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George Ayala Sonya Arreola Sean Howell Thomas J Hoffmann Glenn-Milo Santos 《JMIR Public Health and Surveillance》2022,8(6)
BackgroundGay and bisexual men are 26 times more likely to acquire HIV than other adult men and represent nearly 1 in 4 new HIV infections worldwide. There is concern that the COVID-19 pandemic may be complicating efforts to prevent new HIV infections, reduce AIDS-related deaths, and expand access to HIV services. The impact of the COVID-19 pandemic on gay and bisexual men’s ability to access services is not fully understood.ObjectiveThe aim of this study was to understand access to HIV services at the start of the COVID-19 pandemic.MethodsOur study used data collected from two independent global online surveys conducted with convenience samples of gay and bisexual men. Both data sets had common demographic measurements; however, only the COVID-19 Disparities Survey (n=13,562) collected the outcomes of interest (HIV services access at the height of the first COVID-19 wave) and only the Global Men’s Health and Rights Survey 4 (GMHR-4; n=6188) gathered pre-COVID-19 pandemic exposures/covariates of interest (social/structural enablers of and barriers to HIV services access). We used data fusion methods to combine these data sets utilizing overlapping demographic variables and assessed relationships between exposures and outcomes. We hypothesized that engagement with the gay community and comfort with one’s health care provider would be positively associated with HIV services access and negatively associated with poorer mental health and economic instability as the COVID-19 outbreaks took hold. Conversely, we hypothesized that sexual stigma and experiences of discrimination by a health care provider would be negatively associated with HIV services access and positively associated with poorer mental health and economic instability.ResultsWith 19,643 observations after combining data sets, our study confirmed hypothesized associations between enablers of and barriers to HIV prevention, care, and treatment. For example, community engagement was positively associated with access to an HIV provider (regression coefficient=0.81, 95% CI 0.75 to 0.86; P<.001), while sexual stigma was negatively associated with access to HIV treatment (coefficient=–1.39, 95% CI –1.42 to –1.36; P<.001).ConclusionsHIV services access for gay and bisexual men remained obstructed and perhaps became worse during the first wave of the COVID-19 pandemic. Community-led research that utilizes novel methodological approaches can be helpful in times of crisis to inform urgently needed tailored responses that can be delivered in real time. More research is needed to understand the full impact COVID-19 is having on gay and bisexual men worldwide. 相似文献
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Stephanie K. Behel Duncan A. MacKellar Linda A. Valleroy Gina M. Secura Trista Bingham David D. Celentano Beryl A. Koblin Marlene LaLota Douglas Shehan Lucia V. Torian 《Journal of urban health》2008,85(5):727-743
We investigated whether there were racial/ethnic differences among young men who have sex with men (MSM) in their use of,
perceived importance of, receipt of, and satisfaction with HIV prevention services received at health care providers (HCP)
and HIV test providers (HTP) that explain racial disparities in HIV prevalence. Young men, aged 23 to 29 years, were interviewed
and tested for HIV at randomly sampled MSM-identified venues in six U.S. cities from 1998 through 2000. Analyses were restricted
to five U.S. cities that enrolled 50 or more black or Hispanic MSM. Among the 2,424 MSM enrolled, 1,522 (63%) reported using
a HCP, and 1,268 (52%) reported having had an HIV test in the year prior to our interview. No racial/ethnic differences were
found in using a HCP or testing for HIV. Compared with white MSM, black and Hispanic MSM were more likely to believe that
HIV prevention services are important [respectively, AOR, 95% confidence interval (CI): 3.0, 1.97 to 4.51 and AOR, 95% CI:
2.7, 1.89 to 3.79], and were more likely to receive prevention services at their HCP (AOR, 95% CI: 2.5, 1.72 to 3.71 and AOR,
95% CI: 1.7, 1.18 to 2.41) and as likely to receive counseling services at their HTP. Blacks were more likely to be satisfied
with the prevention services received at their HCP (AOR, 95% CI: 1.7, 1.14 to 2.65). Compared to white MSM, black and Hispanic
MSM had equal or greater use of, perceived importance of, receipt of, and satisfaction with HIV prevention services. Differential
experience with HIV prevention services does not explain the higher HIV prevalence among black and Hispanic MSM.
