东北某地男同性恋者艾滋病病毒／艾滋病的知识态度行为调查

目的 了解男同性恋者艾滋病相关知识、态度及危险行为状况，为行为干预提供线索。方法 采用横断面调查设计，对进出某酒吧的男同性恋者进行问卷调查。结果 文化程度普遍较高，但对艾滋病知识缺乏，知识的来源主要是通过报纸、杂志和电视。安全套使用率低，每次性行为均使用安全套的比例为14.4%，不使用安全套的原因主要是自己或性伴侣不喜欢用或性行为时身边无安全套。随着艾滋病知识的增加，每次都用安全套的比例呈现上升趋势，从未使用安全套的比例则呈现明显下降的趋势。11.7%做过艾滋病病毒（HIV）检测，无人获得过HIV检测阳性结果。不做HIV检测的原因主要是自认为感染的可能性不大，认为自己是阴性或不想考虑阳性的事。首次性行为年龄中位数为18岁；性伴侣数较多，平均为10.3个。40.5%的调查对象在半年内有过女性性伴侣，96.6%在半年内有过男性性伴侣，84.5%半年内有无保护肛交史。结论 该市男同性恋者艾滋病相关知识缺乏，危险性行为普遍存在，安全套使用率低，艾滋病极有可能在此人群中流行，应尽快采取措施加强预防。     

西安市农民工MSM对艾滋病的认知和HIV感染状况

目的了解西安市农民工中男男性行为人群（MSM）对艾滋病的认知状况、高危行为的发生和HIV感染状况。方法通过线索调查在1年内有过男男性行为史的农民工的艾滋病知识和高危行为发生情况,并对其进行HIV抗体检测。结果 2011年4月至2012年9月,入住碑林区某便民旅社的有男男性行为史的农民工,共507人,其中95.7%的人听说过艾滋病,获得艾滋病知识的主要来源为电视广播的占62.3%,74.8%的人想了解艾滋病,72.6%的人最近1个月有〈10次的同性性行为,29.8%的人最近1个月内性行为中每次坚持使用安全套。HIV抗体检测的比例为60.6%,确证阳性检出率为3.6%。结论大部分有男男性行为史的农民工,对艾滋病本身和艾滋病患者持害怕、歧视的态度;有男男性行为史的农民工对艾滋病的认识仍不全面,要开展有针对性的宣传教育,普及安全套的正确使用,尽可能地扩大农民工中MSM人群的HIV抗体检测。     

204例MSM人群HIV／梅毒感染状况及行为学特征分析

目的了解天津市部分男男同性性行为人群（MSM）艾滋病相关危险行为,以及艾滋病病毒（HIV）、梅毒（SP）感染状况,为预防性病、艾滋病传播提供依据。方法采用横断面调查,对进入酒吧的男同性恋者进行问卷调查,同时抽取血样进行梅毒和HIV的实验室检测。结果调查的204人中,HIV感染率为5．9％,梅毒感染率为18．7％。艾滋病知识知晓率为81．4％,近6个月每次性行为均使用安全套的比例为47．9％,HIv感染者安全套使用率低,仅为11．1％,71．4％的HIV感染者最近6个月存在多性伴现象。结论天津市MSM人群危险性行为普遍存在,安全套使用率低,HIV、梅毒感染率较高,应加强对该人群艾滋病性病相关的宣传教育及干预工作,控制HIv的传播。     

大理州男男性行为人群艾滋病病毒抗体阴性队列调查

目的了解大理州男男性行为人群(MSM)艾滋病防治知识、行为及艾滋病病毒(HIV)抗体和梅毒血清学年阳转情况,为制定干预措施提供依据。方法采用前瞻性队列研究,招募符合标准的MSM 200人,每6个月随访调查一次,项目期共完成两次随访调查。结果 6个月随访调查180人,保持率90.00%;12个月随访调查179人,保持率89.50%。艾滋病防治知识知晓率从招募时的80.00%提高到100.00%;最近六个月与同性的商业性行为比例,从招募时的9.00%下降到1.12%;最近六个月与同性肛交时每次都使用安全套的比例,从招募时的47.42%上升到83.24%;最近一次与同性肛交时使用安全套的比例,从招募时的89.69%上升到96.09%;异性性行为在50.00%左右,与异性性行为时每次都使用安全套的比例在10.00%～20.00%之间,最近一次与异性性行为使用安全套的比例在40.00%左右。研究期间有1人出现HIV抗体阳转,无梅毒阳转。结论艾滋病知识知晓率提高,危险性行为降低,安全套使用率提高,异性性行为普遍存在,干预措施有效。     

