Predictors of Early Initiation of Vaginal and Oral Sex Among Urban Young Adults in Baltimore, Maryland

Over the past three decades, most research on adolescent sexual behavior has focused on vaginal intercourse and related behaviors, including contraception and unintended pregnancy. In this study, we describe the prevalence and correlates of vaginal, oral, and anal sex in an epidemiologically defined population in Baltimore, Maryland. Young adults (ages 18–24), who had been enrolled in a behavioral intervention trial during elementary school, were interviewed by telephone between 1998 and 2002 to assess their sexual behavior. Of 1679 respondents interviewed, 70.8% were Black and 55% were women. Overall, 93% of the young adults reported vaginal intercourse, 78% reported receiving oral sex, 57% reported performing oral sex, and 10% reported receptive anal intercourse. Among men, 27% reported insertive anal intercourse. Blacks initiated vaginal intercourse at an earlier age than Whites; White women performed oral sex earlier than Black women. Significant interactions were observed between age of first vaginal partner and both gender and race/ethnicity. Blacks with older partners initiated sex at an earlier age than both Blacks with a partner the same age or younger and Whites. We also observed a relationship between older female sex partners and earlier vaginal sex initiation among men. We conclude that older sex partners play an important role in sexual initiation among young adults. In light of the rates of oral and anal sex, sexual education and intervention programs should address the risk for unintended consequences of these behaviors.     

Obesity, Body Image, and Unsafe Sex in Men who have Sex with Men

Little is known about the relationship among body weight, body image, and HIV/AIDS sexual risk behaviors. We examined this issue in a midwestern U.S. metropolitan area community sample of 316 men who have sex with men, a group at relatively high risk for HIV/AIDS. All data were self-reported by questionnaire using standard items to assess current body image, height and weight, and HIV/AIDS sexual risk behaviors. Logistic regression models were used to estimate cross-sectional associations. Forty-nine (15%) of the 316 men were classified as obese, and 56 (18%) had unsafe sex in the past three months. Normal weight or overweight men were 3.6 times more likely than obese men to have had unsafe sex, after adjusting for differences in body image and age. Men with better body image were 1.4 times more likely than men with lower body image to have had anal sex, after adjusting for differences in body weight and age. Non-obese men were no more or less likely than were obese men to have engaged in anal sex or in any sex in the past three months. This is the first study showing a positive relationship between below-obese body weight and unsafe sex and between better body image and anal sex in men who have sex with men. Future research should investigate these novel findings, perhaps using other study designs and data collection tools with less measurement error. Advances in knowledge about HIV/AIDS risk factors, including body weight and body image, could potentially contribute to more effective approaches to reducing this risk.     

Sexual Risk Behaviors of HIV-Positive,HIV-Negative,and Serostatus-Unknown Black Men Who Have Sex with Men and Women

Black men who have sex with men and women (MSMW) are at high risk for HIV infection and transmission. This study compared the sexual risk behaviors of Black MSMW who self-reported being HIV-positive with those who reported being HIV-negative and those who did not know their HIV status. Respondent-driven sampling (RDS) was used to recruit 1,154 Black MSM in Philadelphia and New York who completed an audio computer-assisted self-interview (ACASI). Of these men, 212 had engaged in anal sex with male partners and vaginal or anal sex with female partners in the past 3 months. A quarter (23.6%; n = 50) of MSMW self-reported testing positive for HIV at their last test, 59.4% (n = 126) reported testing negative for HIV at their last test, and 17.0% (n = 36) reported never having an HIV test. Multivariate logistic regression analysis revealed that HIV-positive MSMW were much less likely than HIV-negative men and never-tested men to have engaged in unprotected intercourse with main male and main female partners perceived to be HIV-negative or of unknown serostatus. However, HIV-positive men were equally as likely as HIV-negative men to have unprotected intercourse with non-main male and non-main female partners perceived as HIV-negative or of unknown serostatus. Our findings indicate that some HIV-positive MSMW engage in unprotected sex that places female and male partners at risk for HIV infection. However, MSMW who have never taken an HIV test, or who have not been recently tested, may be a greater source of HIV transmission to their female and male partners.     

