男性同性恋、男性同性性行为与艾滋病

20世纪80年代初,艾滋病(AIDS)首先在美国的男性同性恋人群中开始流行,从此AIDS的防治与男性同性恋人群紧密地联系在一起。那么AIDS到底和男性同性恋的联系怎样呢?是否男同性恋者一定会感染艾滋病病毒(HIV)呢?1对男同性恋的认识1.1男同性恋的存在由来已久同性恋是一个客观存在的事实,“同性恋(homo-sexuality)”这一名词是德国医生Benkert于1869年创造的。这个词描述的是对异性不能做出性反应,却被与自己性别相同的人所吸引。今天,同性恋、异性恋和双性恋都已被认为是不同类型的“性取向”,尽管对其定义的表述各有不同,但多数认为是“…     

男男性行为者的性病感染与控制

男男性行为者（MSM）人群处于社会生活边缘,艾滋病打破了这个群体的掩蔽状态,也促进了公共卫生事业新理念、新思维的形成和发展。 1同性性行为与同性恋 “中国当代性文化——中国两万例‘性文明’调查报告”中统计,同性性行为的发生率,大学生为7．5％,农村已婚者为2．3％,城市已婚者为0．5％。“当代中国人的性行为和性关系”认为在20～64岁的中国人中,有2．0％的男性认为自己是同性恋者,女性为0．7％;认为自己愿意与同性别人过性生活的男性为1．9％,女性0．6％。在男性中1．3％的人承认自己在一生中曾经与同性发生过超过接吻的性行为,而女性为0．4％。“性爱十年：全国大学生性行为的追踪调查”对同性性行为的调查结果显示,男、女生每次调查结果的统计比较没有显著性差异,发生年龄段也同样没有显著性差异（图1）。     

男男性行为的历史文化背景及现状

同性恋一词（Homosexuality）最初由1名匈牙利人1869年在文学作品中使用,后被德国学界接纳并被翻译成英文。这个词描述的是对异性不能做出性反应,却被自己同性别的人所吸引。今天,同性恋、异性恋和双性恋被认为是不同类型的“性取向”。男性同性性行为是指男性之间发生的性行为,男男性接触者（MSM）是指曾与男性发生过性行为的男性,包括男同性恋者、男双性恋者和部分男异性恋者,MSM范围要比男同性恋者广泛得多。     

Osteoporosis in men

With the prolongation of life expectancy, osteoporosis has become an increasing problem in the majority of developed countries worldwide. The paper discusses the frequency, pathogenesis, diagnostic criteria and treatment options for osteoporosis in men. Every third hip fracture occurs in men, and more than 11% of the male population over the age of 50 years suffer the fracture. Diagnostic tests for idiopathic osteoporosis are performed in men under 60 years of age without other potential risk factors of developing the disease. In the majority of cases, their low bone mineral density (BMD) is caused by a low peak bone mass. Secondary osteoporosis occurs in about 30 % of men, and involutionary osteoporosis developed in men over 60 years of age results from their decreased testosterone and IGF-1 levels. The study results showing that BMD levels in both sexes provide similar fracture risk information suggest that the existing diagnostic criteria for female osteoporosis can also be employed in men. It has been proved that biphosphonate and teriparitide therapy significantly increase BMD levels in men. The administration of androgens has been shown to be effective in men with hypogonadism, although their validity for patients with eugonadism has not yet been discussed. An improved knowledge of the bone metabolism and bone remodelling has recently opened the door to an extensive series of molecules that may play a key role in the treatment of male osteoporosis in the future.     

Gay men and other men who have sex with men in West Africa: evidence from the field

This paper presents a synthesis of lessons learned from field experiences in HIV prevention, treatment and care services for men who have sex with men in the four contiguous West African countries of the Gambia, Guinea-Bissau, Guinea-Conakry and Senegal. Service provision for men who have sex with men in these countries is contextualised by the epidemiology of HIV, as well as the socio-political environment. These countries share notable commonalities in terms of social structures and culture, though past approaches to the needs of men who have sex with men have varied greatly. This synthesis includes three distinct components. The first focuses on what is known about HIV epidemiology among men who have sex with men in these countries and provides an overview of the data gaps affecting the quality of service provision. The second aspect describes the HIV prevention and treatment services currently available and how organisations and strategies have evolved in their approach to working with men who have sex with men. Finally, an examination of the political and cultural climate highlights socio-cultural factors that enable or impede HIV prevention and treatment efforts for men who have sex with men. The review concludes with a series of recommendations for impactful research, advocacy and service provision to improve the health and human rights context for men who have sex with men in West Africa.     

