男男性行为人群安全套使用需求调查

目的通过互联网和现场两种招募方法,了解男男性性行为人群(MSM)的安全套需求情况。方法通过互联网和现场面对面两种方式进行问卷调查,结果采用SAS 9.0软件进行数据分析。结果通过互联网调查3488人,现场调查394人。互联网调查对象年龄以26～35岁为主,大专以上文化程度占80.57%,干部/职员的比例以及月收入在3 000元以上的比例,均高于现场调查。采用安全套的排序方式网络调查和现场调查结果基本一致:购买安全套时考虑的因素,厚度排第一位;肛交时,配有足量的润滑剂排第一位,润滑剂的剂量以10克为宜;60%以上的人没有固定使用某个品牌安全套的习惯。结论安全套的质量是MSM在选择安全套时最关注的方面,在肛交时希望安全套配足量润滑剂、越薄越好,其他喜好因人而异。     

Binge drinking concurrent with anal intercourse and condom use among men who have sex with men

Men who have sex with men (MSM) are the demographic group most severely affected by HIV in the USA. Global association studies have shown that MSM who binge drink are more likely to engage in risky sexual behaviors and day- and event-level analyses have linked binge drinking to sexual risk behavior on specific days and during specific sexual encounters. Despite this strong foundation of research, no studies have examined the association between the frequency of situational binge drinking (i.e., binge drinking concurrent with sexual activity) and aggregated sexual risk over periods of longer duration. We used multivariable logistic regression to assess the relationship between situational binge drinking (i.e., binge drinking concurrent with anal intercourse) and condomless anal intercourse (CAI) and among a cross-sectional sample of 124 MSM in San Francisco, CA. There was a positive relationship between frequency of situational binge drinking and CAI (1–5 times vs. never: adjusted odds ratio?=?2.78, 95% CI?=?1.01–7.63; 6–10 times vs. never: 6.19, 1.27–30.22; more than 10 times vs. never: 11.88, 1.31–107.60). By filling a methodological gap and complementing existing global and event-level analyses, this positive situational relationship strengthens the evidence linking binge drinking and sexual risk, enhances the comparability of the existing literature, and further suggests that the integration of dual strategies that aim to prevent HIV and reduce binge drinking may be warranted.     

HIV-testing behavior among young migrant men who have sex with men (MSM) in Beijing, China

Previous studies suggested a rapid increase of HIV prevalence among men who have sex with men (MSM) in China in recent years, from 0.4% in 2004 to 5.8% in 2006. However, some MSM had never been tested for HIV. In order to expand the accessibility to HIV testing, understanding HIV-testing behavior and barriers among MSM is important. Using data collected from 307 young migrant MSM (aged 18-29 years) in 2009 in Beijing, we aimed to identify psychological and structural barriers to HIV testing. MSM were recruited through peer outreach, informal social networks, Internet outreach, and venue-based outreach. Participants completed a confidential self-administered questionnaire. Results show that about 72% of MSM ever had an HIV test. Logistic regression analysis indicated that the HIV-testing behavior was associated with sexual risk behaviors (e.g., multiple sexual partners and inconsistent condom use for anal sex) and history of sexually transmitted diseases. Eighty four MSM (28%) who never had an HIV test reported that the psychological barriers mainly were perceived low risk of HIV infection and fears of being stigmatized. The structural barriers reported inconvenience of doing test and lack of confidentiality. Future HIV prevention programs should be strengthened among MSM to increase their awareness of HIV risk. Efforts are needed to increase access to quality and confidential HIV testing among MSM and reduce stigma against MSM.     

男男性接触者性病就医意向调查分析

目的 了解男男性接触者（MSM）目前的就医选择及对就医环境、医生的需求，为改善医疗服务、促进其正确求医行为提供依据。方法 采用问卷调查形式对昆明市76名MSM进行调查。结果 43.8％的MSM在性病就医时首先选择皮肤病性病专科医院，27．4％选择综合医院的相关科室，12．3％选择个体诊所。63．5％希望是男医生接诊，32．4％无所谓。在就医环境处理等许多方面，MSM与其他人群相比并无特别的需求。结论 对MSM开展性病诊疗服务时，需要医生对该人群有一个正确的了解，采用不评判、不歧视态度，创造宽松的就医环境，同时为其提供保密的、良好的、规范和富有责任心的服务是非常重要的。     

