大连市男男性行为人群艾滋病危险行为调查

目的了解辽宁省大连市男男性行为人群(MSM)行为学特征及艾滋病病毒(HIV)、丙型肝炎(HCV)和梅毒感染率,探索HIV感染的影响因素。方法采用定向抽样方法招募MSM,进行面对面的问卷调查,并采血样进行HIV、梅毒和HCV检测。结果共招募932名MSM,HIV抗体阳性率3.43%(32/932),梅毒血清学阳性率12.12%(113/932),HCV抗体阳性率1.07%(10/932);最近6个月,88.73%(827/932)的调查对象曾经与男性发生过肛交;其中每次使用安全套的占52.18%;多因素Logistic回归模型提示,受教育程度低、外地户籍、最近6个月为男性提供商业性服务的男性、梅毒抗体阳性的MSM其HIV感染的风险高;最近1年接受过HIV抗体检测是HIV感染的保护因素。结论大连市MSM HIV感染率高,高危行为普遍存在。     

上海市奉贤区MSM人群艾滋病知识知晓、性行为及感染现况调查

目的通过对221名MSM人群开展艾滋病专项调查,分析了解辖区内MSM人群艾滋病知识知晓程度、相关危险性行为及感染状况,从而针对性地制定实施MSM人群防治性病艾滋病的综合干预措施。方法对招募到的MSM对象进行一对一、面对面问答式或自填式匿名问卷调查;采集对象人群血样,开展相关生物学指标检测。结果有79.64%(176人)找男性性伴的方式主要通过互联网/交友软件,艾滋病相关知识知晓率为74.21%(164/221)。在性取向方面,同性恋有122人(55.20%),双性恋有84人(38.01%),其余不确定。在最近六个月,221人中有162人(73.30%)与同性发生过肛交性行为,其中54.94%的MSM每次都使用安全套,4.32%从未使用安全套;221人中有65人(29.41)与异性发生过性行为,其中35.39%的MSM每次都使用安全套,46.15%从未使用安全套。HIV初筛阳性17例,确证新发阳性14例,HIV阳性率6.33%;梅毒初筛阳性30例,确诊阳性17例,梅毒阳性率7.69%;丙肝筛查阳性1例,确诊1例,丙肝阳性率0.45%。其中,HIV合并梅毒感染3例。结论应开展有针对性的宣传教育,高危干预,动员检测,提高MSM人群的防病意识,从而有效遏制艾滋病病毒的蔓延。     

思明区男男性行为人群艾滋病感染状况及危险因素分析

目的了解思明区男男性行为人群(MSM)艾滋病知识水平、HIV、HCV和梅毒感染状况及影响因素,为制定防治措施和干预策略提供依据。方法用网络招募监测对象,由经培训的专业人员进行问卷调查,采血检测HIV、HCV和梅毒抗体。结果思明区2014—2015年监测MSM人群共555人,艾滋病知识知晓率98.6%,HIV阳性率10.1%,梅毒阳性率6.7%,HCV阳性率0%。555人中最近半年与同性肛交性行为发生率88.6%(492人),安全套坚持使用率31.9%(157/492);与同性商业性行为发生率1.6%(8/492),安全套坚持使用率62.5%(5/8);与异性性行为发生率28.1%(156人),安全套坚持使用率5.8%(9/156)。外省/外籍、大专文化、肛交时不用套、梅毒阳性和未接受过同伴教育者,其HIV阳性率较高。结论思明区MSM人群艾滋病防治知识知晓率较高,但安全套坚持使用率较低,认知与行为分离。应开展同伴教育,坚持使用安全套,以降低MSM人群感染和传播艾滋病的风险。     

泉州市2010-2012年男男性行为人群哨点监测结果分析

目的 了解泉州市男男性行为（MSM）人群HIV、梅毒及丙肝感染率及影响因素现状和变化趋势,为制定防治策略提供依据。方法 连续3年用“滚雪球”和“方便抽样”法招募到样本,对MSM人群进行问卷调查,并进行HIV、梅毒及丙肝的血清学检测。结果 2010—2012年调查数为373人、365人和322人,HIV的初筛阳性率为7.2%、7.7%和9.6%,梅毒的阳性率为9.6%、5.8%和9.3%,丙肝的阳性率为0.4%、0.6%和0.3%;MSM人群艾滋病防治知识知晓率86.3%～87.0%;MSM人群使用安全套的意识在逐年增强,但使用率仍不够高;MSM人群艾滋病防治服务覆盖率55.3%～65.2%。结论 泉州市MSM人群HIV初筛阳性处于较高水平,且仍处上升趋势,应加强该人群艾滋病防治工作力度。     

