Sexual practices and condom usage in a cohort of homosexual men in relation to human immunodeficiency virus status

Between January 1, and October 31, 1987, 420 homosexual men who participated in a cohort study of infection with the human immunodeficiency virus (HIV) completed a questionnaire that examined their sexual practices during the previous six months. Of the subjects, 205 (48.8%) men were HIV-seropositive and 215 (51.2%) men were HIV-seronegative. Although there was an appreciable level of condom usage in both groups, 13.5% of the HIV-seronegative men had engaged in unprotected receptive anal intercourse and 6.3% of the HIV-seropositive men had engaged in unprotected insertive anal intercourse. Condom breakage was reported on approximately 6% of occasions by a minority of subjects. Among subjects who were in a relationship with a regular male sexual partner, the most commonly reported sexual practices were deep kissing, mutual masturbation and receptive oral intercourse without ejaculation. No HIV-seronegative man engaged in unprotected receptive and/or insertive anal intercourse, receptive oral intercourse with ejaculation or receptive and/or insertive "fisting" with a regular partner who was HIV-seropositive. No HIV-seropositive man engaged in unprotected insertive anal intercourse to ejaculation with an HIV-seronegative partner, although they did so with partners who were HIV-seropositive or of unknown status. On multivariate analyses the subject's antibody status was found to be associated with receptive anal intercourse with a condom (P = 0.007) and mutual masturbation (P = 0.001), with HIV-seronegative men being more likely to practise either; no significant independent effect was associated with the partner's antibody status. These findings provide important information on the types and levels of sexual practices in a group of homosexual men after the recognition of the acquired immunodeficiency syndrome in this country.     

商业性性服务MSM HIV/梅毒感染及高危行为调查

目的 了解深圳市既往提供过商业性性服务的男男性行为者高危行为特征及梅毒/HIV感染情况.方法 知情同意原则下,对2009～2011年深圳市MSM人群资料应用SAS8.0软件进行x2检验.结果 2943例MSM中,393例(13.4％)最近半年内提供过商业性性服务,梅毒感染率为24.7％,HIV感染率为9.2％,梅毒合并HIV感染率为5.6％.与既往无商业性性服务的MSM人群相比,既往提供过商业性性服务的MSM人群普遍多性伴;与男性肛交时每次使用安全套比例较高,与男性口交时从不使用安全套比例较低,与女性发生性行为时从不使用安全套比例较低;梅毒感染率、HIV感染率较高.结论 深圳市既往提供过商业性性服务的MSM人群为艾滋病性病易感人群,应对这一亚群引起足够重视.     

广西部分地区男男性行为者安全套使用情况及影响因素分析

目的 分析广西部分地区男男性行为者（men who have sex with men, MSM）的危险行为、安全套使用情况及其影响因素。方法 在广西南宁市、柳州市和贺州市通过方便抽样的方法招募MSM,开展面对面问卷调查,收集其社会人口学、行为学、艾滋病相关知识、安全套使用等基本信息。采用卡方检验、Logistic回归模型分析最近6个月同性肛交坚持使用安全套的影响因素,计算OR（95%CI）值,以P<0.05为差异有统计学意义。结果 375名MSM中,认为当地MSM疫情严重占56.3%,曾经吸食过新型毒品占5.1%,最近6个月同性肛交性行为坚持使用安全套仅占58.4%,最近6个月性伴数3人以上占25.9%,最近6个月与异性发生过性行为占14.1%。多因素Logistic回归模型分析结果显示,文化程度高中或中专及以上[OR=1.86(95%CI:1.01~3.43)]、认为当地MSM艾滋病疫情严重[OR=3.79(95%CI:1.61~8.95)]、最近1年做过HIV检测[OR=1.93(95%CI:1.18~3.15)]、最近1年患过性病[OR=0.36(95%CI:0.14~0.90)]为最近6个月同性肛交坚持使用安全套的-影响因素。结论 广西MSM安全套坚持使用率低,需结合不同特点的MSM采取针对性干预措施,提高安全套坚持使用率,减少艾滋病的传播。     

