A social network typology and sexual risk-taking among men who have sex with men in Cape Town and Port Elizabeth,South Africa

Despite the high prevalence of HIV among men who have sex with men in South Africa, very little is known about their lived realities, including their social and sexual networks. Given the influence of social network structure on sexual risk behaviours, a better understanding of the social contexts of men who have sex with men is essential for informing the design of HIV programming and messaging. This study explored social network connectivity, an understudied network attribute, examining self-reported connectivity between friends, family and sex partners. Data were collected in Cape Town and Port Elizabeth, South Africa, from 78 men who have sex with men who participated in in-depth interviews that included a social network mapping component. Five social network types emerged from the content analysis of these social network maps based on the level of connectivity between family, friends and sex partners, and ranged from disconnected to densely connected networks. The ways in which participants reported sexual risk-taking differed across the five network types, revealing diversity in social network profiles. HIV programming and messaging for this population can greatly benefit from recognising the diversity in lived realities and social connections between men who have sex with men.     

Intimate partner violence among rural South African men: alcohol use,sexual decision-making,and partner communication

Nearly one-third of South African men report enacting intimate partner violence. Beyond the direct health consequences for women, intimate partner violence is also linked to varied risk behaviours among men who enact it, including alcohol abuse, risky sex, and poor healthcare uptake. Little is known about how to reduce violence perpetration among men. We conducted retrospective, in-depth interviews with men (n = 53) who participated in a rural South African programme that targeted masculinities, HIV risk, and intimate partner violence. We conducted computer-assisted thematic qualitative coding alongside a simple rubric to understand how the programme may lead to changes in men's use of intimate partner violence. Many men described new patterns of reduced alcohol intake and improved partner communication, allowing them to respond in ways that did not lead to the escalation of violence. Sexual decision-making changed via reduced sexual entitlement and increased mutuality about whether to have sex. Men articulated the intertwined nature of each of these topics, suggesting that a syndemic lens may be useful for understanding intimate partner violence. These data suggest that alcohol and sexual relationship skills may be useful levers for future violence prevention efforts, and that intimate partner violence may be a tractable issue as men learn new skills for enacting masculinities in their household and in intimate relationships.     

Breakage is the norm: use of condoms and lubrication in anal sex among Black South African men who have sex with men

Abstract

This paper explores condom use and lubrication practices among Black men who have sex with men in South African townships. Results are from 81 in-depth individual interviews conducted among a purposive sample from four townships surrounding Pretoria as part of a larger qualitative study. Awareness that condoms should be used to have safer anal sex was ubiquitous. Fewer men reported that lubricants should be used to facilitate anal intercourse. Partner pressure and partner distrust were the most common barriers cited for not using condoms and lubricants. Knowledge about condom-lubricant compatibility was rare. Condom problems were a norm, with widespread expectations of condom failure. Men’s subjectivities – their perceptions of and preferences for specific brands, types and flavours of condoms and lubricants – influenced engagement with such safer-sex technologies. However, what was available in these settings was often neither what men needed nor preferred. Findings show the need to enhance access to appropriate and comprehensive: safer-sex supplies, health services and health education, and underline the importance of efforts to develop targeted programmes relevant to experiences of men who have sex with men in the South African context.     

Intervening in masculinity: work,relationships and violence among the intimate partners of female sex workers in South India

Although health researchers have begun to examine the forms of violence and power dynamics that play out in the intimate relationships of female sex workers (FSWs) in India, this knowledge has tended to focus on the perspectives of women, leaving men’s motivations and attitudes relatively unexamined. This paper examines the contours of masculinity and gender norms from the perspective of the intimate partners of FSWs. Based on six months of ethnographic research in Northern Karnataka, the study employed two focus group discussions (FGDs) with Devadasi FSWs (N = 17), as well as four FGDs (N = 34) and 30 in-depth interviews with their intimate partners. Given the precarious labour conditions in this region, tensions developed in the participants’ relationships with FSWs, as these men were unable to meet local ideals of manhood. Violence became a way that men attempted to re-secure a sense of control in their relationships with women, and to fulfil fantasies of male power. We recommend that programs engaging men not only address intimate partner violence but also attend to the social and structural realities surrounding these men’s daily lived experiences.     