西安市男男性行为人群艾滋病感染状况及影响因素分析

目的对2013年西安市男男性行为人群（men who have sex with men,MSM）专题流调数据进行分析,了解该人群艾滋病病毒（human immunodeficiency virus,HIV）、梅毒（syphilis）、丙型肝炎病毒（hepatitis C,HCV）感染状况,分析HIV感染危险因素,为制定有效干预策略提供依据。方法通过横断面调查的方法,对600名MSM进行行为学调查及血清学检测,通过单因素χ^2及多因素Logistic回归分析HIV感染危险因素。结果调查对象平均年龄（28.57±7.02）岁,以汉族为主;艾滋病（acquired immune deficiency syndrome,AIDS）知识知晓率77.67%;最近6个月发生同性肛交比例为78.33%,最近1次肛交安全套使用率为78.30%;最近6个月同性商业性行为比例为6.00%,最近1次同性商业性行为安全套使用率为88.89%;HIV检出率9.17%,HIV确证阳性率4.17%,梅毒检出率4.83%,丙肝检出率0.50%。单因素分析显示,样本来源、文化程度、最近1年是否患性病3个因素对MSM感染HIV的影响均有统计学意义（均有P〈0.05）;多因素分析显示,文化程度高是MSM感染HIV的保护因素,最近1年患性病感染HIV的风险是未患性病的2.53倍,梅毒检测结果为阳性感染HIV的风险是梅毒阴性的3.17倍。结论西安市MSM人群HIV感染情况相当严峻,应在各类MSM活动场所继续扩大宣传力度,推广安全套使用,加强完善性病诊疗服务,以控制HIV在该人群中的传播。     

2012—2014年鞍山市男男性行为人群的HIV感染情况及其影响因素

目的了解鞍山市男男性行为者(MSM)的人类免疫缺陷病毒(HIV)感染情况及其影响因素,为开展有针对性的监测和干预工作提供依据。方法对鞍山市2012—2014年MSM艾滋病哨点的监测数据进行统计分析。结果 1 208例MSM调查对象,HIV阳性率为6.71%,梅毒阳性率6.71%,丙型肝炎(丙肝)阳性率0.99%;艾滋病知识知晓率为92.80%。最近6个月,82.78%的调查对象发生过肛交性行为,最近1次肛交性行安全套使用率为88.80%,安全套坚持使用率为65.70%;近1年中,93.87%的MSM接受过安全套宣传和发放/艾滋病咨询与检测或同伴教育服务;单因素分析结果 ,是否接受过艾滋病预防服务和安全套使用情况是该人群HIV感染的主要影响因素(P<0.05);logistic多因素分析显示,接受过艾滋病预防服务的MSM人群的HIV感染率较低(OR=0.402,P<0.05),梅毒抗体检测结果呈阳性的MSM人群感染HIV的风险较高(OR=0.655,P<0.05)。结论 MSM的HIV感染率达到了较高水平,危险因素广泛存在,建议深入开展艾滋病宣传、安全套推广以及规范性病诊疗等综合干预工作,控制HIV的传播。     

广西男男性行为人群梅毒感染危险因素分析

[目的]了解广西男男性行为人群艾滋病性病感染状况和影响因素,为广西艾滋病防治政策和策略的制定提供科学依据。[方法]使用预先设计的调查问卷,由经过培训的调查员指导调查对象填写问卷调查表,利用EPI DATA软件录入数据,用SPSS13.0软件做Logistic回归分析。[结果]共调查955人,HIV阳性率为0.9%,梅毒阳性率为6.3%。在单因素分析中,民族,男性性伴数、最近1次使用安全套情况、最近6个月安全套使用频率、男男商业性行为、最近6个月与女性发生过性关系、性病史、HIV检测结果同梅毒检测结果有关联。在多因素分析中,民族和与女性发生性关系是梅毒感染的保护因素,男男性伴数、最近6个月安全套使用频率、男男商业性行为、性病史是梅毒感染的危险因素。[结论]男男性行为人群梅毒流行和扩散的影响因素复杂,增强自我防范是预防梅毒感染的关键。     