合肥市青年男男性行为者梅毒和HIV感染状况分析

目的了解合肥市青年男男性行为者(MSM)梅毒和HIV感染状况以及相关的因素,为对该人群进行梅毒与HIV预防干预提供依据。方法采用应答者驱动招募、关键知情人介绍及在MSM网站上发布广告三种方法招募年轻的男男性行为者,进行匿名问卷调查与HIV和梅毒血清学检测。结果202名调查对象平均年龄为20.7岁,大学及以上学历占66.9%,在校学生为62.4%,63.4%的人自认为是同性性取向,26.7%的人自认为是双性性取向。HIV感染率为1.0%,RPR阳性率为7.0%,TPPA阳性率为13.1%。单因素2检验表明,曾进行过HIV检测、一生中肛交同性性伴4个以上与梅毒感染相关,2值分别为10.944与7.696(均P<0.01)。结论年轻的男男性行为者中梅毒感染情况严重,HIV在该人群中流行条件已经具备,急需在该人群中开展性病艾滋病的高危行为干预,尤其要加强大、中学校学生性病艾滋病知识宣传和健康教育。     

性病门诊男男同性恋者艾滋病知识知晓率和性行为调查

目的：对性病门诊就诊的男男同性恋的性行为方式、安全套使用情况、艾滋病相关知识掌握情况等进行问卷调查,以了解该人群的行为特征,为制定相应的健康教育及行为干预提供科学的依据。方法：2009年1月至12月在多家综合医院性病门诊采用自行设计调查问卷对200名就诊MSM（men who have sex with men,男男同性恋）的人口学特征、性行为方式、安全套使用情况、HIV相关知识的掌握程度等进行匿名式问卷调查。结果：被调查者年龄（26.7±8.9）岁,近1年来有121人（62.6%）被确诊过性病。近6个月来,同性性伴侣数为（9.2±4.8）人,102人有异性性伴侣（52.8%）。与同性性交时,123人有肛交行为（63.7%）,117人有口交行为（60.6%）。与异性性交时,92人有阴道交(90.2%), 37人有肛交行为（36.2%）,59人有口交行为（57.8%）。经卡方检验,同性性行为和异性性行为的行构成有统计学差异（P＜0.01）。不同性行为方式安全套使用频率有统计学差异（χ2=188.396, P<0.001）。而人免疫缺陷病毒（human immunodeficiency virus,HIV）相关知识与安全套使用情况分析发现除异性肛交安全套使用与HIV知识得分有线性关系外,其他性行为方式的安全套使用与HIV 知识得分间无线性相关关系。结论：被调查对象艾滋病知识知晓率较高,能够主动通过多种途径获得艾滋病知识,但其HIV相关知识掌握程度与安全套使用频率无明显相关性。MSM在与异性性交时无保护性行为比例高。如何对性病门诊的MSM采取更为有效的方式进行干预以减少其高危性行为值得思考。     

深圳市男性双性性行为者高危行为及梅毒／HIV感染调查

目的了解深圳市男性双性性行为者（men who have sex with men and women,MSMW）高危行为特征及梅毒/HIV感染情况。方法对2009—2011年深圳市MSM人群监测资料进行统计分析。结果2009。2011年2943例MSM中,809例（27．49％）最近半年内发生了双性性行为。MSMW人群梅毒感染率为17．80％,HIV感染率为7．05％,梅毒合并HIV感染率为3．83％。与近半年内无双性性行为的MSM人群相比,MSMW人群女性性伴数≥5个的比例较高,男性肛交性伴数≥2个的比例较高,与女性发生性行为时从不使用和偶尔使用安全套比例较高,与男性肛交时每次使用安全套比例较高,与男性口交时从不使用安全套比例较低,梅毒感染率和HIV感染率较低。结论深圳市MSMW人群与女性发生性行为时每次使用安全套比例低,作为艾滋病性病传播桥梁作用的危险不可低估。     

Associations among condom use, sexual behavior, and knowledge about HIV/AIDS. A study of 13,293 public school students