Gender-based violence and HIV sexual risk behavior: Alcohol use and mental health problems as mediators among women in drinking venues, Cape Town

Gender-based violence is a key determinant of HIV infection among women in South Africa as elsewhere. However, research has not examined potential mediating processes to explain the link between experiencing abuse and engaging in HIV sexual risk behavior. Previous studies suggest that alcohol use and mental health problems may explain how gender-based violence predicts sexual risk. In a prospective study, we examined whether lifetime history of gender-based violence indirectly affects future sexual risk behavior through alcohol use, depression and post-traumatic stress disorder (PTSD) in a high-risk socio-environmental context. We recruited a cohort of 560 women from alcohol drinking venues in a Cape Town, South African township. Participants completed computerized interviews at baseline and 4 months later. We tested prospective mediating associations between gender-based violence, alcohol use, depression, PTSD, and sexual risk behavior. There was a significant indirect effect of gender-based violence on sexual risk behavior through alcohol use, but not mental health problems. Women who were physically and sexually abused drank more, which in turn predicted more unprotected sex. We did not find a mediated relationship between alcohol use and sexual risk behavior through the experience of recent abuse or mental health problems. Alcohol use explains the link between gender-based violence and sexual risk behavior among women attending drinking venues in Cape Town, South Africa. Efforts to reduce HIV risk in South Africa by addressing gender-based violence must also address alcohol use.     

浙江省男男性行为人群网络临时性伴的知情交友状况分析

目的 分析浙江省MSM网络临时性伴的HIV感染状况知情交友（知情交友）状况及相关因素,为干预措施制定提供参考依据。方法 2018年6-12月在杭州市、宁波市、温州市、台州市和绍兴市,由社会组织和自愿咨询与检测门诊招募符合研究对象标准的MSM,招募样本量为793人。采用自行设计问卷,采用面对面方式问卷调查,收集社会人口学特征、艾滋病知识、性行为、知情交友行为等信息。采用SPSS 20.0软件进行统计学分析。结果 在MSM 767人中,最近6个月发生网络临时性行为302人,发生网络型临时性行为、网络/场所混合型临时性行为者分别占62.6%（189/302）和37.4%（113/302）。在网络临时性伴的知情交友中,已告知、已询问和已知晓者分别占54.6%（165/302）、49.2%（146/297）和42.9%（82/191）,知晓网络临时性伴HIV阴性状况后坚持使用安全套者占75.8%（113/149）。多因素logistic回归分析结果显示,最近6个月网络临时性伴的知情交友中未询问的相关因素包括年龄25~34岁（aOR=2.17,95%CI：1.20~3.91）、最近6个月网络临时性伴数>2个（aOR=2.13,95%CI：1.27~3.57）、不认为网络临时性伴HIV感染风险较高（aOR=1.96,95%CI：1.14~3.35）、既往HIV检测数>1次（aOR=0.38,95%CI：0.22~0.66）。结论 浙江省MSM网络临时性伴的知情交友的意愿较高,但知情交友行为及知晓对方HIV检测结果的比例较低,针对MSM的网络临时性伴较多、认为网络临时性伴感染风险低和HIV检测次数较少者,需加强健康教育和促进知情交友的行为干预。     

广州和成都市男男性行为兼异性性行为者的HIV感染状况及性行为特征

目的 了解中国男男性行为兼异性性行为者(MSMW)的HIV感染状况及其与男性和女性的性行为特征.方法 采用“滚雪球”方法在广州和成都市各招募300名MSMW为研究对象,进行问卷调查(社会人口学特征、最近6个月男性性伴种类和特征、男男性行为及安全套使用状况、最近12个月异性性伴种类和特征、异性性行为及安全套使用状况)和HIV抗体检测.结果 共600名MSMW接受问卷调查和HIV检测,HIV感染率和检出率分别为26.2％和8.5％;最近6个月有28.0％的调查对象拥有≥5名男性性伴,肛交行为时每次使用安全套者占44.2％,最近3次和最近1次男男肛交性行为使用安全套者分别为52.3％和63.0％;最近12个月有86.0％的调查对象与女性发生性行为,其中配偶、婚前女友、婚外情人、女性偶然性伴和女性商业性伴的比例分别为65.0％、27.2％、1.5％、12.7％和4.5％,约1/3的调查对象异性性行为时坚持每次使用安全套,36.5％在最近3次异性性行为时均不使用安全套.最近6、12个月成都市MSMW男男性行为时每次使用安全套分别为55.7％和38.3％,均高于广州市(32.7％和25.3％).HIV阳性者中,与男性发生肛交性行为者为91.1％,最近6个月与男性发生肛交行为时每次使用安全套者为49.7％,最近3次和最近1次男男肛交性行为使用安全套者分别为60.5％和69.4％;最近12个月有82.8％阳性调查者与异性发生过性行为,42.0％每次性行为坚持使用安全套,最近3次性行为使用安全套者占47.8％.最近6、12个月,既往检测HIV阳性MSMW从不使用安全套同性和异性性行为的比例(分别为4.3％和12.9％)均低于本次检测HIV阳性MSMW(22.0％和46.3％).结论 MSMW人群的HIV感染率已经处于较高水平,并存在较高比例的无保护男性肛交性行为和女性阴道性交行为,该人群在HIV跨性别传播中的桥梁作用可能加快HIV在普通人群中的蔓延.     