A complete list of the members of the Young Men’s Survey Study Group and cooperating organizations appears at the end of this
article. 相似文献
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Zijie Yang Lan Wei Wei Xie Lin Chen Zhengrong Yang Yan Zhang Shaochu Liu Wei Tan Chenli Zheng Yongxia Gan Dongmin Li Huachun Zou Wanying Chen Ling Ma Niu Ju Yinghui Sun Fan Lv Jin Zhao 《JMIR Public Health and Surveillance》2022,8(8)
BackgroundMen who have sex with men (MSM) are at high risk for HIV infection. Accurate estimation of the population size and monitoring the risk sexual behavioral change of MSM is of great importance to develop targeted HIV prevention and interventions.ObjectiveThe goal of the research was accurate estimation of the population size and monitoring the risk sexual behavioral change of MSM.MethodsStreet interception investigation methods were conducted among males aged 16 years and older in selected sites in Shenzhen in 2014 and 2019. A population survey was used to estimate the population size of MSM. Logistic regression analysis was applied to evaluate the difference in behavioral characteristics in MSM from 2014 to 2019.ResultsIn this study, we surveyed 10,170 participants in 2014, of whom 448 (4.41%, 95% CI 4.01%-4.80%) participants were men who have ever had sex with another man (MSMe) and 229 (2.25%, 95% CI 1.96%-2.54%) were men who had sex with another man in the previous 6 months (MSMa). A total of 10,226 participants were surveyed in 2019, of which 500 (4.90%, 95% CI 4.47%-5.31%) and 208 (2.03%, 95% CI 1.76%-2.31%) participants were MSMe and MSMa, respectively. The results showed that the population size of MSM who are active (MSMa) in Shenzhen was 155,469 (2.29%, 95% CI 2.28%-2.30%) in 2014 and 167,337 (2.05%, 95% CI 2.04%-2.06%) in 2019. It was estimated that there were about 12,005,445 (2.04%, 95% CI 2.04%-2.04%) MSMa in China in 2019. Compared with 2014, the MSMa in 2019 were more likely to seek sex partners through mobile phone apps and less likely to have male and female sex partners in addition to having inconsistent condom use and more than 6 sex partners in the previous 6 months.ConclusionsIn Shenzhen, the proportion of MSMa among the general male population was lower in 2019 than in 2014, and the prevalence of HIV risk behavior was reduced in 2019. Although the preferred platform to find male sex partners among MSM has changed, intervention with high–HIV risk MSM could still help to reduce HIV risk behaviors among the whole MSM group. Because MSM prefer to seek sex partners through mobile phone apps, further study is needed to strengthen internet interventions with high–HIV risk MSM to curb the spread of HIV. 相似文献
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Lin Chen Wanjun Chen Tingting Jiang Zhikan Ni Qiaoqin Ma Xiaohong Pan 《JMIR Public Health and Surveillance》2021,7(9)
BackgroundFinding casual sex partners on the internet has been considered a huge challenge for HIV transmission among men who have sex with men (MSM) in China.ObjectiveThis study aimed to identify the characteristics and risk factors of finding causal sex partners on the internet among MSM in Zhejiang Province, China.MethodsThis was a cross-sectional study. Participants were enrolled by 4 community-based organizations (CBOs) and 10 Voluntary Counselling and Testing (VCT) clinics through advertisements in bathrooms, bars, and gay hook-up apps from June to December 2018. A CBO- or physician-assisted survey was conducted to collected information on finding casual sex partners, perceived HIV infection, and HIV risk behaviors.ResultsAmong 767 participants, 310 (40.4%) reported finding causal sex partners on the internet. Factors associated with finding casual sex partners on the internet included watching pornographic videos on the internet more than once a week (adjusted odds ratio [aOR]=1.881, 95% CI 1.201-2.948), discussing “hooking-up online” with friends (aOR=4.018, 95% CI 2.910-5.548), and perceiving that the likelihood of HIV infection among casual sex partners sought on the internet was “medium” (aOR=2.034, 95% CI 1.441-2.873) or “low” (aOR=2.548, 95% CI 1.524-4.259). Among the participants who reported finding casual sex partners on the internet, 30.2% (91/310) reported having unprotected sex with casual sex partners encountered on the internet in the past 6 months. On multivariate logistic regression analyses, knowing the HIV infection status of casual sex partners sought on the internet was significantly associated with performing inserted intercourse (aOR=1.907, 95% CI 1.100-3.306) and a decreased risk of inconsistent condom use (aOR=0.327, 95% CI 0.167-0.642).ConclusionsWeb-based casual sexual behavior is becoming more prevalent, and the rate of unprotected sex among MSM in Zhejiang Province is high. Future HIV prevention approaches should emphasize the importance for MSM to proactively determine the HIV infection status of potential casual sex partners sought on the internet. 相似文献