BACKGROUND: This school-based study explored associations between Mexican young people's condom use, other sexual behaviors, and HIV/AIDS knowledge. METHODS: Students (n=13,293, 11-24 years of age) from a random sample of public schools in the central Mexican state of Morelos completed a self-administered questionnaire. We performed logistic regression analysis of condom use and sexual behavior variables and a knowledge-based index on HIV/AIDS prevention and transmission. RESULTS: Average age at sexual debut was 13.6 +/- 1.9 years among young men and 14.2 +/- 2.2 years among young women; 34.5% of sample participants reported using condoms during their first sexual intercourse. More students had intermediate HIV/AIDS knowledge levels (46%, 95% confidence interval [95% CI], 45.2-46.9) than high levels (37%, 95% CI 36.2-37.8, p <0.01). Students knew more concerning HIV transmission than about prevention of HIV infection. Among young men, high levels of HIV/AIDS knowledge increased likelihood of condom use (odds ratio [OR] 1.4, 95% CI, 1.1-1.7), while among young women high levels of knowledge decreased likelihood of using condoms (OR 0.7, 95% CI, 0.5-1.0). Young men with high levels of HIV/AIDS knowledge were more likely to have had three or more sexual partners (OR 1.7, 95% CI, 1.3-2.2), but young women with high knowledge levels were more likely to have only one lifetime sexual partner (OR 0.6, 95% CI, 0.4-0.9). CONCLUSIONS: As in previous studies in smaller samples, levels of knowledge with regard to HIV/AIDS were low in Mexican youth. HIV/AIDS education programs for Mexican students should focus on conveying knowledge on HIV prevention. Because apparently knowledge is not directly correlated with condom use among young women, prevention strategies that deal with social acceptability of condoms and social skills related with condom negotiation are also needed.     

MSM人群艾滋病相关KAP调查

目的调查男男性接触者（MSM）艾滋病（AIDS）相关知识态度及高危行为，为针对性地开展MSM人群AJDs防治工作提供依据。方法对山东省济宁市市中区MSM进行不记名问卷调查，所得数据进行统计学分析。结果调查对象年龄中位数为25岁，49．5％的人认为与一个未感染艾滋病病毒的性伴发生性行为能降低艾滋病病毒传播的危险。最近6个月，平均男性性伴数为（6．7±4．4）个。最近一次与男性发生肛交性行为时使用安全套的比例为50．6％。结论MSM人群艾滋病知识还有不足，存在艾滋病传播的高危性行为，应该加强健康教育和行为干预，从而有效的防制MsM人群AIDS的快速蔓延。     

Male-to-female transmission of human immunodeficiency virus

Ninety-seven female sexual partners of 93 men infected with human immunodeficiency virus were studied. All of the women had sexual contact within the year before their partner had been diagnosed as having acquired immunodeficiency syndrome or was found to have a positive reaction on the human immunodeficiency virus serologic test. Fifty-seven percent were the partners of bisexual men. Overall, 23% of the women were infected (95% confidence interval, 15% to 32%). The total number of exposures to the index case (sexual contacts with ejaculation) and the specific practice of anal intercourse, also with the infected partner, were associated with transmission. Neither condom use, total number of sexual partners since 1978, nor lifetime number of sexually transmitted diseases was associated with infection.     

Human immunodeficiency virus infection, hepatitis B virus infection, and sexual behaviour of women attending a genitourinary medicine clinic

During the six months immediately after a public information campaign about the acquired immune deficiency syndrome 1115 women who attended a genitourinary medicine clinic in west London were tested for antibodies to the human immunodeficiency virus (HIV). Three women (0.27%) were positive, and all three were regular sexual partners of men with high risk lifestyles--two intravenous drug users and one bisexual. A consecutive series of 647 women from the cohort was tested for antibodies for hepatitis B core antigen: 27 were positive, of whom six had been born in the United Kingdom and were not known to have been at risk. The two women who were seropositive for HIV who completed a questionnaire on their sexual behaviour before they were tested reported both anal and oral receipt of semen and were in the upper fifth percentile for lifetime sexual partners. More than half (53%) of 424 women who reported that they had non-regular sexual partners never used a condom. It is concluded that heterosexual women in London are at a low risk of becoming infected with HIV.     

