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     

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.     

绵阳市年轻男男性行为者性行为特征及肛交多性伴影响因素

目的 了解年轻男男性行为者（YMSM）性行为特征现状,分析肛交多性伴影响因素。方法 以四川省绵阳市15~24周岁YMSM为对象,用滚雪球抽样法招募调查对象,进行社会人口学及性行为等调查和血清学检测。肛交多性伴影响因素单因素分析用χ²检验,多因素分析用非条件Logistic回归。结果 共回收有效问卷362份,近6个月肛交63.8%、异性性伴7.7%、男性商业性伴8.8%、固定性伴74.7%、偶然性伴53.3%,多性伴32.3%,性角色插入方31.3%、被插入方41.0%、均可27.6%。多性伴者HIV-抗体阳性率15.4%,高于无多性伴的6.1% (P=0.004）。多因素分析结果显示,社区朋友>10人、曾自杀未遂、浴室/公园/互联网型寻找性伴、近6个月偶然性伴、近6个月固定性伴无保护肛交是多性伴危险因素,年龄>18岁、文化程度大专及以上是保护因素(P<0.05)。结论 YMSM具一定性行为特征,多性伴与人口学特征、社会及性行为相关联,应针对性开展行为干预。     

中青年男男性行为者高危行为特征及HIV检测现状

目的 了解中青年男男性行为者定期检测HIV的情况,分析性行为特征及影响因素,为推广定期检测提供实践依据。方法 通过医疗机构、社会组织、网络平台等途径,采用混雪球方法招募调查对象,开展匿名式电子问卷调查。结果 2016年1月—2018年6月开展男男性行为者专题宣传、干预、检测活动,符合要求的调查对象832人,招募并回收问卷792份,其中有效问卷760份,其中定期进行HIV抗体检测人数仅占58.68%,单因素分析显示,学历、对艾滋病防控知识、近1年性行为史、男男性行为角色、近半年男性性伴个数、近半年未戴安全套情况与是否定期HIV检测可能较为密切的关系,差异有统计学意义（P<0.05）。结论 中青年男男人群定期进行HIV抗体检测率有待于进一步提高,需进一步加强艾滋病防控及检测的干预,提高高危人群安全性行为意识。     

深圳市男男性行为者双性性行为特征及影响因素

目的了解深圳市男男性行为者（Men who have sex with men,MSM）双性性行为特征及影响因素。方法对2009～2011年深圳市MSM人群监测资料进行单因素和多因素Logistic回归分析。结果共有2 943例接受自愿咨询检测,HIV感染率为7.88%,梅毒感染率为20.76%,HIV合并梅毒感染率4.38%。最近6个月内,809例（27.49%）发生了双性性行为。多因素Logistic回归分析结果表明,MSM人群发生双性性行为与文化程度、婚姻状况、月收入、做过MB、性取向及性角色有关。大专及以上文化程度为MSM人群发生双性性行为的阻碍因素,已婚、月收入3千元、5千元和≥1万元、曾经或现在仍做MB、性取向为双性恋和异性恋者、性角色以主动为主者、主动被动两者兼有者和极少肛交或多口交为MSM人群发生双性性行为的促进因素。结论应在MSM人群中采取有效的干预措施,以阻断HIV由MSM人群向普通人群传播。     

云南省曲靖市存在两性性伴的男男性行为者艾滋病高危行为调查分析

目的了解曲靖市存在两性性伴的男男性行为者艾滋病高危行为状况,确定干预工作的重点。方法采用"滚雪球"的方式接触目标人群,进行一对一问卷调查。结果存在两性性伴的男男性行为者,女性性伴数平均为(1.05±0.22)人,男性性伴数平均为(3.78±2.59)人。最近一次与男性性伴肛交时使用安全套的占72.7%;最近一次与女性发生性行为时,使用安全套的仅占22.0%。结论曲靖市存在两性性伴的男男性行为者,无保护性行为较常见,存在较大感染和传播艾滋病的风险。     