绵阳城区男男性行为者性伴特征及影响因素

目的了解绵阳市城区男男性行为者(MSM)性伴现况。方法采用应答者趋动招募抽样法(RDS),在MSM活动场所定时、定点进行性伴及相关因素招募和寻问式匿名现场调查。结果共调查MSM 400人,首次插入性性行为平均(18±3.59)岁。最近6个月与男性发生过性行为占88.4%(352/398),平均(2±3.29)人;买性占4.7%(17/359),平均(1±2.49)人;卖性占2.5%(9/355),平均(4±6.19)人;与女性发生过性关系占18.3%(73/400),平均(1±2.42)人。调查者中不同婚姻状况、性取向、首次插入性行为年龄、认识当地MSM朋友数、性伴居住城市数、近6月男男肛交安全套使用,艾滋病知识是否来自书籍、来自学校,是否知道性伴没有健康问题、是否知道性伴健康状况者,近6个月男男肛交用安全套等因素与男男肛交数有关。多因素Logistic回归分析,最终进入回归模型的有婚姻、认识当地MSM朋友数、首次插入性行为年龄、性伴居住城市数、不知道性伴健康状况共5个(P<0.05),在婚(OR=5.074)、认识当地MSM朋友数≥9人(OR=2.192)、不知道性伴健康状况(OR=1.235)、首次插入性行年龄≤24岁(OR=6.948～9.871)者近6月肛交人数较多,性伴居住城市数≤1个者肛交人数较少。结论绵阳城区MSM首次性行为较早,多种性伴共存,多性伴普遍。     

深圳市男男性行为者安全套使用影响因素分析

目的了解深圳地区男男性行为者（MSM）安全套使用情况,分析MSM肛交时安全套使用影响因素。方法应用同伴推动抽样（RDS）法进行抽样调查,收集MSM人群人口学和安全套使用等资料。结果共抽样调查351例MSM。最近半年,57．0％MSM肛交时每次均使用安全套,13．1％口交时每次均使用安全套,36．8％与女性发生性行为时每次均使用安全套,75．8％与男男性工作者发生性行为时每次均使用安全套。肛交时使用安全套受未婚、有女性性伴、HIV风险感知、性伴数≥5等因素影响。未婚、有女性性伴的MSM在最近半年肛交时安全套使用率高;HIV风险感知高、性伴数≥5的MSM在最近半年肛交时安全套使用率低。结论应有针对性地开展健康教育及行为干预,提高MSM安全套使用率。     

与女性经常性交的未婚男男性行为者艾滋病高危性行为研究

目的 探讨男男性行为者(MSM)中流动人口艾滋病高危行为状况.方法 采用定向抽样法开展横断而调查,对9个城市2250名MSM的匿名调查问卷进行分析,比较其中流动人口与常住人口两亚人群的高危行为发生状况.结果 MSM流动人口组近6个月性伴数(平均9.61个)、口交(平均8.61个)和肛交(平均7.52个)性伴数,近1个月口交(平均2.89个)和肛交(平均3.69个)性伴数,近6个月女性性伴数(平均1.17个)均明显高于常住人口组(P<0.05或P<0.01).MSM中近6个月内流动人口组与男性肛交时以及同非妻子女性性交时每次使用安全套的百分率(分别为37.15%、23.28%)均低于常住人口组(P<0.05或P<0.01).MSM流动人口组从事男性性工作、与gay网友性交过、近1年在男性间参加群交、近1年与男性性交时出血、近1年在外地与男性性交、目前有固定女性性伴(分别为17.89%、12.56%、22.13%、31.38%、32.36%、31.86%)均明显高于常住人口组(P<0.05或P<0.01).结论 MSM流动人口具有比常住人口更多的HIV高危行为;该亚人群具有将HIV传播到其他地区的条件,应加强对MSM流动人口的行为干预,以阻断其在HIV传播过程中的"桥梁"作用.     