兰州市城关区801名男男性接触人群艾滋病和梅毒流行病学调查分析

目的了解甘肃省兰州市城关区男男性接触人群（men who have sex with men,MSM）艾滋病和梅毒流行趋势,分析相关危险因素,为降低MSM人群艾滋病和梅毒感染率提供科学依据。方法分析2012—2013年城关区MSM人群相关知识、行为调查问卷和血清学相关资料。结果在调查的801名MSM人群中,年龄最小17岁,最大57岁,21～30岁居多,占52.18%;高中文化程度居多,占41.95%,未婚占73.16%,本地户籍占92.76%;艾滋病相关知识知晓率为81.40%,最近一次与同性发生肛交行为安全套使用率为81.52%,最近六个月与同性发生肛交行为每次都使用安全套的比例仅为35.46%;有49.93%的MSM人群在最近六个月发生过商业性肛交性行为,每次都用安全套的比例为62.25%;有15.36%的MSM人群在最近六个月与异性发生过性行为,每次都用安全套的比例为51.22%;HIV阳性率3.75%,梅毒阳性率10.61%。结论兰州市城关区MSM人群安全套坚持使用率低、多性伴、梅毒感染率较高等促使HIV的传播,部分MSM双性恋的行为,使HIV具有向普通人群传播的危险。     

杭州市≥50岁男性艾滋病高危性行为及其影响因素

目的了解有非婚性行为的≥50岁中老年男性艾滋病防治知识知晓情况、性行为特点及影响因素、艾滋病病毒(HIV)及梅毒感染状况。方法由村(居委会)干部推荐,或由有非婚性行为者介绍同伴的方法招募目标人群,开展问卷调查和血液检测。结果共调查到有高危性行为的中老年男性300名,艾滋病知识知晓率为28.00%,与非婚性伴性生活中"每次均使用安全套"的比例7.67%,不使用安全套的原因多为"不喜欢用"和"觉得不需要"。本次调查无HIV抗体阳性发现,梅毒阳性率6.00%。工作单位为民营企业的人群相较于其他工作单位的人群有较高的安全套使用率[比值比(OR)=0.132, 95%可信区间(CI):0.023～0.770],在与30～39岁的临时性伴发生性行为时安全套使用率较低(OR=4.520, 95%CI:1.580～7.026)。结论应在老年男性中广泛普及艾滋病防治知识的同时,改进干预策略、增强自我保护意识、提高安全套使用率,完善该人群HIV抗体检测服务和实验室网络。     

来宾市945名低档暗娼艾滋病感染状况及影响因素调查分析

目的分析广西来宾市945名低档暗娼的艾滋病感染状况及其影响因素,为制定干预措施提供决策依据。方法对来宾市辖区的945名低档暗娼进行问卷调查,收集调查对象的社会人口学资料、艾滋病知识知晓率、性行为等基本信息,采集调查对象的血样,检测HIV抗体。结果来宾市低档暗娼平均年龄(38.2±7.6)岁,以小学及小学以下文化为主(89.2%);最近一次性行为安全套使用率为93.2%,最近1个月性行为时坚持使用安全套比例为88.4%;HIV抗体阳性检出率为2.6%;多因素logistic回归分析结果显示,最近1个月使用安全套频率是HIV感染的保护因素。结论来宾市低档暗娼年龄偏大,文化程度低,与客人发生商业性行为时坚持使用安全套频率不高,艾滋病危害意识淡薄,应加强对低档暗娼人群进行艾滋病宣传教育,提高其安全意识。     