南充市男男性行为者安全套使用情况分析

目的了解南充市男男性行为者(MSM)安全套使用现状及影响因素。方法用滚雪球法和方便抽样法,在两周时间内选取所有能接触到并获得知情同意的对象。用自制问卷开展调查,所得资料用等级相关等方法进行统计分析。结果共调查214人,其中近1年中同性间发生肛交、口交及与异性发生性关系的比例分别为89.7%9、6.3%和37.4%;坚持每次都使用安全套的比例分别为3.4%、31.3%和25.3%,从不使用者则分别为83.5%、22.9%和41.8%。与男男肛交时安全套使用频率有明显关联的因素包括年龄、经济状况、文化程度、艾滋病感染风险意识、陌生性伴构成等,其中年龄、经济状况、文化程度还与男女间性行为时安全套使用率有明显联系。结论南充市MSM安全套使用率低,艾滋病病毒(HIV)感染风险大,充分认识和高度重视安全套使用过程中的影响因素,是艾滋病防治工作取得成效的关键。     

大学在校学生男男性接触者性取向自我认同与艾滋病相关危险因素定性研究

目的 了解大学在校学生男男性接触者(MSM)中性取向自我认同以及艾滋病相关危险因素,为在该人群有效开展艾滋病行为干预提供依据.方法 采用半结构式访谈提纲,对来自大学院校和科研院所的27名学生MSM进行个人深入访谈.结果 受访对象的年龄分布于19～29岁,大部分是本科生和硕士生,少数民族2人;21人自我认同为同性恋,6人自我认同为双性恋;对艾滋病有一定了解,存在多性伴和"419"(一夜情)行为;学生MSM习惯于上网寻找性伴;受访者中未发现HIV感染者,2人新近感染梅毒.结论 大学生MSM中高危性行为普遍,性病问题值得关注,应采取针对性干预措施.     

Condom use and perceived risk of HIV transmission among sexually active HIV-positive men who have sex with men.

This study examined the association between HIV transmission risk perception and the sexual risk behaviors of HIV-positive men who have sex with men. Respondents rated the degree of risk of transmitting HIV through insertive anal intercourse and insertive oral sex. We examined (a) the perceived level of HIV transmission risk assigned to each sexual behavior and (b) the association between perceived risk for HIV transmission and condom use during insertive anal intercourse and insertive oral sex. We found for behaviors that have achieved less risk consensus that as transmission risk perception increases, so too does the likelihood of condom use. This study highlights the need for more research in understanding how perceived health risk to others influences protective behaviors.     

Safety and acceptability of the Reality condom for anal sex among men who have sex with men

OBJECTIVES: To assess safety and acceptability of Reality condoms for anal sex among men who have sex with men. METHODS: Crossover study among HIV-seroconcordant (33 HIV-negative and 5 HIV-positive) monogamous male couples, randomized to latex male and Reality condom use with anal sex. RESULTS: Slippage with removal was reported more frequently with Reality than male latex condoms [odds ratio (OR), 2.7; 95% confidence interval (CI), 1.2-5.8 for receptive partners and OR, 34.1; 95% CI, 13.8-84.1 for insertive partners]. Receptive partners more frequently reported pain or discomfort (OR, 5.0; 95% CI, 2.6-9.4) and rectal bleeding (OR, 1.9; 95% CI, 0.9-4.1) with Reality condoms than male condoms. Over 20% reported willingness to use the Reality condom in the future with a partner of unknown HIV status; willingness was associated with past problems with male condoms and no problems with Reality condoms among receptive partners, and with past use of Reality condoms and HIV seropositivity among insertive partners. CONCLUSIONS: Men reported more frequent problems with Reality condoms than male latex condoms used for anal intercourse, particularly slippage, discomfort, and rectal bleeding. Design modifications, training, and research on the clinical significance of safety outcomes are needed for use of Reality condoms with anal sex.     

Knowledge and Acceptability of HIV pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in Ghana

ABSTRACT

In Ghana, men who have sex with men (MSM) are disproportionately affected by HIV. Pre-exposure prophylaxis (PrEP) is a biomedical intervention that reduces the risk of HIV infection but is not currently available in Ghana. This paper explores knowledge and acceptability of HIV PrEP among Ghanaian MSM. Qualitative content analysis was conducted on 22 focus group discussions (N?=?137) conducted between March and June 2012 in Accra, Kumasi, and Manya Krobo. Overall, participants reported low knowledge of PrEP. However, once information about PrEP was provided, there was high acceptability. The primary reason for acceptability was that PrEP provided an extra level of protection against HIV. Acceptability of PrEP was conditioned on it having minimal side effects, being affordable and efficient in preventing HIV infection. No acceptability of PrEP was attributed to limited knowledge of side effects and perceived lack of effectiveness. The reasons provided to utilize PrEP and condoms were that condoms protect against other STIs, and sexual partner factors. This is the first known study to explore PrEP knowledge and acceptability among Ghanaian MSM. It is important that key stakeholders preemptively address potential barriers to PrEP acceptability, uptake, and adherence, especially among MSM, once PrEP becomes available in Ghana.     

