调查,同时采集调查对象血液及肛肠拭子标本进行HIV检测及HPV的免疫印迹杂交法分型。结果:55例MSM患者中有20例感染HIV,感染率为36.3%。低危型合并高危型HPV的混合感染占69.1%;高危型HPV感染占前4位的依次分别是16型、52型、66型和58型。结论:患尖锐湿疣的MSM人群中HIV的感染率较高;HPV混合型感染在HIV感染的MSM患者中更为常见。     

男男性接触途径与艾滋病高危行为关系研究

男男性接触者(men who have sex with men，MSM)是最易感染和传播艾滋病病毒(human immuodeficiency virus，HIV)／艾滋病(acquired immuodeficiency sydrome，AIDS)的三大核心人群之一，具有感染HIV的多种高危行为，部分MSM经常出入公共浴池、公厕、公园等公共场所寻找性伴。为了了解MSM的性接触途径与AIDS高危行为关系的特点，我们将2000年调查的MSM按其     

2250例男男性接触者性伴与性传播感染率相关性研究

目的 探讨我国男男性接触者(MSM)性伴状况与性传播感染(STI)感染率相关关系.方法 采用匿名自填问卷方式对9城市MSM进行调查,用SPSS 11.0软件处理.结果 STI组男性伴数量多于非STI组(P<0.05),自身性伴为较少性伴者的STI感染率低于有较多性伴者(P<0.05).通过公厕、公园或浴池结识性伴者的STI感染率,高于通过同学朋友邻居结识性伴者(P<0.05).自认为与性伴关系彼此专一者的STI感染率明显低于与性伴关系非彼此专一者(P<0.01).在婚者STI感染率高于非在婚者(P<0.05),与妻子分居者STI感染率高于与妻子仍有性行为者(P<0.05).结论 减少MSM的男性伴数量,可以降低STI感染率.通过公厕、公园或浴池等场所结识性伴是MSM人群STI/HIV传播的重要途径.MSM中STI/HIV感染存在异性性传播的风险.     

北京市2012年男男性行为者HIV及梅毒感染状况调查

【摘要】 目的 了解北京市男男性行为（MSM）人群HIV及梅毒感染状况,探讨两者之间的相关性。 方法 对北京市艾滋病哨点监测MSM人群600例进行HIV及梅毒实验室检测。用ELISA方法对所有研究对象样本进行HIV初筛,初筛阳性者用免疫印迹方法进行确认;梅毒检测采用快速血浆反应素环状卡片试验（RPR）与梅毒螺旋体明胶凝集试验（TPPA）两种方法同时进行,TPPA阳性者即视为梅毒感染者（包括既往感染与现症感染）;符合条件的HIV阳性血清还接受HIV-1 BED捕获酶联法（BED方法）检测并计算HIV在此人群中的发病率;对MSM人群HIV及梅毒感染状况进行统计学相关性分析。 结果 MSM人群600例,HIV阳性49例,阳性率8.17%;HIV新近感染14例,发病率为4.68%。HIV感染者表现出外地户籍比重大、学历层次相对较高的特点。梅毒RPR与TPPA均阳性51例（8.5%）,感染率（含既往感染）为18.5%（111/600）。 结论 北京市哨点监测MSM人群HIV感染率及发病率、梅毒感染率均维持在较高水平;HIV感染与梅毒感染有显著相关性。     