利用QQ开展MSM人群艾滋病高危行为干预效果评估

目的了解利用QQ开展男男性行为人群（MSM）艾滋病高危行为一对一网络干预服务的效果。方法建立接受规范化一对一QQ网络干预服务的MSM队列,初期网络干预后做首轮在线评估调查,进行6个月的常规干预后,做第2轮相同评估内容的在线调查。结果 400名调查对象经过6个月的干预后,做过HIV抗体检测的比例从57.3%上升到68.3%（P=0.007）,与志愿者交流后表示愿意接受HIV抗体检测服务的比例从67.0%上升到77.5%（P=0.001）;最近6个月有肛交性行为者,最近1次肛交安全套使用率从66.4%上升到81.5%（P=0.000）,安全套坚持使用率从31.1%上升到59.6%（P=0.000）,打算下次发生肛交性行为时使用安全套的比例从83.0%上升到89.5%（P=0.018）。结论艾滋病规范化一对一QQ网络干预对改变MSM人群风险性行为和寻求HIV抗体检测行为改变效果明确,值得在MSM人群艾滋病高危行为干预工作中推广使用。     

东北某地男同性恋者性行为及HIV感染流行病学研究

目的 了解男同性恋者HIV感染的流行状况及潜在危险因素。方法 采用匿名横断面调查设计,对进出酒吧的男同性恋者进行问卷调查,并收集尿液进行HIV抗体检测。结果 共收集尿液标本153份,其中2例经尿ELISA初筛及尿WB确认试剂检测均为阳性,HIV感染率为1.31％。首次性行为年龄中位数为18岁。所有调查对象均与男性发生过性行为,67.1％的调查对象既与男性又与女性发生过性行为。89.9％（18/208）的调查对象在半年内有肛交性行为,无保护肛交性行为的发生率为 84.5％。79.8％在近半年内肛交时曾主动插入过对方,58.7％曾接受过对方插入。31.9％的调查对象有性病史。多因素分析显示有性病史者肛交时安全套使用率显著低于无性病史者,OR值为13.5,95％CI为1.75～103.50。结论 同性恋人群中已经有较高的HIV感染率,并且艾滋病相关的危险行为普遍存在,如不采取有效措施加强控制,艾滋病极有可能在同性恋人群中广泛流行。     

深圳市MSM异性性行为及其对HIV/梅毒感染的影响

目的了解深圳市男男性行为人群（MSM）的异性性行为特征,分析其对该人群艾滋病病毒（HIV）/梅毒感染的影响。方法在知情同意原则下,收集2009-2012年深圳市MSM的社会人口学、高危行为等信息,并采集血液进行HIV/梅毒检测。结果共3445名MSM接受自愿咨询检测,969人（28.13%）最近半年内发生过异性性行为,其中28.07%的人（272/969）女性性伴数≥2个,32.71%的人（317/969）与女性性伴性交时每次使用安全套。梅毒感染率为17.54%（170/969）,HIV感染率为7.53%（73/969）,HIV合并梅毒感染率为4.13%（40/969）。与近半年无异性性行为的MSM相比,发生异性性行为的MSM半年内肛交性伴数和口交性伴数较少,肛交时每次使用安全套的比例较高,梅毒感染率相对较低。结论相当比例的MSM最近半年内有异性性行为,应有针对性地采取干预措施,阻断HIV经异性性传播。     

中国大陆男同性性接触者的艾滋病高危行为及影响因素研究(一)

目的本文描述了中国大陆男同性性接触者(MSM)与HIV/AIDS/STD相关的高危行为、认识和某些影响因素.方法通过自我填写问卷和当面访谈填写问卷两种形式,对426位男性进行了调查.结果本组主要生活在大中城市、接受过较好教育、较为年轻的MSM,平均约18岁开始与同性性交.4/5以上有口-生殖器性交,半数以上有肛门性交行为.累计性伴中位数9人.2/5以上在近一年内有偶遇性性伴.约半数人在调查时有固定性伴,但仅少数人与性伴保持闭合性性关系.约1/3已婚,近半数人与女性性交过.1/4曾患性传播疾病,近一年患病率为6.81%.仅1/10进行过HIV抗体检测,1人阳性.约1/3使用过安全套,通常在少数情况下使用,只有2人坚持使用.不用安全套的原因主要是认为安全套能降低快感、自己无感染HIV的可能和性伴健康,虽然他们已普遍具有关于HIV传播的一般知识.结论中国大陆部分MSM在性方面相当活跃,存在HIV在MSM中高水平流行的可能性.HIV在中国MSM中的流行速度高于90年代初中期在西方国家MSM中的流行速度,而且流行还会直接蔓延到妇女人群.由于社会文化等因素的阻力,对中国MSM的AIDS干预面临重大困难.     