Unseen,unheard and unprotected: prevalence and correlates of violence among female sex workers in Mozambique

Violence against women, including female sex workers, is a public health concern worldwide. This is the first study in Mozambique to estimate the prevalence of and factors associated with physical and sexual violence against female sex workers. We used data collected from 1,250 women recruited using respondent-driven sampling in the cities of Maputo, Beira and Nampula in 2011–12. Participants were 15 years of age and reported having had sex for money in the preceding six months. Prevalence of physical or sexual violence (defined as being hit or battered or raped or forced to have sex within the last 6 months) ranged from 10.0% to 25.6%. Strangers (37.0%) and acquaintances (31.2%) were reported to be the most frequent perpetrators of sexual violence. Among participants who experienced sexual violence, 65.9% and 87.0% did not seek medical care and police assistance, respectively. Physical or sexual violence was associated with city (adjusted odds ratio [AOR] 2.6 and 2.0 Nampula and Beira vs Maputo), age (AOR 1.9, aged 15–24 years vs aged 25 and older), unprotected sex with last client (AOR 1.6) and self-reported sexually transmitted infections (AOR 2.1). The high prevalence of violence found confirms the need for interventions to mitigate this problem.     

Race/ethnic differences in HIV prevalence and risks among adolescent and young adult men who have sex with men

The prevalence of HIV infection is disproportionately higher in both racial/ethnic minority men who have sex with men (MSM) and in men under the age of 25, where the leading exposure category is homosexual contact. Less is known, however, about patterns of HIV prevalence in young racial/ethnic minority MSM. We analyzed data from the Young men’s Survey (YMS), an anonymous, corss-sectional survey of 351 MSM in Baltimore and 529 MSM in New York City, aged 15–22, to determine whether race/ethnicity differences exist in the prevalence of HIV infection and associated risk factors. Potential participants were selected systematically at MSM-identified public venues. Venues and associated time periods for subject selection were selected randomly on a monthly basis. Eligible and willing subjects provided informed consent and underwent an interview, HIV pretest counseling, and a blood draw for HIV antibody testing. In multivariate analysis, adjusted for city of recruitment, and age, HIV seroprevalence was highest for African Americans [adjusted odds ratio (AOR)=12.5], intermediate for those of “other/mixed” race/ethnicity (AOR=8.6), and moderately elevated for Hispanics (AOR=4.6) as compared to whites. Stratified analysis showed different risk factors for HIV prevalence in each ethnic group: for African Americans, these were history of sexually transmitted diseases (STDs) and not being in school; for Hispanics, risk factors were being aged 20–22, greater number of male partners and use of recreational drugs; and for those of “other/mixed” race/ethnicity, risk factors included injection drug use and (marginally) STDs. These findings suggest the need for HIV prevention and testing programs which target young racial/ethnic, minority MSM and highlight identified risk factors and behaviors.     

Adapting the minority stress model: associations between gender non-conformity stigma, HIV-related stigma and depression among men who have sex with men in South India