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Susan E. Manning Lorna E. Thorpe Chitra Ramaswamy Anjum Hajat Melissa A. Marx Adam M. Karpati Farzad Mostashari Melissa R. Pfeiffer Denis Nash 《Journal of urban health》2007,84(2):212-225
Population-based estimates of human immunodeficiency virus (HIV) prevalence and risk behaviors among men who have sex with
men (MSM) are valuable for HIV prevention planning but not widely available, especially at the local level. We combined two
population-based data sources to estimate prevalence of diagnosed HIV infection, HIV-associated risk-behaviors, and HIV testing
patterns among sexually active MSM in New York City (NYC). HIV/AIDS surveillance data were used to determine the number of
living males reporting a history of sex with men who had been diagnosed in NYC with HIV infection through 2002 (23% of HIV-infected
males did not have HIV transmission risk information available). Sexual behavior data from a cross-sectional telephone survey
were used to estimate the number of sexually active MSM in NYC in 2002. Prevalence of diagnosed HIV infection was estimated
using the ratio of HIV-infected MSM to sexually active MSM. The estimated base prevalence of diagnosed HIV infection was 8.4%
overall (95% confidence interval [CI] = 7.5–9.6). Diagnosed HIV prevalence was highest among MSM who were non-Hispanic black
(12.6%, 95% CI = 9.8–17.6), aged 35–44 (12.6%, 95% CI = 10.4–15.9), or 45–54 years (13.1%, 95% CI = 10.2–18.3), and residents
of Manhattan (17.7%, 95% CI = 14.5–22.8). Overall, 37% (95% CI = 32–43%) of MSM reported using a condom at last sex, and 34%
(95% CI = 28–39%) reported being tested for HIV in the past year. Estimates derived through sensitivity analyses (assigning
a range of HIV-infected males with no reported risk information as MSM) yielded higher diagnosed HIV prevalence estimates
(11.0–13.2%). Accounting for additional undiagnosed HIV-infected MSM yielded even higher prevalence estimates. The high prevalence
of diagnosed HIV among sexually active MSM in NYC is likely due to a combination of high incidence over the course of the
epidemic and prolonged survival in the era of highly active antiretroviral therapy. Despite high HIV prevalence in this population,
condom use and HIV testing are low. Combining complementary population-based data sources can provide critical HIV-related
information to guide prevention efforts. Individual counseling and education interventions should focus on increasing condom
use and encouraging safer sex practices among all sexually active MSM, particularly those groups with low levels of condom
use and multiple sex partners
At the time this work was conducted, Manning and Marx were with the Epidemic Intelligence Service, Office of Workforce and
Career Development, Centers for Disease Control and Prevention, Atlanta, GA, USA; Thorpe, Ramaswamy, Hajat, Marx, Karpati,
Mostashari, and Pfeiffer are with the New York City Department of Health and Mental Hygiene, New York, NY, USA; Nash is with
the Department of Epidemiology and International Center for AIDS Care and Treatment Programs, Columbia Mailman School of Public
Health, New York, NY, USA; Manning is with the Massachusetts Department of Public Health, Bureau of Family and Community Health,
Boston, MA, USA. 相似文献
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Objective
To examine healthcare-related correlates of recent HIV testing among New York City (NYC) residents, controlling for socio-demographic and HIV-related risk factors.Methods
Using the NYC 2007 Community Health Survey (population-based telephone survey, n = 8911), recent HIV testing was examined for its association with healthcare-related variables, including medical screening for other conditions, controlling for other HIV testing correlates using multiple logistic regression.Results
Factors associated with a recent HIV test included: provider recommendation for an HIV test (adjusted odds ratio [AOR]: 10.1, 95% confidence interval [CI]:7.6-13.5), Medicaid versus private insurance (AOR: 1.6, 95% CI: 1.2-2.1), and having a personal doctor (AOR: 1.6, 95% CI: 1.3-2.1). The proportion of HIV tests attributed to each factor (attributable-fraction [AF]) was 49% for provider recommendation, 33% for having a personal doctor, and 8.3% for Medicaid insurance. Among subgroups eligible for other medical screening, factors associated with recent HIV testing included recent receipt of blood lipid testing (AOR: 2.2, 95% CI: 1.6-3.0; AF: 45%), and Pap smear (AOR: 2.7, 95% CI: 2.1-3.5; AF: 52%). Recent receipt of mammography and colonoscopy was not associated with recent HIV testing.Conclusions
A substantial proportion of recent HIV testing coverage among New Yorkers may be attributable to healthcare-related factors. Joint medical screening may provide opportunities to increase population HIV testing coverage. 相似文献8.