HIV-related Sexual Risk Taking Among HIV-negative Men Who Have Sex with Men in Zagreb,Croatia

Croatia has a low-level HIV epidemic and, as in a number of other Central and Southeastern European countries, sex between men accounts for most HIV infections. This study examines sexual behavior and the correlates of condom use in a snowball sample of 342 HIV non-infected men who have sex with men (MSM) in Zagreb. The median age of participants in the sample was 27 years. The majority of participants (81%) reported using condom at last anal sex with casual partner and 56% claimed to have used condoms consistently at anal sex with casual partners in the last 12 months. HIV risk self-assessment and number of sexual partners were significantly correlated with condom use at last anal sex with casual partner. Self-assessed HIV-risk and heterosexual activity were found associated with consistent condom use at anal sex with casual partners. To sustain a low-level HIV epidemic, targeted intervention among young MSM is needed in Croatia.     

同性固定性伴侣对男男性接触者AIDS高危行为的影响

目的 了解中国大陆有固定同性性伴侣男男性接触者(Men who have sex with men，MSM)的艾滋病(AIDS)高危行为及相关情况。方法 采用不记名邮寄问卷形式调查。结果 收回有效问卷1109份。有固定同性性伴侣者689人，平均年龄34．0岁，首次性交平均年龄18．7岁，累计男性性伴侣平均34．8人，92．4％有口交行为，82．9％有肛交行为。近1年内，53．7％有过陌生男性性伴侣，53．1％与女性性交过。69人检测过抗艾滋病病毒(HIV)抗体，3人阳性。约87．2％的人曾使用安全套。结论 本组有固定同性性伴侣的MSM在性方面相当活跃，存在HIV高水平流行的可能性，而且流行会在MSM与异性爱人群之间互动。由于社会文化等因素阻力，对中国MSM的AIDS干预尚需要做出更大努力。     

Receiving HIV Serostatus Disclosure from Partners Before Sex: Results from an Online Survey of Chinese Men Who Have Sex with Men

HIV serostatus disclosure before sex can facilitate serosorting, condom use and potentially decrease the risk of HIV acquisition. However, few studies have evaluated HIV serostatus disclosure from partners before sex. We examined the rate and correlates of receiving HIV serostatus disclosure from regular and casual male partners before sex among an online sample of men who have sex with men (MSM) in China. An online cross-sectional study was conducted among MSM in eight Chinese cities in July 2016. Participants completed questions covering sociodemographic information, sexual behaviors, HIV testing (including HIV self-testing) history, self-reported HIV status, and post-test violence. In addition, participants were asked whether they received HIV serostatus disclosure from their most recent partners before sex. Overall, 2105 men completed the survey. Among them, 85.9% were never married, and 35.4% had high school or less education. A minority (20.6%, 346/1678; 17.8%, 287/1608) of men received HIV serostatus disclosure from their most recent regular and casual male partners, respectively. Multivariate analysis indicated that participants who ever self-tested for HIV were more likely to have received HIV status disclosure from regular [adjusted OR (aOR) = 1.92, 95% CI 1.50–2.44] and casual (aOR = 2.34, 95% CI 1.80–3.04) male partners compared to never self-tested participants. Compared to participants who had not received HIV status disclosure from regular partners, participants who received disclosure from regular male partners had higher likelihood in experiencing post-test violence (aOR = 5.18, 95% CI 1.53–17.58). Similar results were also found for receiving HIV serostatus disclosure from casual partners. This study showed that HIV serostatus disclosure from partners was uncommon among Chinese MSM. Interventions and further implementation research to facilitate safe disclosure are urgently needed for MSM.     

Seroadaptation in a Sample of Very Poor Los Angeles Area Men Who Have Sex with Men

Data from 635 very poor men who have sex with men (MSM) were used to identify seroadaptation with 1,102 male partners reported between 2005 and 2007 in Los Angeles as part of the Sexual Acquisition and Transmission of HIV Cooperative Agreement Program. The mean age of the sample was 41.7 years; 53 % had experienced homelessness in the past year. Condoms were reported in 51 % of sexual events involving anal intercourse. HIV seroconcordance was reported in 41 % of sexual partnerships among HIV-positive participants. HIV-positive men were more likely to have oral-only or unprotected receptive anal intercourse and less likely to have unprotected insertive anal intercourse with HIV-negative or unknown partners compared to HIV-positive partners. Even in the face of poverty, HIV-positive MSM report mitigating risks of HIV-transmission though seroadaptation in the context of modest rates of condom use.     