杭州市男男性接触人群梅毒感染现状分析

摘要：目的　了解浙江省杭州市男男性接触人群（ｍｅｎｗｈｏｈａｖｅｓｅｘｗｉｔｈｍｅｎ,ＭＳＭ）的社会人口学特征
及梅毒感染情况,为针对性地开展该群体的健康教育及高危行为干预工作提供依据。方法　对２００９－２０１２
年杭州市７９５名ＭＳＭ 人群进行问卷调查,收集社会人口学和危险行为资料,采集静脉血进行梅毒抗体检
测。采用ＳＰＳＳ１２．０软件对结果进行单因素χ
２ 检验, 以犘＜０．０５ 为差异有统计学意义。结果　杭州市
ＭＳＭ 人群以高学历、未婚青壮年为主。调查对象中,６８４ 人（８６．０４％） 最近半年与男性发生过肛交性行
为,５４人（７．８９％）从未使用安全套,４２５ 人（６２．１４％） 有时使用,２０５ 人（２９．９７％） 每次都用。最近
半年与异性发生性行为者２２８人（２８．６８％）,其中有４７ 人（２０．６１％） 每次都使用安全套。共检出梅毒感
染者８５例,感染率为１０．６９％,各年度感染率差异无统计学意义（χ
２＝１．５５４,犘＞０．０５）;不同文化程度、
不同婚姻状况及不同安全套使用情况的ＭＳＭ 人群梅毒感染率差异有统计学意义（χ
２ 值分别为１２．２３２、
１２．６３０和１０．１５０,犘＜０．０１）; 按是否感染梅毒分组比较,ＨＩＶ 抗体阳性率差异有统计学意义（χ
２ ＝
１４．５６５,犘＜０．０１）。结论　杭州市ＭＳＭ 人群是梅毒感染的高危人群,存在较高无保护男男性行为现象,
应加强对ＭＳＭ 人群及其感染者的健康教育和行为干预。
关键词：男男性接触人群;梅毒;肛交性行为
中图分类号：Ｒ１８３．７　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１４）０２ ０１２１ ０３     

乌鲁木齐市男男性行为者艾滋病新发感染分析

摘要:目的 了解新疆乌鲁木齐市男男性行为(MSM)人群HIV新发感染率,确定今后艾滋病防治工作重点。方法 将乌鲁木齐市艾滋病哨点监测MSM人群4 403例样本纳入研究,用ELISA方法对所有研究对象样本进行HIV初筛,初筛阳性者用免疫印迹方法进行确认,符合条件的HIV阳性血清还接受HIV-1 BED捕获酶联法(BED方法)检测,估算该人群连续2012-2015年的新发感染率;对不同人口学特征的新发感染率进行分层分析;掌握安全套的使用情况。结果 2012-2015年乌鲁木齐市HIV新发感染率分别为2.20%、2.54%、4.36%、5.43%,平均3.72%(95%CI:3.11%~4.32%);多因素分析显示已婚的、艾滋病知识知晓率低的HIV新发感染率高。安全套的使用率普遍较低。结论 乌鲁木齐市MSM人群艾滋病流行处于上升阶段,安全套使用率低,应采取有效的干预措施加以控制。     

Differences in substance use and sexual partnering between men who have sex with men,men who have sex with men and women and transgender women

Men who have sex with men (MSM), men who have sex with men and women (MSM/W) and transgender women (TGW) remain the populations most severely and disproportionately impacted upon by HIV in Los Angeles County. Baseline data from community-based HIV-prevention programmes serving these populations were analysed to explore differences in demographic characteristics, substance use and sexual partnering between the three groups. Despite high HIV prevalence overall (MSM 34.7% versus MSM/W 16.1% versus TGW 21.9%, p < .001), there were striking differences in risk behaviours. Higher rates of homelessness were reported by MSM/W compared to MSM and TGW. Lower rates of education and less substance use were reported by TGW (62.2%), compared to MSM (79.7%) and MSM/W (92.6%). A much higher number of male sexual exchange partners were reported by TGW (MSM 1.04 [SD = 4.8] versus MSM/W 1.54 [SD = 10.3] versus TGW 12.37 [SD = 23.9], p < .001). Findings support the need for HIV-prevention interventions that specifically address the unique risk patterns among each population in order to curb HIV acquisition and transmission.     