目的 了解浙江省MSM HIV感染者(MSM感染者)成功动员性伴参与HIV检测的情况及影响因素。方法 以浙江省2015-2017年MSM感染者作为研究对象,提供4种性伴检测服务方式,调查其动员性伴参与HIV检测情况。用χ2检验比较组间差异,用多因素logistic回归模型分析其影响因素。结果 2015-2017年浙江省新确证的6 269例MSM感染者中,成功动员性伴检测的1 925例(30.7%,1 925/6 269),拒绝动员性伴检测的4 344例(69.3%,4 344/6 269)。共成功动员2 126名性伴,性伴HIV阳性率为13.0%(277/2 126,95% CI:11.6%~14.5%),78.7%(218/277,95% CI:73.8%~83.6%)的阳性性伴为新确证感染病例。多因素logistic回归分析结果显示,在2016年参与调查(与2015年参与调查相比,OR=1.581,95% CI:1.370~1.823)、在2017年参与调查(与2015年参与调查相比,OR=1.394,95% CI:1.208~1.608)、现住址在检测发现地所在地市(与现住址在检测发现地以外地区相比,OR=1.518,95% CI:1.320~1.745)、已婚有配偶(与未婚/离异/丧偶相比,OR=4.449,95% CI:3.837~5.160)、文化程度为初中及以下(与高中及以上相比,OR=1.203,95% CI:1.058~1.367)、既往同性性伴数>5(与既往同性性伴数为1~5相比,OR=1.236,95% CI:1.095~1.395)、主动检测(与被动检测相比,OR=1.340,95% CI:1.193~1.506)的MSM感染者更愿意动员性伴参与HIV检测。同性性伴中HIV阳性者与其对应的MSM感染者在人口学特征上无统计学差异。结论 MSM感染者动员性伴参与检测是扩大HIV检测的重要补充,可以高效地发现潜在阳性者,但是其成功动员性伴检测率仍需进一步提高。建议将性伴动员检测纳入日常工作当中,并重点关注与MSM感染者社会人口学特征相似的性伴。 相似文献
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目的 分析石家庄市MSM HIV自我检测(自检)及相关因素。方法 2020年8-9月,在石家庄市采用方便抽样招募MSM,利用线上调查问卷,收集其社会人口学、行为学和HIV自检等信息,采用logistic回归分析HIV自检相关因素。结果 共调查MSM 304人,最近6个月HIV自检率为52.3%(159/304),其中95.0%(151/159)使用指尖血HIV检测试剂;获得HIV检测试剂的途径,以自己购买(45.9%,73/159)和通过MSM社会组织领取(44.7%,71/159)为主;选择HIV自检原因为检测时间不受限制(67.9%,108/159)和保护隐私(62.9%,100/159),不选择原因为自己不会操作(32.4%,47/145)、不知道有HIV自检试剂(24.1%,35/145)和担心自检结果不准确(19.3%,28/145)。多因素logistic回归分析结果显示,18~29岁(aOR=2.68,95%CI:1.20~5.94)、最近6个月在当地领取过HIV自检包(aOR=8.61,95%CI:4.09~18.11)和主要交友途径通过互联网/社交软件(aOR=2.68,95%CI:1.48~4.88)的MSM更倾向于选择HIV自检。结论 HIV自检为MSM提供了一种更灵活、方便的检测途径,应加强HIV自检的推广,进一步提高MSM的HIV检测率。 相似文献
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Michael L. Campsmith D.D.S. M.P.H. Gary M. Goldbaum M.D. M.P.H. Robert M. Brackbill Ph.D. M.P.H. Kristine Tollestrup Ph.D. M.P.H. Robert W. Wood M.D. JoElla Weybright 《Preventive medicine》1997,26(6):839-844
Background.This article describes the testing behavior for human immunodeficiency virus (HIV) antibody among an urban population of men who have sex with men (MSM) and the reasons given for not being tested for HIV.Methods.A random digit dialing telephone survey of men living in selected neighborhoods of Seattle, Washington, was conducted from June through August 1992.Results.Of 603 MSM interviewed, 82% had ever been tested for HIV; 19% of tested men were seropositive. MSM who were older, nonwhite, with lower income, or not currently sexually active were less likely to have been tested. Among nontesters, 57% believed their risk of infection was too low to justify testing; 52% said they had not tested due to fear of learning the result. Testers and nontesters had similar rates of unprotected sexual behavior.Conclusions.Most MSM who had not been tested for HIV believed they were not at risk of infection and/or were fearful of learning the result. To increase the proportion of MSM who test, public health agencies may need to emphasize that unexpected infection does occur and that new therapies are available for those testing positive. Innovative programs may be necessary to reach those who have not yet decided to be tested. 相似文献
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Wenjian Xu Lijun Zheng Jingjing Song Xing Zhang Xuemeng Zhang Yong Zheng 《Archives of sexual behavior》2018,47(7):1949-1957
Men who have sex with men (MSM) carry the burden of HIV infection in China. Outside of China, a history of childhood sexual abuse (CSA) has been associated with HIV-related risks (behavioral, sexual, and mental health outcomes) among MSM. We therefore evaluated the relationship between CSA and these HIV-related risks among MSM in China. Cross-sectional data were collected via a survey from gay websites and social networking applications from MSM in 30 provinces in mainland China during a 3-month period in 2014 and 2015. Overall, 999 screened MSM who responded to questions on CSA were included. Multinomial logistic regression models—adjusted for sociodemographic confounders—showed that men who reported experiencing regular CSA and contact CSA, respectively, were more likely to use substances (adjusted odds ratio [AOR], 1.91; 95% confidence interval [CI] 1.39–2.62 and AOR, 1.70; 95% CI 1.25–2.31), had a history of sexually transmitted infections (AOR, 1.81; 95% CI 1.29–2.55 and AOR, 1.65; 95% CI 1.18–2.96), had more male sexual partners (AOR, 1.06; 95% CI 1.04–1.09 and AOR, 1.05; 95% CI 1.03–1.08), engaged in more condomless sex with men (AOR, 1.89; 95% CI 1.39–2.56 and AOR, 1.72; 95% CI 1.29–2.30), and experienced more psychological distress (AOR, 1.05; 95% CI 1.02–1.08 and AOR, 1.05; 95% CI 1.03–1.08). Both frequent and contact forms of CSA were positively associated with HIV-related risks among MSM, suggesting that general CSA prevention strategies and interventions are needed to support this population. 相似文献