2011-2015年广东省江门市男男性行为人群HIV和梅毒感染状况及影响因素分析

目的:了解江门市男男性行为人群(MSM)HIV和梅毒感染状况及其影响因素,为控制艾滋病性病的蔓延提供科学依据。方法:利用2011-2015年国家级MSM监测哨点的数据资料进行分析。结果:调查的1 916名调查对象中,艾滋病相关知识总体知晓率为90.19%;HIV抗体阳性率为6.73%,梅毒阳性率为4.07%。最近6个月与同性发生肛交性行为时每次都使用安全套的比例为51.93%。多因素Logistic回归分析结果显示,与异性婚姻状况为在婚/同居(OR=1.408,95%CI 1.153~1.720)、最近6个月与同性发生商业性行为(OR=2.458,95%CI 1.266~3.787)、感染梅毒(OR=5.804,95%CI3.196~10.540)是HIV感染的危险因素;吸毒(OR=1.164,95%CI 1.037~3.722)、最近6个月与同性发生肛交性行为(OR=10.753,95%CI 7.958~12.685)是梅毒感染的危险因素,而最近一年非梅毒STD史是梅毒感染的保护性因素(OR=0.239,95%CI 0.090~0.629)。结论:江门市MSM人群HIV和梅毒感染率较高,且梅毒、已婚/同居与同性发生商业性行为可增加HIV感染的风险;吸毒、与同性发生肛交性行为可增加梅毒感染的风险。     

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。     

贵阳市2010～2014年MSM人群HIV感染者性行为情况

目的：了解2010-2014年贵阳市MSM人群（men who have sex with men,MSM）HIV感染者性行为特征,为预防控制MSM人群HIV感染者二代传播提供依据。方法：本研究以2010-2014年的4-7月份在贵阳市MSM人群监测哨点检测出的HIV感染者为研究对象,以一对一的方式进行问卷调查,并采集静脉血进行HIV和梅毒检测。结果：2010-2014年贵阳市MSM人群监测哨点共检测出的333名HIV感染者,年龄在18-24岁,所占的比例由2010年的55.4%下降到2014年的26.7%,在婚或同居所占的比例在5.0%-15.8%之间;文化程度大专及以上者由2010年的45.7%上升到2014年的70.0%。2010-2014年MSM人群感染者的梅毒感染检出率在6.7%-23.9%之间;最近6个月与同性发生肛交性行为所占的比例分别为79.7%-98.9%,与异性发生性行为所占的比例在7.8%-11.7%之间。73.6%-91.4%的MSM最近6个月同性肛交未坚持使用安全套;异性行为坚持使用安全套所占的比例仅为33.3%。结论：MSM人群HIV感染者年龄较小,主要处于性活跃阶段,梅毒的感染检出率较高,同性性行为及异性性行为时坚持使用安全套的比例均较低,将加速HIV和梅毒在MSM人群间及向异性人群传播。     

兰州市男男性接触人群HIV流行影响因素分析

目的了解兰州市男男性接触人群(MSM)HIV流行影响因素,为制定艾滋病防治策略和干预措施提供科学依据。方法 2006-2010年连续5年采用MSM志愿者"滚雪球"的方法对出入酒吧和洗浴场所的男男性接触者进行问卷调查及血清学检测,并进行卡方检验和多因素Logistic回归分析。结果共调查889人,检出HIV抗体阳性53例,阳性率为5.96%;HIV阳性率呈逐年上升趋势(P=0.006);年龄大(>30岁,OR=3.458,95%CI1.421～8.702)、双性恋(OR=2.047,95%CI1.264～3.123)、首次同性性行为>35岁(OR=2.542,95%CI1.113～5.948)、同性性行为(OR=2.081,95%CI1.014～3.621)、多性伴(OR=3.754,95%CI1.876～7.423)是感染HIV的危险因素;文化程度高(大专及以上文化,OR=0.374,95%CI0.198～0.654)、艾滋病知识(OR=0.549,95%CI0.338～0.910)是感染HIV的保护因素。结论兰州市MSM人群感染及传播HIV的危险行为普遍存在,且具备了艾滋病流行的条件,应采取有效措施加以控制。     

HIV risk factors reported by two samples of male bathhouse attendees in Los Angeles, California, 2001-2002

BACKGROUND: We aimed to describe the use of voluntary HIV counseling and testing services, risk behaviors, and risk factors for unprotected anal sex (UAS) among men who have sex with men (MSM) who attended a bathhouse in Los Angeles during 2001-2002. METHODS: Using 2 cross-sectional study samples, we compared (in order below) 458 of 640 MSM who used voluntary HIV counseling and testing in the bathhouse with 398 MSM surveyed upon exit. Within each group, logistic regression identified factors associated with UAS at their most recent bathhouse visit. RESULTS: Of 640 MSM, 71 (11%) tested HIV-positive for the first time. Of the 50 HIV-positive MSM who completed a survey, 50% tested because of the convenient services. Similar proportions of MSM in both survey samples reported UAS (7%-8%) during their recent bathhouse visit. Risk factors associated with UAS in both survey samples were UAS with men outside the bathhouse and greater numbers of partners within the bathhouse. CONCLUSIONS: Comprehensive prevention services provided within bathhouses may reduce undiagnosed HIV infections among MSM, and targeting HIV prevention at the bathhouse may reduce risks with partners both inside and outside the bathhouse.     