2012年许昌市男男性行为人群艾滋病性病高危行为及影响因素研究

目的了解许昌市男男性行为人群艾滋病高危行为及影响因素,为针对性地开展MSM人群预防艾滋病干预工作提供科学依据。方法采用滚雪球抽样方法,对目标人群进行匿名问卷调查,并采血进行艾滋病/梅毒的血清学检测。结果172人最近六个月发生异性性行为(45.50%),性伴数1个者155人(90.12%);最近一次异性性行为58人使用安全套(33.72%)。最近六个月异性性行为65人从来不用安全套(33.79%)。MSM人群HIV、梅毒感染状况检测378人,检出HIV抗体阳性39人(10.32%),梅毒抗体阳性57人(15.08%)。影响因素分析结果可知,婚姻状况为未婚/离异的最近一次肛交安全套使用情况与已婚/同居差异有统计学意义(P0.05)。结论许昌市男男性行为人群多性伴、低安全套使用率现象普遍,艾滋病/梅毒感染率高,应加大宣传和高危行为干预力度,促进该人群降低危险行为,控制艾滋病的蔓延。     

2009年大连市男男性行为者艾滋病危险行为与HIV感染及影响因素调查

[目的]了解大连市男男性行为者（MSM）的性行为特征、艾滋病病毒（HIV）感染状况及其影响因素,为MSM人群行为干预工作提供依据。[方法]2009年4-6月,在大连市采用定向抽样方法,对402名MSM进问卷调查和HIV抗体检测。[结果]调查402人,最近半年发生同性肛交的357人,占88.81%。这357人中,同性肛交时安全套从未使用的占9.52%,有时使用的占35.29%,每次都用的占55.18%;付钱寻找男男性服务的占2.24%,平均2.38个性伴;提供商业男男性服务的占21.01%,平均服务17人。调查的402人中,最近半年发生异性性行为的136人,占33.83%。这136人中,安全套从未使用的占41.91%,有时使用的占21.32%,每次都用的占36.76%。检测402人,HIV抗体阳性检出率为4.48%,梅毒感染率为13.93%,有4名同时感染HIV和梅毒。多因素非条件Logistic回归分析结果,年龄大、未接受过艾滋病干预服务者是促进HIV感染的因素。[结论]MSM人群存在感染HIV的危险行为,艾滋病干预服务措施有效,中老年MSM是艾滋病预防控制工作的重点人群。     

2010年太原市男男性行为人群艾滋病相关知识、行为及HIV感染情况调查

[目的]了解太原市男男性行为（MSM）人群中艾滋病高危行为特征、艾滋病防治知识知晓情况及艾滋病/性病感染状况。[方法]2010年4～8月,对在太原市MSM人群聚集的活动场所对MSM进行问卷调查,同时检测艾滋病病毒（HIV）抗体、梅毒抗体和丙型肝炎抗体。[结果]调查MSM 272人,平均年龄25.72岁,高中以上文化占84.93%;15～25岁占59.93%;未婚占84.93%。总的艾滋病知识知晓率为43.75%。272人中,最近6个月有79.78%的人与男性发生过肛交性行为,性行为时每次使用安全套的占44.24%,其中13.82%与同性发生过商业性行为,性行为时每次使用安全套的占73.33%;有27.57%的MSM与女性发生过性行为,性行为时每次都使用安全套的占40.00%。检测272人,HIV抗体阳性23例,阳性率8.46%;梅毒阳性37例,阳性率13.60%;丙型肝炎阳性1例,阳性率0.37%。[结论]太原市MSM人群艾滋病/性病感染率较高,高危行为较普遍。     

Developments in male contraception

Relevant research efforts in male contraception involve: 1) hormonal approaches to block sperm production by inhibiting the hypothalamic-pituitary-gonadal axis, 2) disruption of sperm production by drugs that act directly on the testes, 3) interruption of sperm transport, and 4) alteration of secretions of the accessory sex glands and their subsequent effect on the spermatozoa. Both agonistic and antagonistic synthetic analogs of the hypothalamic gonadotropin releasing hormone (GnRH) factor cost too much and lack an effective mode of administration. Recent studies indicate that over 90% of Chinese and Indonesian men can develop complete azoospermia following either a testosterone or a progestin and an androgen combination treatment. Vaccines that utilize GnRH and follicle stimulating hormone as the active antigens have been introduced in clinical studies in the US and India. Drugs such as sulfasalazine, pyrimethamine, nitrofurane, and bis(di-chloracytal) diamines reduce male fertility but side effects make them unacceptable. Dinitropyrroles, halopropanedils, chlorosugars, and indazole carboxylic acids have been tried in laboratory animals. Gossypol rendered men infertile in large-scale clinical studies conducted in China but synthesis of safer analogs has not succeeded. Extracts of another plant, tripterigium wilfordii, are used in China as a popular herbal medicine. Vasectomy has improved with no-scalpel vasectomy and by the novel technique of blocking the vas with cured in situ polymeric plugs. Preliminary data suggest that men prefer condoms made from polyurethane as opposed to latex rubber increasingly used to protect against AIDs and sexually transmitted diseases. The antifungal agents, imidazoles, have spermicidal activity and synthetic variants may reduce undesirable side effects. Research on male-oriented methods has intensified during the last 10-15 years, but a new product is not likely to appear in the next 5-10 years.     