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目的 了解MSM HIV/AIDS的性伴感染状况和溯源效率的相关因素。方法 采用横断面调查方法,2018-2020年在宁波市对MSM HIV/AIDS开展性伴调查和HIV检测,并用限制性抗原亲和力酶联免疫法判定是否新发感染。分类资料采用χ2检验,采用多因素logistic回归分析溯源效率的相关因素。结果 共调查374例新确证MSM HIV/AIDS,动员479例性伴进行调查和HIV检测,性伴HIV阳性率为15.7%(75/479,95%CI:12.4%~18.9%),其中新发感染者性伴HIV阳性率为31.8%(21/66,95%CI:20.3%~43.4%)。新发感染者的性伴HIV阳性者中新发现阳性性伴的比例(76.2%)高于长期感染者(48.1%),差异有统计学意义(P=0.028)。多因素logistic回归分析结果显示,36~45岁年龄组(与18~25岁年龄组相比,OR=3.973,95%CI:1.364~11.569)、HIV主动检测(与HIV被动检测相比,OR=1.896,95%CI:1.083~3.319)、新发感染者(与长期感染者相比,OR=3.733,95%CI:1.844~7.556)的溯源效率更高。结论 MSM HIV/AIDS性伴HIV阳性率高,其中新发感染者和HIV主动检测发现的感染者性伴溯源效率较高。建议加强MSM HIV/AIDS溯源调查,重点关注艾滋病自愿咨询与检测门诊新确证的MSM HIV/AIDS。 相似文献
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BackgroundAll-cause mortality and estimates of excess deaths are commonly used in different countries to estimate the burden of COVID-19 and assess its direct and indirect effects.ObjectiveThis study aimed to analyze the excess mortality during the COVID-19 pandemic in Jordan in April-December 2020.MethodsOfficial data on deaths in Jordan for 2020 and previous years (2016-2019) were obtained from the Department of Civil Status. We contrasted mortality rates in 2020 with those in each year and the pooled period 2016-2020 using a standardized mortality ratio (SMR) measure. Expected deaths for 2020 were estimated by fitting the overdispersed Poisson generalized linear models to the monthly death counts for the period of 2016-2019.ResultsOverall, a 21% increase in standardized mortality (SMR 1.21, 95% CI 1.19-1.22) occurred in April-December 2020 compared with the April-December months in the pooled period 2016-2019. The SMR was more pronounced for men than for women (SMR 1.26, 95% CI 1.24-1.29 vs SMR 1.12, 95% CI 1.10-1.14), and it was statistically significant for both genders (P<.05). Using overdispersed Poisson generalized linear models, the number of expected deaths in April-December 2020 was 12,845 (7957 for women and 4888 for men). The total number of excess deaths during this period was estimated at 4583 (95% CI 4451-4716), with higher excess deaths in men (3112, 95% CI 3003-3221) than in women (1503, 95% CI 1427-1579). Almost 83.66% of excess deaths were attributed to COVID-19 in the Ministry of Health database. The vast majority of excess deaths occurred in people aged 60 years or older.ConclusionsThe reported COVID-19 death counts underestimated mortality attributable to COVID-19. Excess deaths could reflect the increased deaths secondary to the pandemic and its containment measures. The majority of excess deaths occurred among old age groups. It is, therefore, important to maintain essential services for the elderly during pandemics. 相似文献
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《Value in health》2020,23(7):870-879
ObjectivesHuman immunodeficiency virus self-testing (HIVST) is a promising approach to improve HIV testing coverage. We aimed to understand HIV testing preferences of men who have sex with men (MSM) to optimize HIVST implementation.MethodsDiscrete choice experiments (DCEs) were conducted among HIV-negative MSM living in Australia and aged ≥18 years. Men completed 1 of 2 DCEs: DCETest for preferred qualities of HIV testing (price, speed, window period, test type, and collector of specimen) and DCEKits for preferred qualities of HIVST kits (price, location of access, packaging, and usage instructions). Latent class conditional logit regression was used to explore similarities (or “classes”) in preference behavior.ResultsOverall, the study recruited 1606 men: 62% born in Australia, who had an average age of 36.0 years (SD 11.7), and a self-reported median of 4 (interquartile range 2-8) sexual partners in the last 6 months. The respondents to DCETest was described by 4 classes: “prefer shorter window period” (36%), “prefer self-testing” (27%), “prefer highly accurate tests” (22%), and “prefer low prices” (15%). Respondents to DCEKits were described by 4 classes: “prefer low prices” (48%), “prefer retail access (from pharmacy or online stores)” (29%), “prefer access at sex venues” (15%), and “prefer to buy from healthcare staff” (12%). Preferences varied by when someone migrated to Australia, age, frequency of testing, and number of sexual partners.ConclusionA subset of MSM, particularly infrequent testers, value access to HIVST. Expanding access to HIVST kits through online portals and pharmacies and at sex venues should be considered. 相似文献