Marginalization and stigmatization heighten the vulnerability of sexual minorities to inequitable mental health outcomes. There is a dearth of information regarding stigma and mental health among men who have sex with men (MSM) in India. We adapted Meyer's minority stress model to explore associations between stigma and depression among MSM in South India. The study objective was to examine the influence of sexual stigma, gender non-conformity stigma (GNS) and HIV-related stigma (HIV-S) on depression among MSM in South India. A cross-sectional survey was administered to MSM in urban (Chennai) (n=100) and semi-urban (Kumbakonam) (n=100) locations in Tamil Nadu. The majority of participants reported moderate/severe depression scores. Participants in Chennai reported significantly higher levels of GNS, social support and resilient coping, and lower levels of HIV-S and depression, than participants in Kumbakonam. Hierarchical block regression analyses were conducted to measure associations between independent (GNS, HIV-S), moderator (social support, resilient coping) and dependent (depression) variables. Sexual stigma was not included in regression analyses due to multicollinearity with GNS. The first regression analyses assessed associations between depression and stigma subtypes. In Chennai, perceived GNS was associated with depression; in Kumbakonam enacted/perceived GNS and vicarious HIV-S were associated with depression. In the moderation analyses, overall GNS and HIV-S scores (subtypes combined) accounted for a significant amount of variability in depression in both locations, although HIV-S was only a significant predictor in Kumbakonam. Social support and resilient coping were associated with lower depression but did not moderate the influence of HIV-S or GNS on depression. Differences in stigma, coping, social support and depression between locations highlight the salience of considering geographical context in stigma analyses. Associations between HIV-S and depression among HIV-negative MSM emphasize the significance of symbolic stigma. Findings may inform multi-level stigma reduction and health promotion interventions with MSM in South India.     

Substance use,gender inequity,violence and sexual risk among couples in Cape Town

Alcohol and other drug use, gender power inequities and violence are key contributors to sexual risks for HIV among South African men and women. Little is known about the intersection between these sex-risk behaviours among couples in established heterosexual relationships. We conducted 10 focus-group discussions with men and women in relationships of 1 year or longer recruited from shebeens (informal taverns) in Cape Town, South Africa. Participants described: high levels of alcohol consumption at shebeens; low levels of condom use with main and casual sex partners; gender roles disfavouring women's condom negotiating power that also promoted economic dependency on male partners; men often spending a portion of the household income on alcohol and other drugs and sex with others in shebeens; loss of household income driving women to trade sex to provide for their families; and sexual violence and the exploitation of women occurring in shebeens. Findings highlight how the social contexts of alcohol and other drug use, gender inequitable norms and gender violence promote HIV risk within established heterosexual relationships in South African communities. Evidence of this kind should inform the design of HIV-risk-reduction interventions tailored to heterosexual couples who drink alcohol in shebeens.     

男男性行为人群主要性伴类型特征及其未检测HIV相关因素分析

目的 比较主要性伴类型不同的MSM特征,分析MSM最近6个月未检测HIV的相关因素。方法 2021年4-7月在山东省9个城市招募MSM,开展面对面问卷调查,收集其社会人口学特征、高危行为和HIV检测等信息,采集血样用于HIV抗体和梅毒抗体检测。结果 最近6个月发生同性肛交性行为的MSM共3 008人,将MSM根据最近6个月主要性伴类型分为固定性伴组(36.83%,1 108/3 008)、商业性伴组(3.06%,92/3 008)和临时性伴组(60.11%,1 808/3 008)。不同组别MSM的年龄、本地居住时间、文化程度、寻找男性性伴的主要场所、最近6个月新型毒品使用、肛交每次坚持使用安全套、发生群交行为、未检测HIV和最近1年患过性病、接受同伴教育、梅毒检测频率的分布差异有统计学意义(均P<0.05)。多因素logistic回归分析结果显示,MSM最近6个月未检测HIV的相关因素包括年龄<30岁(aOR=1.39,95%CI:1.06~1.83)、已婚/同居(aOR=1.74,95%CI:1.39~2.16)、高中及以下文化程度(aOR=1.39,95%CI:1.15~1.67)、最近6个月未使用新型毒品(aOR=2.27,95%CI:1.89~2.71)、最近1年未接受同伴教育(aOR=1.59,95%CI:1.28~1.98)、从未做过梅毒检测(aOR=11.30,95%CI:8.15~15.66)、最近1年未做但以前做过梅毒检测(aOR=5.65,95%CI:4.19~7.62)、最近6个月主要性伴类型是商业性伴(aOR=1.80,95%CI:1.01~3.20)和最近6个月主要性伴类型是临时性伴(aOR=1.50,95%CI:1.26~1.80)。结论 主要性伴类型不同的MSM特征有所差异,HIV检测比例仍有待提高。今后应针对主要性伴类型不同的MSM特征,充分利用网络和同伴教育等方法扩大MSM HIV检测覆盖率。     