男性避孕技术研究进展

安全、有效、可逆的男性避孕措施可以促进男性参与避孕,降低女性流产比例和风险,控制生育率。目前为止可供选择的临床方法只有阴茎套和输精管结扎术两种。而近年,男用避孕药物尤其是激素避孕的研究取得了长足的进展,并将在近期有望成为一种安全有效、可逆性好、接受性高的避孕新法。分子生物学技术的飞速发展为新的避孕技术和药物的开发提供了良好的平台。     

Local male hormonal therapy in male infertility: A preliminary report

The therapeutic effect of local infiltration of the testis by testosterone crystalline suspension was studied in 18 cases of severe oligozoospermia. Evaluation was done by semen analysis follow-up, and results were correlated with preoperative testicular biopsies. About 40% of the cases showed improvement of sperm count and/or motility. Testicular biopsies of responding cases showed mild inhibitory changes, such as sloughing or partial spermatogenic arrest at late stages, while cases with tubular hyalinization or spermatogenic arrest at the stage of spermatogonia showed no response. The method proved to be simple, safe, and promising.     

广西男性居民包皮环切接受意愿影响因素

目的 了解广西男性居民对包皮环切术(male circumcision,MC)的接受意愿,分析影响其接受意愿的影响因素.方法 于2009年10-12月通过多阶段整群抽样方式对广西钦州市和贺州市男性居民进行访谈式问卷调查.结果 668名调查对象中,选择“愿意”、“可能愿意”、“可能不愿意”和“不愿意”接受MC者分别占15.1% (101/668)、8.1%(54/668)、4.2% (28/668)和2.6% (485/668);将“愿意”及“可能愿意”接受MC者作为有接受手术倾向者,则有包皮环切意愿的占23.2%(155/668);“可能不愿意”或“不愿意”接受MC者中89.8%(459/513)认为是“没有必要,不影响健康”;Logistic回归分析结果表明,存在包茎或包皮过长现象及知道包皮过长会引起包皮垢,影响生殖健康与接受MC意愿相关(P＜0.05).结论 广西男性居民接受MC意愿较低,提高MC基本知识将有助于在该人群中推广包皮环切术.     

Comparing male escorts' sexual behaviour with their last male client versus non-commercial male partner

Apart from research suggesting that male escorts are less likely to have condomless anal sex (CAS) with their male clients compared with male non-clients, little is known about how male escorts' behaviour differs between their clients and non-clients. In spring 2013, 387 Internet-based male escorts completed an online survey that included identical questions about their sexual behaviour with their last male client and male non-client. Encounters with non-commercial partners were significantly more likely to involve a greater range of sexual behaviours, including giving oral sex to partner, kissing, anal receptive sex and sex without condoms. These findings suggest that escorts may display a greater sexual repertoire with non-commercial partners compared to their clients. Encounters with non-commercial partners were also rated as more satisfying than with clients. Condomless anal sex was less common with clients, suggesting that escorts and clients may take active roles in mitigating risks for HIV and STI transmission with each other. Although the modal response for CAS was to abstain, more than half of participants reported CAS during at least one of the two encounters assessed. Behavioural and/or biomedical HIV-prevention strategies would be appropriate for some male escorts to reduce HIV transmission risk.     

Leiomyosarcoma in the male breast

Leiomyosarcoma of a 61 y.o. male's breast was removed by the authors. This observation is the first in the Hungarian and third in the world literature. Short survey is taken of the aetiology, prognosis and therapeutic possibilities of male breast cancers.     

Rural male suicide in Australia

The rate of suicide amongst Australia’s rural men is significantly higher than rural women, urban men or urban women. There are many explanations for this phenomenon including higher levels of social isolation, lower socio-economic circumstances and ready access to firearms. Another factor is the challenge of climate transformation for farmers. In recent times rural areas of Australia have been subject to intense climate change events including a significant drought that has lingered on for over a decade. Climate variability together with lower socio-economic conditions and reduced farm production has combined to produce insidious impacts on the health of rural men. This paper draws on research conducted over several years with rural men working on farms to argue that attention to the health and well-being of rural men requires an understanding not only of these factors but also of the cultural context, inequitable gender relations and a dominant form of masculine hegemony that lauds stoicism in the face of adversity. A failure to address these factors will limit the success of health and welfare programs for rural men.