17.
Pamina?M.?Gorbach Ryan?Murphy Robert?E.?Weiss Christopher?Hucks-Ortiz Steven?Shoptaw 《Journal of urban health》2009,86(1):63-76
The purpose of the study was to determine the potential contribution of bisexual men to the spread of HIV in Los Angeles. We compare the characteristics and behaviors of men who have sex with men and women (MSMW) to men who have sex with only women (MSW) and men who have sex with only men (MSM) in Los Angeles. Men (N?=?1,125) who participated in one of the two waves of data collection from 2005 to 2007 at the Los Angeles site for NIDA’s Sexual Acquisition and Transmission of HIV—Cooperative Agreement Program were recruited using Respondent Driven Sampling. Participants completed Audio Computer Assisted Self Interviews and received oral HIV rapid testing with confirmatory blood test by Western Blot and provided urine specimens for detection of recent powder cocaine, crack cocaine, methamphetamine, or heroin use. MSM, MSW, or MSMW were defined by the gender of whom they reported sex with in the past 6 months. Chi-square tests and ANOVAs were used to test independence between these groups and demographic characteristics, substance use, and sexual behaviors. We fit generalized linear random intercept models to predict sexual risk behaviors at the partner level. Men were mostly of low income, unemployed, and minority, with many being homeless; 66% had been to jail or prison, 29% had ever injected drugs, and 25% had used methamphetamine in the past 30 days. The sample had high HIV prevalence: 12% of MSMW, 65% of MSM, and 4% of MSW. MSMW were behaviorally between MSW and MSM, except that more MSMW practiced sex for trade (both receiving and giving), and more MSMW had partners who are drug users than MSW. Generalized linear random intercept models included a partner-level predictor with four partner groups: MSM, MSMW-male partners, MSMW-female partners, and MSW. The following were significantly associated with unprotected anal intercourse (UAI): MSW (AOR 0.15, 95% CI 0.08, 0.27), MSMW-female partners (AOR 0.4, 95% CI 0.27, 0.61), HIV-positive partners (AOR 2.03, 95% CI 1.31, 3.13), and being homeless (AOR 1.37, 95% CI 1.01, 1.86). The factors associated with giving money or drugs for sex were MSMW-female partners (AOR 1.70, 95% CI 1.09, 2.65), unknown HIV status partners (AOR 1.72, 95% CI 1.29, 2.30), being older (AOR 1.02, 95% CI 1.00, 1.04), history of incarceration (AOR 1.64, 95% CI 1.17, 2.29), and being homeless (AOR 1.73, 95% CI 1.27, 2.36). The following were associated with receiving money or drugs for sex: MSW (AOR 0.53, 95% CI 0.32, 0.89), African American (AOR 2.42, 95% CI 1.56, 3.76), Hispanic (AOR 1.85, 95% CI 1.12, 3.05), history of incarceration (AOR 1.44, 95% CI 1.04, 2.01), history of injecting drugs (AOR 1.57, 95% CI 1.13, 2.19), and had been recently homeless (AOR 2.14, 95% CI 1.57, 2.94). While overall HIV-positive MSM had more UAI with partners of any HIV status than MSMW with either partner gender, among HIV-positive MSMW, more had UAI with HIV-negative and HIV status unknown female partners than male partners. Findings highlight the interconnectedness of sexual and drug networks in this sample of men—as most have partners who use drugs and they use drugs themselves. We find a concentration of risk that occurs particularly among impoverished minorities—where many men use drugs, trade sex, and have sex with either gender. Findings also suggest an embedded core group of drug-using MSMW who may not so much contribute to spreading the HIV epidemic to the general population, but driven by their pressing need for drugs and money, concentrate the epidemic among men and women like themselves who have few resources. 相似文献
18.