The Internet as a newly emerging risk environment for sexually transmitted diseases

CONTEXT: Transmission of sexually transmitted diseases (STDs) such as human immunodeficiency virus (HIV) infection is associated with unprotected sex among multiple anonymous sex partners. The role of the Internet in risk of STDs is not known. OBJECTIVE: To compare risk of STD transmission for persons who seek sex partners on the Internet with risk for persons not seeking sex partners on the Internet. DESIGN: Cross-sectional survey conducted September 1999 through April 2000. SETTING AND PARTICIPANTS: A total of 856 clients of the Denver Public Health HIV Counseling and Testing Site in Colorado. MAIN OUTCOME MEASURES: Self-report of logging on to the Internet with the intention of finding sex partners; having sex with partners who were originally contacted via the Internet; number of such partners and use of condoms with them; and time since last sexual contact with Internet partners, linked to HIV risk assessment and test records. RESULTS: Of the 856 clients, most were white (77. 8%), men (69.2%), heterosexual (65.3%), and aged 20 to 50 years (84. 1%). Of those, 135 (15.8%) had sought sex partners on the Internet, and 88 (65.2%) of these reported having sex with a partner initially met via the Internet. Of those with Internet partners, 34 (38.7%) had 4 or more such partners, with 62 (71.2%) of contacts occurring within 6 months prior to the client's HIV test. Internet sex seekers were more likely to be men (P<.001) and homosexual (P<.001) than those not seeking sex via the Internet. Internet sex seekers reported more previous STDs (P =.02); more partners (P<.001); more anal sex (P<.001); and more sexual exposure to men (P<.001), men who have sex with men (P<.001), and partners known to be HIV positive (P<.001) than those not seeking sex via the Internet. CONCLUSIONS: Seeking sex partners via the Internet was a relatively common practice in this sample of persons seeking HIV testing and counseling (representative of neither Denver nor the overall US population). Clients who seek sex using the Internet appear to be at greater risk for STDs than clients who do not seek sex on the Internet. JAMA. 2000;284:443-446     

上海浦东新区流动人口性病/艾滋病知晓现状及影响因素分析

目的 了解上海浦东地区流动人口的性病/艾滋病知晓现状。方法 采用多级随机抽样的方法，对浦东新区986名15～35岁的流动人口进行问卷调查。结果 (1)调查对象已经掌握部分性病伎滋病知识，但不全面。女性对象的知识得分低于男性(X^2=39．93，P=0．0002)；(2)多因素Logistic回归分析结果显示：影响知识得分的主要因素为性别、年龄、教育程度、工作场所、希望获得知识的态度、正确认识AIDS的威胁6个因素；(3)调查对象相关知识主要来自报纸、书籍和杂志(71．2％)，电视(64．1％)，广播(29．4％)等。结论 应针对流动人口知识的薄弱环节如STD/HIV的主要表现、避孕套的作用和使用方法等方面开展宣教；女性应作为宣教干预的重点；应配合媒体的宣传开展一些专门针对流动人口的专业医师咨询、讲座、宣传小册子等方式的干预。     

男男性接触人群艾滋病高危行为互联网QQ干预效果

目的 了解普宁市男男性接触者人群(MSM)的基本情况,利用互联网QQ对MSM进行艾滋病高危行为干预并评价干预效果,探讨互联网QQ干预模式的可行性,为基层县市提供借鉴经验.方法 建立项目专用QQ群,在普宁市采用同伴推动抽样法(RDS)招募MSM作为干预对象加入该QQ群,通过互联网在QQ群内进行调查及干预,对干预效果进行评价,评价内容包括艾滋病知识知晓率、安全套使用情况、求医意识及行为变化等.结果 干预前与干预后分别调查58、54人.艾滋病相关知识总知晓率由干预前的62.07％提高到干预后的88.89％(P＜0.01);最近一次与男性发生肛交性行为时安全套使用率由干预前的18.97％提高到干预后的40.74％ (P＜0.05),近3个月来与男性发生肛交性行为时每次都使用安全套的比例由于预前的10.34％提高到干预后的31.48％(P＜0.01);如果出现生殖器破损或HIV病毒感染相关症状时,调查对象打算“到合法正规医院就诊”的比例从干预前的53.45％上升到干预后的85.19％ (P＜0.01).干预前后比较差异均有统计学意义.结论 采用互联网QQ对MSM进行艾滋病高危行为干预效果显著,有推广及借鉴价值.     

