2008年聊城市男男性行为者艾滋病高危行为调查

[目的]了解男男性行为者(MSM)的社会学特征、艾滋病高危性行为、知识知晓及HIV感染情况。[方法]2008年6～9月应用同伴推动抽样法(RDS)对聊城市的MSM进行抽样,通过现场问卷调查和血清学检测了解其高危行为因素及HIV感染等情况,资料分析使用RDSAT、Excel软件完成。[结果]调查204名MSM,有58.33%的自我认同为同性恋;艾滋病防治知识知晓率为61.27%;有76.47%的MSM与同性发生过口交性行为,有78.38%的MSM与同性发生过肛交性行为,有60.29%的MSM与异性发生过性关系。发生以上高危性行为的MSM,最近6个月内,有89.32%与多个同性发生过肛交,有89.71%与多个同性发生过口交,有86.99%与异性发生过性行为,但最近6个月肛交性行为时安全套使用率仅为25.53%;检出HIV感染者2例,感染率为1.51%。[结论]聊城市MSM人群有较强的认同感,艾滋病知识知晓率低,性伴多且不固定,安全套使用率低,存在HIV在MSM人群中传播的危险。     

福建省某市男男性接触人群相关血清学监测及分析

[目的]对福建省某市男男性接触者(MSM)进行相关血清学监测,了解该人群中艾滋病病毒(HIV)和梅毒等性传播疾病(STDs)的感染状况,为制定干预措施提供依据。[方法]采用方便抽样法对MSM人群进行匿名问卷调查,并抽取静脉血进行HIV抗体、梅毒抗体、乙肝病毒HBsAg及丙肝病毒抗HCV-IgG的检测。[结果]共采血检测MSM159例,结果梅毒抗体TRUST阳性率为12.6%(20/159),TPPA阳性率为25.8%(41/159);HIV抗体阳性率为1.9%(3/159),其中1例同时检出梅毒和HIV抗体阳性,HIV和梅毒累积感染率为27.0%;HBsAg阳性率为12.6%(20/159);未检出抗HCV-IgG。年龄大于25岁是HIV和梅毒累积感染的危险因素。[结论]HIV/STDs在MSM人群中存在局部流行的可能性,应及时采取干预措施,控制其流行及向一般人群的传播。     

男性肛周尖锐湿疣392例流行病学调查

目的：了解沈阳市及周边地区发病的男性肛周尖锐湿疣患者流行病学特点,为今后针对高危因素及人群开展有效的预防干预工作提供经验和依据.方法：对我院及沈阳市肛肠医院392名符合标准的患者进行匿名问卷调查后,收集数据进行分析比较.结果：392名受访者平均年龄27.74岁,前卫职业人群集中,性安全自觉性差,对本病的了解程度不佳.具有男男性行为的同性恋或双性恋者是本病发病的高危人群,具有频繁肛交、多性伴侣、性病防护意识差等高危性行为特征,但改正不良生活习惯态度良好.公共浴池洗浴及公共卫浴用品的使用也是本病的发病危险因素之一.受访人群中艾滋病病毒（HIV）阳性率为7.14%,梅毒（USR）阳性率为5.61%,合并其他性传播疾病感染者占6.63%,HBsAg及抗-HCV阳性率分别为6.63%及2.04%.结论：针对中青年等高危人群应加强性健康教育普及,提高性安全意识,尤其针对男男性行为者应当予以广泛关注并采取良好有效的干预机制.     

HIV testing history among young adults: The roles of sex,race, and sexual orientation

One in five new HIV diagnoses in the United States is among persons younger than 25 years old. Routine testing is a crucial prevention strategy. We assessed the relationships between sex, race, sexual orientation, and HIV testing among young adults. Odds of affirmative testing history were higher among women than men, and among Latino gay/bisexual men than their White counterparts. Among straight men, odds of having tested were greatest among Blacks. Mechanisms through which race/ethnicity affect HIV vulnerability among young gay/bisexual men of color need to be explored, especially as these populations are more likely to have affirmative testing histories, yet are disproportionately impacted.     

The role of the dorsal anterior insula in sexual risk: Evidence from an erotic Go/NoGo task and real‐world risk‐taking

The insula plays an important role in response inhibition. Most relevant here, it has been proposed that the dorsal anterior insular cortex (dAIC) plays a central role in a salience network that is responsible for switching between the default mode network and the executive control network. However, the insula's role in sexually motivated response inhibition has not yet been studied. In this study, eighty‐five 18‐ to 30‐year‐old sexually active men who have sex with men (MSM) performed an erotic Go/NoGo task while in an MRI scanner. Participants' real‐world sexual risk‐taking (frequency of condomless anal intercourse over the past 90 days) was then correlated with their neural activity during the task. We found greater activity in bilateral anterior insular cortex (both dorsal and ventral) on contrasts with stronger motivational information (attractive naked male pictures versus pictures of clothed, middle‐aged females) and on contrasts requiring greater response inhibition (NoGo versus Go). We also found that activity in the right dAIC was negatively correlated with participants' real‐world sexual risk‐taking. Our results confirmed the involvement of the insular cortex in motivated response inhibition. Especially, the decreased right dAIC activity may reduce the likelihood that the executive control network will come online when individuals are faced with situations requiring inhibitory control and thus lead them to make more risky choices.     