Pamina M. Gorbach Ryan Murphy Robert E. Weiss Christopher Hucks-Ortiz Steven Shoptaw 《Journal of urban health》2009,86(Z1):63-76
The purpose of the study was to determine the potential contribution of bisexual men to the spread of HIV in Los Angeles.
We compare the characteristics and behaviors of men who have sex with men and women (MSMW) to men who have sex with only women
(MSW) and men who have sex with only men (MSM) in Los Angeles. Men (N = 1,125) who participated in one of the two waves of data collection from 2005 to 2007 at the Los Angeles site for NIDA’s
Sexual Acquisition and Transmission of HIV—Cooperative Agreement Program were recruited using Respondent Driven Sampling.
Participants completed Audio Computer Assisted Self Interviews and received oral HIV rapid testing with confirmatory blood
test by Western Blot and provided urine specimens for detection of recent powder cocaine, crack cocaine, methamphetamine,
or heroin use. MSM, MSW, or MSMW were defined by the gender of whom they reported sex with in the past 6 months. Chi-square
tests and ANOVAs were used to test independence between these groups and demographic characteristics, substance use, and sexual
behaviors. We fit generalized linear random intercept models to predict sexual risk behaviors at the partner level. Men were
mostly of low income, unemployed, and minority, with many being homeless; 66% had been to jail or prison, 29% had ever injected
drugs, and 25% had used methamphetamine in the past 30 days. The sample had high HIV prevalence: 12% of MSMW, 65% of MSM,
and 4% of MSW. MSMW were behaviorally between MSW and MSM, except that more MSMW practiced sex for trade (both receiving and
giving), and more MSMW had partners who are drug users than MSW. Generalized linear random intercept models included a partner-level
predictor with four partner groups: MSM, MSMW-male partners, MSMW-female partners, and MSW. The following were significantly
associated with unprotected anal intercourse (UAI): MSW (AOR 0.15, 95% CI 0.08, 0.27), MSMW-female partners (AOR 0.4, 95%
CI 0.27, 0.61), HIV-positive partners (AOR 2.03, 95% CI 1.31, 3.13), and being homeless (AOR 1.37, 95% CI 1.01, 1.86). The
factors associated with giving money or drugs for sex were MSMW-female partners (AOR 1.70, 95% CI 1.09, 2.65), unknown HIV
status partners (AOR 1.72, 95% CI 1.29, 2.30), being older (AOR 1.02, 95% CI 1.00, 1.04), history of incarceration (AOR 1.64,
95% CI 1.17, 2.29), and being homeless (AOR 1.73, 95% CI 1.27, 2.36). The following were associated with receiving money or
drugs for sex: MSW (AOR 0.53, 95% CI 0.32, 0.89), African American (AOR 2.42, 95% CI 1.56, 3.76), Hispanic (AOR 1.85, 95%
CI 1.12, 3.05), history of incarceration (AOR 1.44, 95% CI 1.04, 2.01), history of injecting drugs (AOR 1.57, 95% CI 1.13,
2.19), and had been recently homeless (AOR 2.14, 95% CI 1.57, 2.94). While overall HIV-positive MSM had more UAI with partners
of any HIV status than MSMW with either partner gender, among HIV-positive MSMW, more had UAI with HIV-negative and HIV status
unknown female partners than male partners. Findings highlight the interconnectedness of sexual and drug networks in this
sample of men—as most have partners who use drugs and they use drugs themselves. We find a concentration of risk that occurs
particularly among impoverished minorities—where many men use drugs, trade sex, and have sex with either gender. Findings
also suggest an embedded core group of drug-using MSMW who may not so much contribute to spreading the HIV epidemic to the
general population, but driven by their pressing need for drugs and money, concentrate the epidemic among men and women like
themselves who have few resources. 相似文献
19.