男男性行为人群的异性性伴HIV易感性研究进展

受自身、家庭、社会等因素影响,超过70.0%的MSM具有结婚意愿,超过90.0%的MSM认为婚姻不可避免,由此产生了一类与MSM密切相关的弱势群体即MSM异性性伴（同妻）。因MSM本身即为HIV感染的高危人群,加之其他易感因素的存在,使得同妻感染HIV的风险增加,成为了HIV感染的重点人群。本文从同妻定义、人群规模,同妻生理健康及HIV易感因素方面进行综述,旨在为同妻人群后续开展性传播疾病防控工作的方向提供依据。     

南京市2008－2013年男男性行为人群早期梅毒及HIV感染率变化趋势分析

目的 了解南京市男男性行为人群早期梅毒、HIV感染流行水平及变化趋势,为估计疫情进展,调整、制订控制策略和干预措施提供依据.方法 对2008－2013年自愿接受艾滋病、梅毒咨询检测的男男性行为者进行梅毒和HIV感染的血清学监测,对梅毒血清学试验阳性者进行性病诊疗转介,以明确其临床诊断和分期.分析被调查人群人口学特征及早期梅毒、HIV感染和合并HIV感染的早期梅毒流行状况及其变化趋势.结果 2008－2013年各年度分别监测1 004、1 218、1 236、748、1 019和1 420名男男性行为者.各年度早期梅毒的感染率分别为2.19%、2.71%、2.43%、1.74%、3.04%和2.32%,趋势检验P> 0.05;HIV感染率分别为1.29%、2.63%、5.42%、8.82%、11.97%和10.42%,趋势检验P< 0.01;合并HIV感染的早期梅毒感染率从2008年的0.20%上升至2013年的1.06%,趋势检验P< 0.01;合并HIV感染的早期梅毒占早期梅毒的比例从2008年的9.09%上升至2013年的45.45%,趋势检验P< 0.01.结论 南京市男男性行为人群早期梅毒的流行趋于平稳,HIV感染状况上升趋势明显,合并HIV感染的早期梅毒的流行呈上升趋势,其占早期梅毒的比例也呈逐年增长的态势.在男男性行为人群中需要采取持续有效的干预措施以应对梅毒及HIV感染的流行.     

Survival now versus survival later: immediate and delayed HIV risk assessment among young Jamaican men who have transactional sex with men

This study explored the experiences of young Jamaican men who have sex with men who engaged in transactional sex as a result of homelessness, family neglect or limited financial resources. It further examined the circumstances that affect their immediate or delayed decisions around sexual risk and increased vulnerability for HIV infection. Barriers experienced when accessing condoms, healthcare, HIV testing and other prevention services are also described. Twenty in-depth interviews and one focus group with 10 participants in various parishes in Jamaica were conducted. Findings from this study reveal how stigma and discrimination in the form of pervasive homophobia-influenced participation in the street economy via transactional sex. Socio-structural factors at family and commity level led to diminished social/economic prospects, which extended into adulthood. Sexual decision making was based on immediate needs for protection, food or shelter; concerns about acquiring HIV were considered only after meeting those immediate needs. Future HIV prevention strategies must take seriously the socio-structural factors that influence HIV risk behaviours among young men who have sex with men in Jamaica.     

同性交友方式对男男性行为人群高危性行为及感染HIV的相关影响

目的 了解同性交友方式对MSM的高危性行为及HIV感染的相关影响。方法 采用横断面调查方法,2018年4-11月在宁波市采用滚雪球的非概率抽样法招募MSM,收集其人口学特征、交友方式、同性社交软件使用、高危性行为发生情况等相关信息,研究对象均需进行HIV抗体检测。分类资料采用χ²检验,采用多因素logistic回归分析MSM的HIV感染相关因素。结果 共调查MSM 735人,同性社交软件交友者、QQ或微信交友者和场所交友者分别为447人（60.8%）、237人（32.3%）和51人（6.9%）。同性社交软件交友者最近6个月性行为次数≥ 1次/周和发生多性伴的分别有75人（16.8%）和187人（41.8%）;最近1次和最近6个月发生无保护肛交行为的分别有54人（12.1%）和234人（52.3%）;HIV感染率为12.1%（54/447）。感染时间<2年的HIV/AIDS中,同性社交软件使用时间<2年的比例为68.6%（24/35）。多因素logistic回归分析结果显示,与QQ或微信交友者比较,同性社交软件交友者更易感染HIV（OR=3.03,95% CI：1.30~7.07）。结论 宁波市MSM中,同性社交软件交友者比例较高,存在较高危险性行为和HIV感染风险。应针对同性社交软件交友者加强监测和干预。     