Predictors of HIV risk behavior among Russian men who have sex with men: an emerging epidemic

BACKGROUND: Russia is experiencing one of the sharpest increases in HIV incidence in the world. Almost no research has examined patterns of risk behavior among Russian men who have sex with men (MSM). DESIGN AND METHODS: A total of 434 MSM were surveyed in all of St. Petersburg's gay-identified clubs during June 2000. Men completed questionnaires about their sexual practices, AIDS risk knowledge, safer sex attitudes, behavior change intentions, perceived safer sex norms, and fatalism. RESULTS: Most MSM were bisexual; 79% had female partners in their lives and 37% had female partners in the previous 3 months. Sexually transmitted disease treatment was reported by 32% of the men, 23% had sold sex to gain money, and knowledge about critical HIV risk-reduction steps was low. Of all men surveyed, 38% had unprotected anal sex in the previous 3 months, consistent condom use was reported by only 30% of men, and most recent anal intercourse occasions 37% of particpants'. Regression analyses showed that high-risk behavior was predicted by poor safer sex attitudes, weak behavior change intentions, low knowledge about AIDS risk, perceived peer norms that did not support safer sex, and having a boyfriend. CONCLUSION: To avert a widespread epidemic, HIV prevention interventions for Russian MSM are critically needed. Factors predicting risk were consistent with those found among MSM in other countries early in the HIV epidemic. However, unique cultural factors, including frequent bisexual behavior, the 'newness' of openly gay communities in Russia and lack of community experience in dealing with AIDS, require HIV prevention program tailoring.     

Risk Factors for Syphilis and Prevalence of HIV, Hepatitis B and C among Men Who Have Sex with Men in Beijing, China: Implications for HIV Prevention

To examine the correlates for syphilis and the prevalence for HIV, hepatitis B, hepatitis C among men-who-have-sex-with-men (MSM) in Beijing, China. A total of 541 MSM was recruited using peer-referral, community outreach, and Internet. Questionnaire-based interviews provided information including, demographics, sexual and other risk behaviors. HIV prevalence was 4.8%, syphilis 19.8%, HCV 0.4% and HBsAg 6.5%. The median number of lifetime male sex partners was ten. In the past 3 months, 20.7% drank alcohol ≥1 times per week. In the past month, 21.3 and 14.6% had unprotected anal intercourse with regular and casual male sex partners, respectively. Syphilis infection was associated with less education, alcohol use, finding male sex partners through bathhouses/public washrooms/parks, and diagnoses of sexual transmitted diseases (STDs). Syphilis is now epidemic among Beijing’s MSM. Prevention efforts are urgent as HIV prevalence is already near 5%. Education, condom promotion, STD control, and alcohol-related intervention are needed urgently.     

High levels of unprotected sex with men and women among men who have sex with men: a potential bridge of HIV transmission in Beijing, China.

China is experiencing an emerging HIV epidemic among men who have sex with men (MSM). We investigated sexual risk, risk perception, HIV and condom knowledge, and utilization of prevention services in the first large sample of MSM recruited in Beijing. Four hundred eighty-two MSM were sampled from September 2001 to January 2002. Forty-nine percent of participants reported unprotected anal intercourse with men during the previous 6 months. However, only 15% perceived they are at risk for HIV and many had misconceptions about HIV transmission routes and limited knowledge about condoms. Less than one quarter obtained free condoms (24%) and condom lubricants (19%) in the past 2 years. Multiple logistic regression analysis showed that unprotected insertive anal intercourse was associated with not having a Beijing residence card, having six or more male sexual partners, not having sex with women, having a lifetime history of sexually transmitted diseases (STDs), and having never tested for HIV. Unprotected receptive anal intercourse was independently associated with having six or more male sexual partners, not having sex with women, having a lifetime history of STDs, having never tested for HIV, and having less exposure to HIV prevention services. In addition, 28% reported having sex with both men and women during the previous 6 months, and 11% had unprotected intercourse with both men and women. This finding suggests that MSM are a potential bridge of HIV transmission to heterosexual women (or vice versa) and that addressing the HIV prevention needs of MSM may benefit the wider population.