High risk health behaviours among adult Jamaicans

The purpose of this study was to assess the prevalence of high risk health behaviours among adult Jamaicans aged 15-49 years in 2000, and to compare the results with the 1993 survey. A nationally representative sample of 2013 persons aged 15-74 years was surveyed in 2000 using cluster sampling in the Jamaica Healthy Lifestyle Survey (Wilks et al, unpublished). Interviewer administered questionnaires and anthropometrical measurements were done. Data for a sub-sample of adults aged 15-49 years were analyzed The sub-sample included 1401 persons (473 men and 928 women). Significantly more men (18.6%) than women (4.3%) reported never having had a blood pressure check (p = 0.0001). Approximately one-third of the women reported that they had never had a Pap smear (36.0%) or a breast examination (31.2%). Current cigarette smoking was reported in 28.6% of men and 7.7% of women (OR 3.73 CI 2.71, 5.15), while 49.0% of men and 15.0% of women ever smoked marijuana (OR 3.28 CI 2.56, 4.20). Significantly more men (28.0%) than women (11.7%) reported ever having a sexually transmitted disease (OR 2.93 CI 2.16, 3.97); having more than one sexual partner in the past year (49.1% vs 11.4%, OR 4.31 CI 3.22, 5.76) and usually using a condom during sexual intercourse (55.3% vs 40.5%, OR 1.3 CI 1.11, 1.68). Between 1993 and 2000, significant trends include: more persons reported having a blood pressure check, a reduction in multiple sexual partners, increased condom use at last sex (women), reduced crack/cocaine use (males) and increased marijuana smoking. Although there were some significant positive lifestyle trends between 1993 and 2000, high risk behaviours remain common among Jamaican adults. Comprehensive health promotion programmes are needed to address these risk behaviours.     

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。     

扬州市MSM人群艾滋病高危行为特征?感染状况及影响因素分析

目的:了解江苏省扬州市男男性行为者(men who have sex with men,MSM)艾滋病高危行为特征?感染情况及其影响因素?方法:采用横断面调查设计,采取分类滚雪球抽样的方法于2008年5月起,对扬州市范围内的MSM人群就艾滋病知识态度?高危行为特征的面对面问卷调查结果,以及血样的人类免疫缺陷病毒(human immunodeficiency virus,HIV)及其他性传播疾病(sexually transmitted disease,STD)感染的实验室检测数据进行统计分析?结果:所调查300例MSM中,82.7%最近6个月发生过同性性行为,其中79.4%有多个同性性伴;48.7%曾与异性发生过性行为,其中21.2%有多个异性性伴;最近6个月与同性发生肛交性行为时坚持使用安全套的比例为52.0%,与异性发生性行为时该比例为21.2%?均采集血样进行了血清学检测,确证HIV阳性22例,阳性率为7.3%;确证梅毒抗体阳性66例,阳性率为22.0%;未发现丙型肝炎病毒抗体阳性?在多因素Logistic回归模型中,常通过互联网寻找性伴(OR=1.93,95%CI:1.01~3.67)和最近6个月曾与固定性伴发生性行为(OR=0.45,95%CI:0.25~0.79)与最近6个月同性性行为时安全套坚持使用率的关系有统计学意义;梅毒感染(OR=3.17,95%CI:1.25~7.99)与HIV感染的关系具有统计学意义?结论:扬州市MSM人群无保护性性行为及多性伴现象较为普遍,HIV和梅毒感染率较高,需要进一步加强对该人群的行为干预以防止艾滋病在该人群中的蔓延以及传播至一般人群?     