Differences in substance use and sexual partnering between men who have sex with men, men who have sex with men and women and transgender women

Men who have sex with men (MSM), men who have sex with men and women (MSM/W) and transgender women (TGW) remain the populations most severely and disproportionately impacted upon by HIV in Los Angeles County. Baseline data from community-based HIV-prevention programmes serving these populations were analysed to explore differences in demographic characteristics, substance use and sexual partnering between the three groups. Despite high HIV prevalence overall (MSM 34.7% versus MSM/W 16.1% versus TGW 21.9%, p < .001), there were striking differences in risk behaviours. Higher rates of homelessness were reported by MSM/W compared to MSM and TGW. Lower rates of education and less substance use were reported by TGW (62.2%), compared to MSM (79.7%) and MSM/W (92.6%). A much higher number of male sexual exchange partners were reported by TGW (MSM 1.04 [SD = 4.8] versus MSM/W 1.54 [SD = 10.3] versus TGW 12.37 [SD = 23.9], p < .001). Findings support the need for HIV-prevention interventions that specifically address the unique risk patterns among each population in order to curb HIV acquisition and transmission.     

Oral sex and HIV among men who have sex with men

Sexual transmission of the human immunodeficiency virus (HIV) continues to pose a public health problem worldwide. Men who have sex with men are still at differential risk of infection. Although there is evidence to claim that HIV can be transmitted by oral sex, the perception of this risk is ambiguous and relates paradoxically to behavior change. New models of risk perception must be developed in various areas of knowledge to obtain a fuller understanding of this phenomenon.     

The continuing HIV epidemic among men who have sex with men

OBJECTIVES: This study characterized the AIDS epidemic among urban men who have sex with men (MSM). METHODS: A probability sample of MSM was obtained in 1997 (n = 2881; 18 years and older) from New York, Los Angeles, Chicago, and San Francisco, and HIV status was determined through self-report and biological measures. RESULTS: HIV prevalence was 17% (95% confidence interval = 15%, 19%) overall, with extremely high levels in African Americans (29%), MSM who used injection drugs (40%), "ultraheavy" noninjection drug users (32%), and less educated men (< high school, 37%). City-level HIV differences were non-significant once these other factors were controlled for. In comparing the present findings with historical data based on public records and modeling, HIV prevalence appears to have declined as a result of high mortality (69%) and stable, but high, incidence rates (1%-2%). CONCLUSIONS: Although the findings suggest that HIV prevalence has declined significantly from the mid-1980s, current levels among urban MSM in the United States approximate those of sub-Saharan countries (e.g., 14%-25%) and are extremely high in many population subsegments. Despite years of progress, the AIDS epidemic continues unabated among subsegments of the MSM community.     

男男性接触者包皮环切术接受意愿调查

目的 了解男男性接触者(MSM)对进行包皮环切术(Male Circumcision,MC)的接受意愿.方法 2008年8-9月,通过"滚雪球"和方便抽样招募方式对辽宁省沈阳市123名MSM进行访谈式问卷调查.结果 123名调查对象中,61.8%的MSM存在异性性伴,其中57.9%在最近1个月与女性性伴的性行为中未使用安全套.4.9%的MSM曾接受过包皮环切手术.未进行过包皮环切术的MSM中47.O%愿意接受MC.而对于免费提供的MC,接受比例为60.0%.Logistic回归分析显示,存在包茎现象及认为包皮环切可预防性病感染与MSM愿意接受MC存在显著的关联性(P＜0.05).结论 MSM存在向其异性性伴传播人类免疫缺陷病毒(HIV)的危险性.MC干预可降低MSM的HIV感染率及向普通人群传播的风险.     

男男性行为者抑郁症状流行病学研究现状

男男性行为者抑郁症状的发生率较高,国内外对抑郁症状相关因素的研究主要关注男男性行为者性取向、HIV感染、性行为特征,非自愿性行为/童年期性虐待、社会支持等方面.不同研究报道的抑郁症状发生率变异范围较大,可能与抑郁症状评定工具、研究对象的情况及抽样方法有关.本文对男男性行为者抑郁症状及其影响因素的研究进行综述,为深入研究男男性行为者抑郁症状提供线索和依据.