男男性行为者中流动人口艾滋病高危行为研究

目的 探讨男男性行为者(MSM)中流动人口艾滋病高危行为状况.方法 采用定向抽样法开展横断而调查,对9个城市2250名MSM的匿名调查问卷进行分析,比较其中流动人口与常住人口两亚人群的高危行为发生状况.结果 MSM流动人口组近6个月性伴数(平均9.61个)、口交(平均8.61个)和肛交(平均7.52个)性伴数,近1个月口交(平均2.89个)和肛交(平均3.69个)性伴数,近6个月女性性伴数(平均1.17个)均明显高于常住人口组(P<0.05或P<0.01).MSM中近6个月内流动人口组与男性肛交时以及同非妻子女性性交时每次使用安全套的百分率(分别为37.15%、23.28%)均低于常住人口组(P<0.05或P<0.01).MSM流动人口组从事男性性工作、与gay网友性交过、近1年在男性间参加群交、近1年与男性性交时出血、近1年在外地与男性性交、目前有固定女性性伴(分别为17.89%、12.56%、22.13%、31.38%、32.36%、31.86%)均明显高于常住人口组(P<0.05或P<0.01).结论 MSM流动人口具有比常住人口更多的HIV高危行为;该亚人群具有将HIV传播到其他地区的条件,应加强对MSM流动人口的行为干预,以阻断其在HIV传播过程中的"桥梁"作用.     

男男性行为者中流动人口艾滋病高危行为研究

目的 探讨男男性行为者(MSM)中流动人口艾滋病高危行为状况.方法 采用定向抽样法开展横断而调查,对9个城市2250名MSM的匿名调查问卷进行分析,比较其中流动人口与常住人口两亚人群的高危行为发生状况.结果 MSM流动人口组近6个月性伴数(平均9.61个)、口交(平均8.61个)和肛交(平均7.52个)性伴数,近1个月口交(平均2.89个)和肛交(平均3.69个)性伴数,近6个月女性性伴数(平均1.17个)均明显高于常住人口组(P<0.05或P<0.01).MSM中近6个月内流动人口组与男性肛交时以及同非妻子女性性交时每次使用安全套的百分率(分别为37.15%、23.28%)均低于常住人口组(P<0.05或P<0.01).MSM流动人口组从事男性性工作、与gay网友性交过、近1年在男性间参加群交、近1年与男性性交时出血、近1年在外地与男性性交、目前有固定女性性伴(分别为17.89%、12.56%、22.13%、31.38%、32.36%、31.86%)均明显高于常住人口组(P<0.05或P<0.01).结论 MSM流动人口具有比常住人口更多的HIV高危行为;该亚人群具有将HIV传播到其他地区的条件,应加强对MSM流动人口的行为干预,以阻断其在HIV传播过程中的"桥梁"作用.     

Sex with Men Before Coming-Out: Relation to Sexual Activity and Sexual Risk-Taking Behavior

This study examined the difference in sequence of coming-out and first same-sex experience in relation to risk-taking behavior in a sample of Dutch gay and bisexual men. A questionnaire assessed age of disclosure (coming-out) and age of first same-sex experience, and information on sexual history, sexual relationships, and sexual behavior. It was found that 68% of respondents engaged in their first same-sex experience before coming-out. This proportion increased with age. Men who had sex with men before coming-out reported more lifetime sex partners and more casual sex partners in the past 6 months than men in which this sequence was reversed. In addition, among this group a higher proportion of men reported STDs, engaging in anal intercourse with casual partners in the previous 6 months, and unprotected anal sex with casual sex partners in the recent past, compared to men who came out before having their first same-sex experience. The extent to which external factors (such as tolerance toward homosexuals) or internal factors (such as personality factors) can account for the difference in sexual behaviors in general and sexual risk-taking behavior in particular could be subject of further study.     

Patterns of Exchange Sex and HIV Infection in High-Risk Heterosexual Men and Women

Heterosexual partnerships involving the trade of money or goods for sex are a well-described HIV risk factor in Africa and Southeast Asia, but less research has been conducted on exchange partnerships and their impact on HIV infection in the United States. In our study, men and women were recruited from high-risk risk neighborhoods in New York City through respondent-driven sampling in 2006–2007. We examined the factors associated with having an exchange partner in the past year, the relationship between exchange partnerships and HIV infection, and the risk characteristics of those with exchange partners by the directionality of payment. Overall, 28% of men and 41% of women had a past-year exchange partner. For men, factors independently associated with exchange partnerships were older age, more total sexual partners, male partners, and frequent non-injection drug use. For women, factors were homelessness, more total sexual partners, more unprotected sex partners, and frequent non-injection drug use. Exchange partnerships were associated with HIV infection for both men and women, although the relationships were substantially confounded by other behavioral risks. Those who both bought and sold sex exhibited the highest levels of risk with their exchange and non-exchange partners. Exchange partnerships may be an HIV risk both directly and indirectly, given the overlap of this phenomenon with other risk factors that occur with both exchange and non-exchange partners.