深圳市男男性行为者艾滋病知晓率及异性性行为特征调查

目的了解男男性行为者艾滋病知晓率及异性性行为特征,为有针对性地制定干预措施提供参考依据。方法成立彩虹工作组,开展外展服务,知情同意原则下,填写调查问卷。结果共调查458例,双性恋占42．6％;艾滋病知识知晓率低,风险感知认识薄弱;最近一年曾经和女性发生性行为的比例达26．6％,和自己的配偶或固定女友发生性行为时,多数不用或从来不用安全套的比例较高,与之相反,和不固定非商业性女性或女性性工作者发生性行为时,每次用或多数用安全套的比例较高。结论相当比例的男男性行为者具有双性性行为,起着HIV传播的桥梁作用,应加强健康教育和行为干预。     

MSM艾滋病防治信息获取意愿及不同来源效力认定的人口和行为学特征

目的 了解男男性行为者(MSM)艾滋病防治信息获取途径意愿及对不同信息来源效力的自我认定,分析其人口及行为学特征。方法 以四川省绵阳市辖区MSM为对象,采用滚雪球抽样法招募调查对象,在社区组织办公场所和临时茶园进行自填式匿名行为学及血清学调查。结果 合格调查1 176人,艾滋病防治信息获取途径意愿依次为朋友41.9% 、网站22.3%、同伴20.6%,影响效力最大者依次为朋友62.0%、同伴21.0%、家人10.9%、男朋友6.0%,87.7%认为互联网是影响最大媒介渠道。年龄≥30岁、双性恋及其他性取向、本地居住时间≤12个月、社区朋友数<5人者源于家人,离异丧偶者源于男朋友,年龄20~29岁、大专及以上文化、本地居住时间>12个月、知晓艾滋病知识、做过HIV检测、近6个月肛交有保护性、有异地性行为者源于朋友,高中及以下文化、社区朋友数≥10人、接受过同伴教育、近1次肛交有保护性、多性伴、高频率肛交者源于同伴的防治信息效力最大(P均<0.05)。结论 MSM以朋友、同伴获取防治信息的意愿高、效力大,网络的媒介渠道作用明显,不同防治信息效力认定具有不同人口及行为学特征。     

绵阳市男男性行为者异地性行为现状及影响因素

目的了解男男性行为者(MSM)异地性行为现状,分析影响因素。方法 2016年2—11月,以四川省绵阳市辖区MSM为对象,采用滚雪球抽样法,在知情同意下,进行调查对象招募调查及血清学检测。结果合格调查1 073人中,有异地性行为者为6.7%。异地性行为地方为附近县的15.3%、绵阳34.7%、成都15.3%、省外等其他地区34.7%。每天平均性行为(1.6±1.038)次,偶然性伴72.1%、固定性伴27.9%。寻找性伴场所类型69.1%为网络型、11.8%为家庭型,肛交有保护性73.5%。异地性行为HIV感染率12.5%,高于无异地性行为的5.5%(P0.05)。多因素分析,离异丧偶、本地居住时间短、生理需求为第一需求、最近1次肛交无保护性行为、近6个月肛交人数≥2发生异地性行为可能性较高(P均0.05)。结论 MSM异地性行为以大中城市、网络型、偶然性伴为主,无保护、多性伴比例较高,增大了HIV感染和跨区域传播风险。     

男男性行为者艾滋病高危行为现状调查

目的了解男男性接触人群中艾滋病相关高危行为特征,为该类人群艾滋病防治工作提供数据。方法分析2011-2012年开展男男性接触人群调查时所收集的资料,比较男男性接触人群中艾滋病感染者与未感染者的相关高危行为特征。结果与未感染者相比（90.6%）,艾滋病感染者艾滋病防治知识知晓水平较低（81.7%）;与未感染者相比（40.8%）,发生首次性行为的性伴女性所占比例较高（55.0%）。最近6个月,艾滋病感染者发生插入性性行为的男性性伴数多于未感染者（78.3%vs 65.2%）,与男性发生无保护性性行为的比例高于未感染者（73.3%vs64.9%）,与女性发生性行为的比例高于未感染者（36.7%vs 22.9%）,性病感染几率高于未感染者（21.7%vs15.4%）。结论男男性接触人群中艾滋病感染者相关高危行为较未感染者严重,应进一步加强对该类人群的宣传教育,采取干预措施减少其高危行为,防止艾滋病由男男性接触人群向一般人群传播。     