Sarah Wiatrek Maria Zlotorzynska Ramona Rai Patrick Sullivan Travis Sanchez 《JMIR Public Health and Surveillance》2021,7(3)
The American Men’s Internet Survey (AMIS) is an annual web-based behavioral survey conducted in the United States of men who have sex with men (MSM). This rapid surveillance report describes the sixth cycle of data collection (September-December 2018; AMIS 2018). The key indicators were the same as those previously reported for past AMIS cycles. The AMIS methodology has not substantively changed since AMIS 2017. MSM were recruited from a variety of websites using banner advertisements and email blasts. In addition, participants from AMIS 2017 who agreed to be recontacted for future research were emailed a link to AMIS 2018. Men were eligible to participate if they were aged ≥15 years, resided in the United States, provided a valid US ZIP code, and reported ever having sex with a man or identified as gay or bisexual. The analysis was limited to those who reported having oral or anal sex with a male partner in the past 12 months. We examined demographic and recruitment characteristics using multivariable regression modeling (P<.05) stratified by the participants’ self-reported HIV status. The AMIS 2018 round of data collection resulted in 10,129 completed surveys from MSM representing every US state, Puerto Rico, and Guam. Most participants were non-Hispanic White, aged between 15 and 24 years, living in urban areas in the southern United States, and recruited from general social networking websites. The plurality (4230/10,129, 41.76%) of participants was in the youngest age group, 15-24 years, followed by the 40 years and older age group (3088/10,129, 30.49%). The self-reported HIV prevalence was 6.08% (616/10,129). Compared with HIV-negative or unknown status participants, HIV-positive participants were more likely to have had anal sex without a condom with a male partner in the past 12 months (adjusted odds ratio [aOR] 2.02, 95% CI 1.63-2.50) and more likely to have had anal sex without a condom with a serodiscordant or an unknown status partner (aOR 3.90, 95% CI 3.27-4.66). The reported use of marijuana in the past 12 months was higher among HIV-positive participants than among HIV-negative or unknown status participants (aOR 1.39, 95% CI 1.15-1.68). The reported use of methamphetamines and other illicit substances in the past 12 months was higher among HIV-positive participants than among HIV-negative or unknown status participants (aOR 3.42, 95% CI 2.41-4.87 and aOR 1.90, 95% CI 1.56-2.32, respectively). Most HIV-negative or unknown status participants (6838/9513, 71.88%) reported ever taking an HIV test previously, and 52.51% (4995/9513) of the participants reported undergoing HIV testing in the past 12 months. HIV-positive participants were more likely to report testing and diagnosis of sexually transmitted infections than HIV-negative or unknown status participants (aOR 3.50, 95% CI 2.89-4.24 and aOR 2.61, 95% CI 2.10-3.25, respectively). 相似文献
20.
《Vaccine》2020,38(13):2849-2858
IntroductionMen who have sex with men (MSM), especially those infected with human immunodeficiency virus (HIV), are at disproportionate risk for human papillomavirus (HPV) infection. Data about anal HPV prevalence among MSM in southern China are limited.MethodsMSM were recruited between January 1 and August 31, 2017 in three metropolitan cities: Guangzhou, Shenzhen and Wuxi. A self-completed tablet-based questionnaire was used to collect information about socio-demographic/sexual behavioral characteristics, history of sexually transmitted infections (STIs) and recreational drug use. An anal brush was used to collect exfoliated cells for HPV DNA testing and genotyping, and a blood sample was taken for HIV testing. Penile/anal warts were checked by a clinician.ResultsA total of 536 MSM were enrolled, including 39 HIV-positive and 497 HIV-negative individuals. Compared with HIV-negative MSM, prevalence of any HPV genotype (79.5% vs 46.7%), any high-risk genotype (64.1% vs 36.6%) and any nonavalent vaccine-preventable genotype (53.9% vs 31.6%) was significantly higher in HIV-positive MSM, with all P < 0.01. HIV infection (adjusted odds ratio [AOR], 4.28; 95% confidence interval [CI], 1.87–9.80), using recreational drugs (AOR, 1.87; 95% CI, 1.22–2.87), having ≥ 3 years of sexual experience (AOR, 1.52; 95% CI, 1.01–2.28), having ≥ 6 lifetime male partners (AOR, 1.92; 95% CI, 1.29–2.86), and engaging receptive anal intercourse (AOR, 2.30; 95% CI, 1.48–3.57) were associated with higher anal HPV prevalence. Any HPV prevalence increased with age, from 24.5% at < 20 years to 55.8% at ≥ 40 years.ConclusionsAnal HPV prevalence was high among MSM in southern China, significantly associated with HIV status and sexual experience. HPV prevalence increased with age among MSM. A targeted HPV vaccination program for teenage MSM might be necessary. Our findings will inform targeted HPV modelling among MSM in China. 相似文献