Substance use and high-risk sex among men who have sex with men: a national online study in the USA

This paper describes drug and sexual risk behaviors during a six-month period in 2001 of 2,916 gay and bisexual men who were recruited online. Bivariate and multivariate analyses examined correlates of unprotected anal intercourse (UAI). Drug and alcohol use were also examined by US region. UAI was associated with using alcohol or drugs, including poppers, crystal methamphetamine, cocaine, marijuana and Viagra before or during sex. Meeting sex partners both online and offline and having multiple sex partners were also predictive of UAI. Significant regional differences were seen in the prevalence of drug use and alcohol use. Findings are discussed in relation to the need to integrate messages about the relationship between drug use and sexual behavior into HIV prevention programs.     

Incidence of Hepatitis-C among HIV infected men who have sex with men (MSM) attending a sexual health service: a cohort study

Background  

We aimed to determine the incidence of Hepatitis C (HCV) infection among HIV-infected men who have sex with men (MSM) attending a Sexual Health Centre.     

Rectal use of nonoxynol-9 among men who have sex with men

OBJECTIVES: To assess recent rectal use of nonoxynol-9 (N-9), intent to use the product, and factors associated with N-9 use among men who have sex with men (MSM). DESIGN: Cross-sectional survey of a diverse sample of MSM in the San Francisco Bay Area. METHODS: Recruitment conducted at multiple street locations on various days/times or through referral during the Fall of 2001. RESULTS: Sixty-one percent (349/573) had heard of N-9, of which 55% (192/349) reported hearing in the prior year that N-9 may not be protective against HIV. Of men aware of N-9, 83% (289/349) knowingly used it in their lifetime, of which 67% (193/289) used it during anal intercourse in the previous year. Forty-one percent (79/193) of those who used N-9 during anal intercourse in the past year did so without a condom because they thought it may protect against HIV. Older men were more likely than younger men to have used N-9 for protection. Men who heard that N-9 may not protect were less likely, and African-Americans (versus Caucasians) were more likely, to say they would definitely use N-9 during anal intercourse in the future. Latinos (versus Caucasians), those with unknown HIV serostatus (versus HIV-negative), and those with lower education were less likely to know about N-9 at all, and thus were at risk for unknowingly using N-9. CONCLUSIONS: Many MSM used N-9 during or following public health warnings about the product. Actions (e.g., information campaigns, warning labels specific to rectal use) should be considered by communities to reduce rectal use of N-9.     

Determinants of condom use among HIV-positive men who have sex with men

The main objectives of this study were to identify the determinants of condom use among HIV-positive men having anal sex with HIV-negative men or men of unknown HIV status and moderators of the intention-behaviour relationship. A cohort of 237 sexually active HIV-positive men having sex with men was followed over a period of six months. The cognitive variables measured were guided by an extended version of the theory of planned behaviour. Results indicated that past behaviour (odds ratio [OR] = 9.75; 95% confidence interval [CI]: 4.48-21.26), intention (OR = 3.13; 95% CI: 1.25-7.81), self-efficacy (OR = 3.62; 95% CI: 1.40-9.37) and use of sex drugs (OR = 0.16; 95% CI: 0.06-0.45) contributed to the prediction of 100% condom use. Self-efficacy also interacted with intention as a significant moderator of the intention-behaviour relationship (OR = 20.96; 95% CI: 2.90-151.51). Interventions promoting condom use should increase self-efficacy to use condoms and target users of sex drugs.     

A shared regulatory perspective on deferral from blood donation of men who have sex with men (MSM)

National Regulatory Authorities (NRAs) establish deferral criteria for donors with risk factors for transfusion transmissible infections (TTI). In most jurisdictions, epidemiological data show that men who have sex with men (MSM) have a significantly higher rate of TTI than the general population. Nevertheless, changes from an indefinite donor deferral for MSM have been considered in many countries in response to concerns over a perceived discrimination and questioning of the scientific need. Changes to MSM donor deferral criteria should be based on sound scientific evidence. Safety of transfusion recipients should be the first priority, and stakeholder input should be sought.     