Seroprevalence of sexually transmitted infections among accepted and deferred blood donors in Jamaica

Critical donor selection and testing increases the safety of blood transfusion by excluding donors at risk of transmitting infections. This study investigated the seroprevalence of and risk factors for sexually transmitted infections (STIs) among accepted and deferred blood donors in Jamaica. A total of 1015 blood donors consisting of 794 (78%) accepted donors and 221 (22%) deferred donors presenting at the Central Blood Bank, Jamaica, over a six-month period, were recruited for this study. A standardized questionnaire was administered to each participant and a sample of blood obtained for detection of hepatitis B surface antigen, antibodies to Treponema pallidum, human immunodeficiency virus (HIV) and human T-cell lymphotrophic virus type-1 (HTLV-1). Deferred donors were three times more likely to be seropositive for STI than accepted donors (16.3% vs 5.2%, OR 3.57, 95% CI 2.16 - 5.90, p < 0.0001). Males had significant association between STI seropositivity and having fathered children with two or more women (p = 0.0085), unprotected sexual intercourse with several persons (p = 0.0326), and history of genital herpes (p = 0.0121). Significant risk factors identified among females were unprotected sex with several partners (p = 0.0385); having more than ten lifetime partners (p = 0.0105); and use of depoprovera (p = 0.0028). This study confirms higher rates of STI among deferred blood donors and supports the donor deferral system in Jamaica.     

中小城市男男性接触者艾滋病知识水平与行为调查

目的了解中小城市男男性接触者(MSM)的艾滋病相关知识水平及其高危行为状况。方法采用滚雪球抽样法和方便抽样法选取对象,用自行设计的《同志健康需求评估》问卷开展调查。结果共调查214名MSM,对艾滋病传播知识的正答率超过70%;在近一年内,90.7%的调查对象性伴数超过1个,66.0%的被调查者与陌生性伴发生性关系;肛交与口交率分别达到84.7%和91.2%,且每次使用安全套率分别为32.9%和3.6%;44.4%在婚或离异,37.2%与异性发生过性关系。结论中小城市MSM人群存在高度流行并向一般人群传播的危险因素,对其开展切实有效的艾滋病干预工作已是刻不容缓。     

男男性行为人群中HIV感染者艾滋病相关高危行为特征分析

目的了解男男性行为人群(MSM)中HIV感染者的高危行为特征,为开展MSM人群艾滋病防治工作提供建议。方法利用2006~2007年重庆市开展MSM人群调查的资料,比较MSM人群中HIV感染者与非HIV感染者的高危行为特征。结果MSM人群中的HIV感染者较非感染者艾滋病防治知识认知水平较低(85.5%vs 90.3%),HIV感染者发生首次性行为的性伴女性所占比例高于非HIV感染者(53.4%vs 41.5%)、最近6个月发生插入性性行为的男性性伴数多于非HIV感染者(79.0%vs 65.1%),最近6个月与男性发生无保护性性行为的比例高于非感染者(73.4%vs 64.9%),最近6个月与女性发生性行为的比例高于非感染者(36.8%vs 23.1%),最近1次与女性发生性行为时安全套使用率更低(18.4%vs 35.6%)、自报性病感染史高于非感染者(21.1%vs 15.4%)、梅毒感染率HIV感染者高于非感染者(19.2%vs 7.6%)。结论MSM人群中HIV感染者多性伴、高无保护性性行为比例、防治知识缺乏、高性病感染等高危因素使他们成为了HIV感染者,同时,HIV感染者与女性发生性行为的比例较高,并...     