青岛市2016年部分高校学生男男性行为者性伴状况研究

目的 了解高校学生MSM性伴相关状况,分析其寻找性伴的相关因素,为开展高校艾滋病预防干预工作提供参考。方法 依托青岛市MSM民间组织的艾滋病自愿咨询检测点,2016年10月采用滚雪球法招募青岛市部分高校学生MSM,按照现况调查估算样本量为267人,采用自填式问卷调查,收集其人口学特征、性伴状况等信息,采用SPSS 17.0软件统计分析调查内容。结果 共招募304名高校学生MSM,完成调查300名,来自24所高校,平均年龄20.7岁,同性性伴主要为熟人,第1个同性性伴和最近1个同性性伴为熟人的分别占58.7%（176/300）和62.3%（187/300）。通过互联网来寻找性伴占86.0%（258/300）。喜欢选择男性作为性伴占88.3%（265/300）,喜欢选择在校就读学生作为性伴占42.7%（128/300）。结论 高校学生MSM主要通过互联网寻找性伴,同性性伴主要为熟人,喜欢选择男性在校学生作为同性性伴。艾滋病防治工作应该关注高校学生人群MSM及其性健康。     

浙江省台州市2013-2015年男男性行为者人群同性群交行为调查

目的 了解浙江省台州市MSM同性群交行为特征及其相关因素。方法 2013年3月至2015年9月,经浴室、酒吧等场所招募MSM,通过问卷调查收集其性行为等信息,并进行HIV检测。使用logistic回归模型分析群交行为相关因素。结果 共调查1 435名MSM,HIV阳性率为12.5%（179/1 435）。16.1%（231/1 435）报告在最近1年曾有群交行为。最近1年有群交行为的MSM与最近1年无群交的MSM相比,一生同性性伴数≥10个（53.7%比19.0%,χ²=125.527,P<0.01）、有异性性伴（86.6%比68.2%,χ²=31.935,P<0.01）、最近1年与女性发生性行为未使用安全套（28.1% 比19.8%,χ²=6.540,P<0.05）的比例更高。多因素logistic回归模型分析显示,与MSM群交行为相关因素包括年龄（≥50岁比≤24岁,aOR=2.25,P=0.027）,与女性婚姻（离异或丧偶比未婚,OR=0.29,P=0.001）,户籍（本地比外地,aOR=1.56,P=0.023）,一生同性性伴数（≥21个比2~5个,aOR=8.06,P<0.001;11~20个比 2~5个,aOR=3.25,P<0.001）,一生异性性伴数（≥6个比0个,aOR=2.63,P=0.005;2~5个比0个,aOR=2.58,P=0.001;1个比0个,aOR=2.01,P=0.010）。结论 台州市MSM人群群交行为比例较高、安全套使用率低、性行为关系复杂,HIV感染率高、传播风险较大。     

男男性行为人群无保护肛交影响因素分析

目的 了解重庆市男男性行为(MSM)人群同性无保护肛交情况及其影响因素。方法 2006年和2007年7-9月分别进行了2次横断面调查,通过面对面访谈方式进行问卷调查。收集人口学特征、艾滋病知识、高危行为及既往性传播感染信息,并采血进行梅毒和人类免疫缺陷病毒(HIV)检测。结果 2次招募合格调查对象1 434人,平均年龄为27.0岁,未婚占78.8%,高中及以上文化程度者占86.1%;65.7%MSM自我认同为同性恋,近6个月同性无保护肛交发生率为63.6%;19.9%有异性性行为。同性无保护肛交的独立相关变量包括大龄(OR=1.02,95% CI=1.0~1.03)、未接受性病相关服务(OR=1.4,95% CI=1.1~1.7)、曾有性传播疾病相关症状(OR=1.7,95% CI=1.2~2.3)及未参与卖同性性行为(OR=3.0,95% CI=1.9~4.7);艾滋病知识得分越高者发生同性无保护肛交越少(OR=0.9,95% CI=0.8~1.0)。结论 重庆市MSM人群同性无保护肛交发生率高,多性伴及异性性行为多见。HIV和梅毒感染率较高。