Alcohol use, drug use and alcohol-related problems among men who have sex with men: the Urban Men's Health Study

Aims . To measure the prevalence and independent associations of heavy and problematic use of alcohol and recreational drugs among a household-based sample of urban MSM (men who have sex with men).
Design . Cross-sectional survey.
Participants . Men who identified as being gay or bisexual or who reported sex with another man in the prior 5 years were included in this analysis ( n = 2172).
Setting . A probability telephone sample of MSM was taken within Zip Codes of four large American cities (Chicago, Los Angeles, New York and San Francisco) estimated to have total concentrations of at least 4% of all households with one resident MSM.
Measurements . Standard measures of alcohol use, problems associated with alcohol use, and recreational drug use were administered by trained telephone interviewers.
Findings . Both recreational drug (52%) and alcohol use (85%) were highly prevalent among urban MSM, while current levels of multiple drug use (18%), three or more alcohol-related problems (12%), frequent drug use (19%) and heavy-frequent alcohol use (8%) were not uncommon. The associations of heavy and/or problematic substance use are complex, with independent multivariate associations found at the levels of demographics, adverse early life circumstances, current mental health status, social and sexual practices and connection to gay male culture.
Conclusions . The complex pattern of associations with heavy and/or problematic substance use among urban MSM suggests that heavy and/or problematic substance use is grounded in multiple levels: the individual, the interpersonal and the socio-cultural.     

湖北省男男性行为人群艾滋病流行状况及影响因素调查

目的了解湖北省男男性行为人群(MSM)艾滋病流行状况和行为学影响因素。方法采用滚雪球、场所和网络招募的方法,对MSM进行问卷调查和血清学检测。结果 2010年和2011年湖北省MSM艾滋病哨点分别调查2 275人和2 644人。两年各发现73例和98例艾滋病病毒(HIV)感染者,阳性率为3.22%(73/2 266)和3.71%(98/2 644)。干预和人口学特征是导致安全套使用、商业性行为、异性性行为、吸毒和接受干预等方面差异的影响因素。结论湖北省艾滋病哨点干预措施对遏制MSM人群艾滋病流行有积极的作用,但"知行分离"情况较为严重,应重视人口学特征对行为学的潜在影响。     

山东省男性同性恋者综合行为监测情况分析

目的了解山东省男性同性恋行为特征及性病艾滋病感染状况,为实施有效的干预措施和防治对策提供信息和依据。方法对同性恋活动场所的157名男性同性恋者进行匿名问卷调查,并采集血标本。结果共调查男性同性恋者157人,以青壮年为主,平均年龄26岁,文化程度较高。艾滋病病毒(HIV)及梅毒阳性率均为4.5%。这部分人群艾滋病知识总知晓率较高,但采取高危险性行为的比例也非常高,最近6个月在肛交时坚持使用安全套的比例仅为29.9%。结论山东省男性同性恋人群中已经有较高的HIV感染率,并且艾滋病相关的高危行为普遍存在,必须对此类高危人群采取有效干预措施,同时加强中学生的性健康教育也迫在眉捷。     

Depression and anxiety among HIV-positive men who have sex with men and men who have sex with women in China

ABSTRACT

China is experiencing an emerging HIV epidemic among men who have sex with men (MSM). Minority stress theory posits that marginalized populations experience additional stress, which influences experiences of psychological distress and health outcomes. This study aimed to understand psychological distress of MSM relative to men who have sex with women (MSW) in an urban Chinese setting. Cross-sectional survey data were collected from 162 HIV-positive Chinese men receiving HIV treatment at Beijing’s Ditan Hospital. Multiple linear regression with imputation was used to identify correlates of psychological distress. Relative to MSW, MSM were younger, more educated, and less likely to be in a relationship or have children. While both groups reported clinically elevated levels of depression and anxiety, sexual behavior was not associated with either outcome. Higher endorsement of depression symptomology was associated with worse reported physical health (β?=??1.37, p?<?.05) and greater endorsement of maladaptive coping (β?=?2.39, p?<?.05), whereas higher endorsement of anxiety symptomology was associated with greater endorsement of adaptive coping (β?=?0.78, p?<?.05), diminished physical health (β?=??0.86, p?<?.05), and a high school or greater level of education (β?=?4.13, p?<?.05). These findings suggest that interventions targeting coping strategies may address psychological distress among HIV-positive Chinese men.