中小城市男男性接触者艾滋病知识情况调查

目的深入了解中小城市男男性接触者(MSM)的艾滋病相关知识情况,为开展针对性的干预提供依据。方法采用滚雪球抽样法和方便抽样法选择对象,用自行设计的《同志健康需求评估》问卷开展调查。结果共回收有效问卷214份,平均年龄32±11.02岁,文化程度、婚姻状况、职业、经济状况等因素与艾滋病相关知识掌握程度间不存在明显联系,但年龄、是否上网、性伴侣数多少等因素可影响艾滋病相关知识的掌握。调查对象的知识主要来自大众媒体的宣传。结论中小城市MSM艾滋病相关知识仍处于较低水平,年龄、上网情况、性伴侣数量是其知识传播过程中的影响因素,制定针对性的干预计划,是提高MSM知识水平的重要环节。     

男性双性性行为者性取向及群体性行为特征分析

目的研究男性双性性行为者性取向构成及群体性行为特征。方法选择男男性行为者(MSM)聚集的浴池、酒吧、公园、会所为目标场所,采用分层整群抽样方法,抽取473名兼有异性性行为的MSM,开展匿名问卷调查,同时进行艾滋病和梅毒血清学检测。对社区志愿者组织(CBO)关键人物及场所业主开展深度访谈。对相关信息资料进行定性和定量分析。结果 473名MSM中,检出HIV阳性率为4.44%,梅毒阳性率为20.93%;同性恋占52.22%,双性恋占36.36%,异性恋占6.34%,性取向不确定者占5.08%;75.90%的人曾与异性谈过恋爱;在性角色扮演方面,"1"(扮演"丈夫"者)占37.63%,"0.5"(可扮演"丈夫"或"妻子"者)占45.03%,"0"(扮演"妻子"者)占比最低,为16.28%,拒答者占1.06%;通过网络途径结识性伴的占31.50%;65.96%的人经历过"一夜情";性行为时坚持使用安全套比例为37.21%。结论男性双性性行为人群性取向构成多元化,多性伴现象严重,安全套使用率低,应有针对性地加强该人群的干预。     

Sexual practices and "beats": AIDS-related sexual practices in a sample of homosexual and bisexual men in the western area of Sydney

One hundred and seventy-six men who had engaged in sexual activity with other men in the past six months were interviewed, in the western area of Sydney, about their sexual activities and knowledge as related to the acquired immunodeficiency syndrome (AIDS). Comparisons were made between men who had frequented "beats" (public toilets, parks or isolated roads where men meet for homosexual encounters) in the past six months, and those who did not use beats. One-quarter of those men who frequented beats reported beats as their only venue for meeting men for sexual contact, while other men reported them as one of many venues that they used to meet men. Although all interviewed men were engaging in sexual activities with men, 12 men described themselves as heterosexual, and 12% of those men who used beats, and 7% of the beat non-users, were married or in de-facto relationships. In comparing those who used beats with the beat non-users, 64% of beat users had engaged in sexual practices with between six and 50 different partners in the past six months compared with 8% of beat non-users. Beat users also were more likely to engage in unprotected anal intercourse with causal partners. Nineteen men claimed to be HIV-seropositive for the human immunodeficiency virus, with 11 of these men still engaging in high-risk sexual activities. The implications for AIDS education are discussed.     

Attitude towards intimate partner violence against women and risky sexual choices of Jamaican males

For young Jamaican men, it is necessary to prove their virility to their peers and prove to their parents that they are of heterosexual orientation. These demands have produced a society in which men are sexually aggressive, even to the point of using violence to control the sexual choices of women. This paper examines whether Jamaican men who support intimate partner violence (IPV) against women are more likely to have unsafe sexual practices and social attitudes that could increase women 's risk of contracting sexually transmitted infections. Men who responded 'yes' to violence against women are more likely themselves to have multiple sexual partners and less likely to use condoms consistently. They are also more likely to have forced a partner to have sex within the last year. Multivariate regression analysis shows that men who responded 'yes' to IPV are likely to be young, less educated and living in urban areas. Clearly, women in certain regions or subpopulations face an increased risk of contracting sexually transmitted infections due to the sexual choices of their partners. Intervention programmes to reduce sexually transmitted infections need to be developed with specific aspects of the cultural context of sexual relationships in mind. It seems especially important that male sexual choices and attitudes be directly addressed. Specific suggestions are made about an approach that has a proven record of success in reducing risky practices in high risk groups.