某同性恋浴室男男性接触者ＨＩＶ／梅毒感染状况的研究

目的:了解经常在浴室活动的男男性接触人群(MSMs)HIV/梅毒相关知识、态度、行为及其感染状况,为制定有效的防治措施提供信息和依据.方法:在某MSMs聚集的浴室对目标人群进行匿名问卷调查,并采集静脉血进行HIV/梅毒检测.结果:该人群艾滋病知识总知晓率为75.3%.只有21.6%的男男性接触者(MSM)在每次肛交时坚持使用安全套,而从未使用、有时使用安全套者占78.4%.近3个月与异性发生过阴道交行为的MSM有117人,仅19.7%每次使用安全套.HIV阳性率为4.7%,TPPA阳性率为39.9%,RPR阳性率为27.0%.年龄、近3个月性伴数、婚姻状况、文化程度、安全套使用情况、籍贯等因素与HIV/梅毒感染率之间无统计学联系.结论:经常出入浴室的MSMs中高危性行为普遍存在,HIV/梅毒感染率高,应尽快采取针对性的行为干预措施.     

Sex Workers' Sexual Health and Peer Education Project in Goroka, Eastern Highlands Province, Papua New Guinea

We conducted a survey among female sex workers in Goroka, Eastern Highlands Province, Papua New Guinea to evaluate the frequency of sexually transmitted disease (STD) symptoms they suffered, their STD and HIV (human immunodeficiency virus) transmission knowledge and health-seeking behaviours, the forms that their HIV risk perception took, and the types and quantities of educational resources to which they had access and in fact used. This survey was a part of a larger study of sex workers that was carried out in two other cities, Lae, the capital of Morobe Province, and Port Moresby, the nation's capital. We interviewed 190 self-identified female sex workers who had been recruited between January 1999 and October 1999 through peer-mediated contacts. In an average one-week period, the women had intercourse with two customers, two to three times, and one boyfriend once or twice. In the surveyed group, 83% of the women had a history of symptomatic STDs and 73% had gone to an STD clinic for treatment. Of the women who used condoms at all, 7% used them each time they had sex with clients, but only 3% used them each time they had sex with steady partners. The remaining 93% of the women used condoms on some occasions or not at all. Most women (72%) knew about male-female transmission of HIV, but fewer cited other sexual and non-sexual modes of transmission. The majority of the women (71%) felt that they were of low or unknown risk of acquiring HIV infection. When asked where or to whom they would go when concerned about AIDS (acquired immune deficiency syndrome) or STDs, most women (93%) said that they would go to a health care provider. Evaluating the sex workers' understanding of STDs and HIV has been essential in designing education and intervention projects so as better to address the future morbidity and mortality associated with STDs and AIDS.     

性病门诊男性就诊者艾滋病哨点监测结果分析

目的:了解性病门诊男性就诊者艾滋病流行状况和流行因素,为制定相应防控措施提供科学依据。方法:2012年4月至6月对首次到眉山市人民医院性病相关门诊就诊的400名年龄在15周岁及以上的男性就诊者进行面对面问卷调查,并采集血样进行艾滋病、梅毒、丙肝检测。结果:艾滋病知识总知晓率87.00%;14.25%的调查对象承认在最近3个月有商业性行为;10.75%的调查对象承认最近3个月与临时性伴发生过性行为;0.25%的人承认与同性发生过肛交性行为;16.50%的被调查者最近1年接受过有关预防艾滋病性病服务;0.50%最近1年做过艾滋病病毒(HIV)检测并知晓检测结果。HIV抗体检出率2.25%;梅毒抗体检出率3.75%;丙肝抗体检出率0.75%。结论:性病门诊就诊者存在知识和行为分离的现象;应对性病门诊就诊者开展针对性的行为干预,控制艾滋病经高危人群向一般人群扩散。     