Setting typologies and HIV prevalence among men who have sex with men in China: implication for surveillance and intervention

An increasing trend of HIV prevalence has been observed among men who have sex with men (MSM) in China. However, the prevalence and its increase varied among MSM recruited from different settings, indicating the highest prevalence and its increase among those MSM from bathhouse or sauna. The findings have important implications for surveillance and interventions in this population.     

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.     

HIV, sexual risk, and ethnicity among men in England who have sex with men

OBJECTIVES: To examine ethnic group differences in HIV testing history and sexual HIV risk behaviours that may account for such differences, among men in England who have sex with men (MSM), in order to inform HIV prevention planning priorities. METHODS: A self completion survey in the summer of 2001 was carried out in collaboration with community based health promoters. Three recruitment methods were used: "gay pride" festivals, health promoter distributed leaflets, internet version advertised with gay service providers. The leaflet was produced with an alternative cover for targeted recruitment of black men. RESULTS: In a sample of 13,369 MSM living in England, 17.0% were from minority ethnic groups and 5.4% had tested HIV positive. Compared to the white British majority, Asian men were 0.32 times as likely to be living with diagnosed HIV infection, while black men were 2.06 times as likely to be doing so. Among men who had not tested HIV positive, Asian men were less likely to have sex with a known HIV positive partner, while black men were more likely to have insertive unprotected anal intercourse both with a partner they knew to be HIV positive and with a partner whose HIV status they did not know. CONCLUSIONS: Among MSM in England, HIV prevalence is higher among black men and lower among Asian men compared with the white British majority. Increased sexual HIV risk behaviour, especially exposure during insertive anal intercourse, accounts for some of this difference. HIV prevention programmes for MSM and African people should both prioritise black MSM.     

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.     

Men who have sex with men: a comparison of a probability sample survey and a community based study

We compared characteristics of men who have sex with men (MSM) in a probability sample survey with a community based study in London. The majority of men in both surveys reported male sex partner(s) in the last year but MSM recruited through the population based survey had lower levels of HIV risk behaviour, reported fewer sexually transmitted infections and HIV testing than those recruited from gay venues. Community samples are likely to overestimate levels of risk behaviour among all MSM.     

Prevalence of syphilis and HIV infections among men who have sex with men from different settings in Shenzhen, China: implications for HIV/STD surveillance

HIV/STD surveillance system data are important for developing prevention and control programmes for men who have sex with men (MSM), now a core group in Chinese HIV/STD surveillance activities. MSM were recruited from different settings in Shenzhen and were tested for HIV and syphilis. A substantial prevalence of HIV and syphilis infections was found in this population. However, risk behaviours and sociodemographic characteristics varied greatly among MSM recruited from the different settings (gay sauna, gay bar and MSM clinic), suggesting that carefully considering and selecting appropriate settings to represent the MSM population is critical for developing HIV and STD surveillance and prevention programmes.     