襄阳市MSM人群艾滋病新发感染影响因素探讨

目的 掌握襄阳市男男性行为人群(MSM)艾滋病病毒(HIV)新发感染影响因素,为制定防控措施提供依据。 方法 采用滚雪球法召集襄阳市MSM,对其进行艾滋病防治知识、行为等方面的问卷调查,检测HIV抗体、梅毒和丙型肝炎抗体。对数据进行描述性、单因素和多因素分析。 结果 襄阳市MSM人群HIV新感染率估算值为4.72%(95%CI=3.03%～6.42%)。单因素分析显示,年龄、本地居住时间、文化程度、艾滋病防治知识得分、最近一次同性肛交时使用安全套、最近六个月同性性行为坚持使用安全套、最近一年曾被诊断患过性病、最近一年接受同伴教育、梅毒感染共9个因素与艾滋病新发感染相关(P≤0.10)。多因素分析显示,最近六个月同性肛交时坚持使用安全套(OR=0.16,95%CI=0.05～0.54,P=0.00)是HIV新发感染的保护性因素,且影响最大。年龄大于等于60岁(OR=4.78,95%CI=0.92～24.75,P=0.04)、本地居住时间12个月以内(OR=4.36,95%CI=1.37～13.81,P=0.01)、文化程度初中及以下(OR=2.44,95%CI=1.05～5.70,P=0.04)、梅毒阳性(OR=4.44,95%CI=1.25～15.77,P=0.02)是危险因素。 结论 襄阳市MSM人群HIV新发感染率较高。应采取有效措施提高该人群安全套坚持使用率,加大对60岁及以上、本地居住时间12个月以内、文化程度初中及以下、梅毒阳性的MSM人群综合干预措施力度。     

绵阳市2014年MSM艾滋病知识和行为特征及性行为保护性影响因素

目的 了解男男性行为人群(MSM)艾滋病知识及行为现状,分析性行为保护性影响因素。 方法 2014年4-10月,以绵阳市辖区所辖9个县(市、区)MSM为对象,在固定场所知情同意下,应用滚雪球抽样法,进行调查对象招募和自填式匿名行为学调查和血清学检测。采用χ²检验比较率,采用非条件logistic回归分析探讨MSM性行为保护性影响因素。 结果 共调查1 097例,艾滋病知识知晓率99.0%(1 086/1 097),近6月男性肛交85.6%(939/1 097)、商业性行为1.7%(16/939)、异性性行为8.2%(90/1 097),近6月性行为保护性分别依次为68.7%(640/932)、37.5%(6/16)、24.4%(22/90),近1次分别依次为89.3%(832/932)、62.5%(10/16)、61.1%(55/90),不同地区男性肛交、异性性行为保护性差异有统计学意义(均P＜0.05)。近6月男性肛交有、无保护性艾滋病病毒(HIV)感染率分别为1.6%(10/640)、8.6%(25/292)(P=0.000)。多因素分析结果:文化程度高中/中专(OR=1.621,95%CI: 1.028～2.555,P=0.038),本地居住时间≥3个月(OR=8.353,95%CI:1.666～41.878,P=0.010)、知晓艾滋病知识(OR=1.774,95%CI: 1.064～2.960,P=0.028)、近1年接受过预防服务(OR=3.690,95%CI: 2.591～5.236,P=0.000)是MSM有保护性行为的促进因素,近1周肛交次数≥2(OR=0.516,95%CI:0.363～0.733,P=0.000)是危险因素。 结论 2014年绵阳市MSM艾滋病知识知晓率高,性行为保护性地区间不平衡,整体水平不高,受文化程度、本地居住时间、艾滋病知识知晓、预防服务、肛交频率等影响,应针对性开展行为干预。     

青岛市男男性行为人群艾滋病高危性行为调查

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。     

Seeking sex partners through the internet and mobile phone applications among men who have sex with men in Taiwan

It has become popular for men who have sex with men (MSM) to use mobile-phone geosocial networking applications (mobile apps) to find sex partners. A cross-sectional online survey was conducted in Taiwan to compare the sexual and substance-use behaviors of MSM seeking sex partners through the internet and mobile apps. Of the 1060 participants, 65.8% used the internet via computer and 37.7% used a mobile app to find sexual partners, while 30.3% used recreational drugs or alcohol in the previous 6 months. MSM who exclusively used mobile apps to seek sex partners were significantly more likely than MSM seeking sex via computer to be older, to have used recreational drugs or alcohol, and to have sex with HIV-positive partners. Additionally, using mobile apps to seek sex partners was significantly associated with having sex with online partners through either mobile apps or computer-based internet use (adjusted odds ratio (AOR), 7.12 [3.87–13.11]), self-reporting as HIV-positive (AOR, 2.24 [1.12–4.12]), using recreational drugs (AOR, 1.67 [1.21–2.32]), having disclosed HIV status to sexual partners (AOR, 1.44 [1.03–2.02]), and having sex with HIV-positive partners (AOR, 1.81 [1.06–3.10]). In conclusion, the mobile apps may serve as a feasible platform for HIV-positive MSM to find other HIV-positive partners.     

Disclosure appraisal mediating the association between perceived stigma and HIV disclosure to casual sex partners among HIV+ MSM: a path model analysis

HIV stigma is widely believed to be related to HIV disclosure. However, there is a dearth of studies examining the mechanisms that link stigma to disclosure. This is a specific study to assess the relationship between perceived stigma and HIV disclosure to casual sex partners based on a social cognitive theory. HIV+ men who have sex with men (MSM) from two US cities (N?=?297) completed questionnaires administered using audio computer-assisted self-interviewing. Path modeling analysis was used to assess the theory-based structural relationships. Perceived stigma was negatively associated with attitudes, intention and behavior of HIV disclosure to casual sex partners. The association was fully mediated by disclosure appraisal, including disclosure outcome expectations, costs and self-efficacy. Findings of this study add new knowledge regarding HIV stigma and disclosure, and provide timely data supporting more effective behavioral interventions to encourage HIV disclosure among MSM.