武汉市同性恋酒吧男男性接触者HIV高危行为的现况调查

目的:描述武汉市男男性接触者HIV高危行为的现状,探讨其影响因素。方法:在武汉市同性恋酒吧对96名男男性接触者进行问卷调查。结果:调查对象中21-30岁年龄段者占41.7%,高中及以上学历者占95.8%,职业以学生、企业职员和公务员为主;50.0%曾与一个女性有过性交,13.5%与1名以上的女性有过性交;44.8%第一次发生男男性关系的年龄在16-18岁。全部调查对象在过去的6个月中有过同性性行为,其中77.1%有过口交行为,87.5%有过肛交行为。结论:武汉市男男性接触者中的HIV相关行为存在高度的危险性。     

性病门诊男性就诊者肛门生殖器HPV隐性感染及其危险因素

目的：评估性病门诊男性就诊者肛门生殖器人乳头瘤病毒（HPV）隐性感染的发生率及其相关的危险因素。方法：采用横断面研究方法,对600例性病门诊非尖锐湿疣男性就诊者进行问卷调查,并以PCR法检测其肛门生殖器脱落细胞中的HPV DNA。结果：600例研究对象的HPV DNA总阳性率为14.50%（87/600）,其中性病(STD)患者HPV阳性率［23.90%（38／159）］显著高于非STD就诊者［11.11%（49／441）］（P< 0.05）。这组人群中HPV DNA 阳性的预测值是初次性生活年龄的提前(OR=1.2、95%CI 1.1 ～ 1.3,P<0.05)、近2年内有尖锐湿疣病史(OR=3.3、95%CI 1.2 ～ 9.3,P<0.05)和其他STD史(OR=3.8、95%CI 1.4 ～ 10.2,P<0.05)。年龄、包皮状况、近2年内性伴数、平均性生活频率、安全套的使用频率以及性伴尖锐湿疣病史与HPV DNA阳性无明显关联。结论：男性肛门生殖器HPV隐性感染的比率较高,HPV隐性感染在STD人群中更常见。初次性生活年龄的提前、近2年内有尖锐湿疣病史及其他STD史可能是男性HPV隐性感染的危险因素。     

DETECTION OF HIV INFECTION IN MEN SUFFERING FROM SEXUALLY TRANSMITTED DISEASES IN NORTH EAST REGION

In a prospective study, 715 men in the age group 18-45 years with various sexually transmitted diseases (STD) from Jan 1993 to June 1996 were examined for presence of human immunodeficiency virus (HIV) infection. Majority (86%) were young adults in the age group of 21-35 years. Five hundred and fifty eight (78.04%) men were married and 157 (21.9%) were single. Majority men (87.3%) gave history of heterosexual exposures with female commercial sex workers. None had used condom during sexual intercourse. Out of 715, majority (30.9%) cases had chancroid. Blood samples were tested for HIV 1-2 antibodies during treatment and surveillance period by Enzyme Linked Immunosorbent Assay (ELISA) technique. Nine cases of STDs were positive for HIV 1-2 antibodies by ELISA test and 8 (1.1%) were confirmed by Western blot assay. All HIV seropositive men got infection from female commercial sex workers which were detected during their surveillance period. This study highlights the importance of screening of STD patients for HIV infection during treatment as well as surveillance period.KEYWORDS: Human immunodeficiency virus infection, Sexually transmitted disease, Surveillance     

Sexual behaviour and HIV knowledge among Dermatology cum Genitourinary Clinic attendees, Johor Bahru, Malaysia

A study was conducted in the Dermatology cum Genitourinary Clinic, Hospital Sultanah Aminah Johor Bahru to determine a local population's knowledge of HIV and their sexual behaviour in relation to it. A total of 231 men and 217 women were interviewed. The sexual culture seen is one of relatively late age of first sexual intercourse, low level of partner change and low level of condom use. Men reported a higher involvement in risk behaviour. Nearly all the respondents (95.8%) have heard of HIV/AIDS but had incorrect perceptions of its mode of transmission and its associations with risk groups. This study enable us to gain background information about our patients sexual behaviour and HIV knowledge. There is a need to continue HIV education to improve our public's HIV knowledge and the results of this study provides a baseline against which future educational interventions can be gauged.