High prevalence of sexually transmitted diseases among men who have sex with men in Jiangsu Province, China

OBJECTIVE:: The objective of this study was to investigate the prevalence of sexually transmitted diseases (STDs), including HIV infection, and sexual risk behaviors among men who have sex with men (MSM) in Jiangsu Province, China. DESIGN:: The authors conducted a cross-sectional study. METHODS:: From February to July 2003, men who attended 10 participating gay bars in five cities in Jiangsu Province were asked to complete a self-administered questionnaire, including measures of alcohol use and sexual risk behaviors. Blood samples and urethral swabs were taken to examine the presence of STDs, including HIV infection. RESULTS:: A total of 144 men were recruited in the study. Forty-six percent of men reported unprotected anal intercourse with their male sexual partners in the past 3 months. No one was found to be HIV-infected, but the prevalence of STDs was high: gonorrhea 2.7%, chlamydial infection 8.0%, nonchlamydial nongonococcal urethritis 27.7%, active syphilis 6.9%, hepatitis B virus infection 9.1%, herpes simplex virus-2 infection 7.8%, and genital warts 13.2%. CONCLUSIONS:: Given that HIV prevalence among MSM in some other parts of China has been as high as 3%, STDs facilitate the transmission of HIV, and high prevalence of STDs and sexual risk behaviors among MSM exist in Jiangsu Province, the potential for the future spread of HIV is of concern, and it is urgent to provide MSMs with STD healthcare services and HIV/AIDS/STD prevention education and intervention.     

Unsafe sexual behavior and correlates of risk in a probability sample of men who have sex with men in the era of highly active antiretroviral therapy

OBJECTIVE: To assess the levels and correlates of potential exposure to and transmission of HIV in a contemporary, community-based probability sample of men who have sex with men (MSM). METHODS: In 2003, 311 sexually active MSM participated in a random-digit dial telephone survey in Seattle neighborhoods with a high prevalence of MSM. The primary outcomes were potential exposure to and transmission of HIV, defined as unprotected anal intercourse with a man of opposite or unknown HIV status in the preceding 12 months. RESULTS: Fourteen percent of respondents reported being HIV-positive, 77% reported being HIV-negative, and 8% had not been tested. Of 241 HIV-negative MSM, 25 (10%; 95% confidence interval [CI], 7-15%) were potentially exposed to HIV; among 45 HIV-positive MSM, 14 (31%; 95% CI, 20-46%) were potential HIV-transmitters. Among HIV-negative men, the strongest bivariate correlates of potential exposure to HIV were recent bacterial sexually transmitted disease (odds ratio [OR], 5.8), number of recent male sexual partners (OR, 1.01 per partner), recent sex at a bathhouse (OR, 9.1), and recent use of sildenafil (OR, 4.4), amyl nitrite (OR, 6.2), and methamphetamine (OR, 8.0). Among HIV-infected men, the strongest correlates of potential HIV transmission were recent use of amyl nitrite (OR, 3.1), number of recent male sex partners (OR, 1.07 per partner), and having a male spouse or domestic partner (OR, 0.3). CONCLUSIONS: Most MSM knew their HIV status and adopted safer sexual behaviors to reduce their risk of HIV acquisition or transmission. However, 10% of HIV-negative MSM and 31% of HIV-positive MSM recently engaged in behaviors that placed them at high risk for acquiring or transmitting HIV.     

Prevalence of chlamydia and gonorrhoea among a population of men who have sex with men

OBJECTIVES: Few data are available on the prevalence of sexually transmitted diseases (STDs) in men who have sex with men (MSM), making it difficult to develop STD screening guidelines for this population. The objective of the study was to determine the prevalence of urethral infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae within a large, community based population of MSM, and to assess the feasibility of rectal screening in this population. METHODS: This was a cross sectional study of 566 MSM, who were predominantly middle aged, white, asymptomatic, and engaged in sex with multiple partners. All provided a urine sample to screen for chlamydial and gonorrhoea infections using a PCR assay; rectal screening was performed on 48 participants. RESULTS: Urethral C. trachomatis infections were detected in 1/566 participants (prevalence 0.2%, 95% CI 0.004% to 1.0%), and rectal C. trachomatis infections were detected in 2/48 men (prevalence 4.2%, 95% CI 0.5% to 14.2%). No gonorrhoea infections were detected, and none of the 117 HIV positive men had either infection. CONCLUSIONS: Chlamydial and gonorrhoea infections were uncommon in this sample of MSM, even among those with multiple sexual partners or HIV infection. These data call into question recommendations to screen all MSM based on their individual sexual behaviours or HIV. Additional data are needed on the prevalence of these infections in MSM from different settings.