Increased condom use without other major changes in sexual behavior among the general population in Switzerland.

OBJECTIVES: This study is part of a continuous evaluation of the Swiss AIDS prevention strategy from 1987 through 1994. METHODS: Annual telephone surveys of samples representative of the general population aged 17 through 45 years have been conducted since 1987 to monitor behavioral change. RESULTS: No major changes in level of sexual activity (lifetime number of partners, frequency of sexual encounters in the past week) or potential exposure to risk of HIV transmission (acquisition of a new steady partner during the year or of casual partners in the last 6 months) were observed. Systematic condom use with a new steady partner increased between 1988 and 1994, from 40% to 64% among 17- to 30-year-olds and from 57% to 72% among those aged 31 to 45. Systematic condom use with casual partners increased from 8% to 56% between 1987 and 1994 among 17- to 30-year-olds and from 22% to 42% between 1989 and 1994 among those aged 31 to 45. Condom use was higher among those with multiple partners. CONCLUSIONS: A general-population approach to AIDS prevention was able to achieve large-scale improvements in condom-based protection against HIV infection without inducing other major changes in sexual behavior.     

Influence of HIV positive status on sexual behavior among males.

OBJECTIVE: To compare HIV seronegative (HIV-) and HIV seropositive (HIV+) males in terms of sexual behavior with female and male partners of different types. METHOD: Cross-sectional study. From August 1994 to February 1995, a sample of 236 respondents (150 HIV- and 86 HIV+) recruited from public health centers in the State of S. Paulo (Brazil), answered a questionnaire, including questions on demographic aspects, HIV and AIDS related knowledge, sexual orientation, use of alcohol and other drugs, sexual behavior with regular and casual female and male partners, and perceived risk of HIV infection. Sexual behavior with regular and casual female and male partners within the previous three months, was investigated. RESULTS: A lower proportion of HIV+ engaged in sexual contact with regular female partners (p < .01) and in vaginal intercourse with this type of partner (p < .01). A lower proportion of HIV+ engaged in overall sexual activity (p < .001) and reported lower frequency of penetrative sexual practices (p < .05). A high level of condom use with female and male partners was identified with no significant differences being found between the two serostatus groups. Some risky sexual behavior was identified, however, especially with regular partners, suggesting that some men were continuing to practice unsafe sex. CONCLUSIONS: The high level of condom use identified suggests that safer sex advice has been taken up. Condom use was not universal, however, and some men continue to place themselves at risk, especially with regular partners. Prevention programs should strive not only to encourage HIV- to practice safer sex, but also to encourage HIV+ to do so in order to prevent further transmission of the virus.     

Seeking sexual partners on the internet: a marker for risky sexual behaviour in men who have sex with men

OBJECTIVE: In order to generate a generalizable estimate regarding risk for STI and HIV acquisition in men who have sex with men (MSM) who seek partners on the internet, we examined the sexual practices of MSM who seek partners on the internet compared to MSM who do not, using a community-based sample of MSM from British Columbia. METHODS: 'Sex Now', a questionnaire that was developed to examine trends in sexual behaviour in gay men, was offered to men attending Gay Pride events throughout the province of British Columbia, Canada between May and August 2004. Logistic regression analysis was used to model the association between seeking sexual partners online and other variables of interest, using odds ratio as the measure of association. RESULTS: Of the 2,312 MSM who completed the survey, 766 (33.1%) had used the internet to find a partner in the past year. In logistic regression analyses, MSM who found partners on the internet were more likely to have had more than 10 sexual partners in the past year (overall, insertive and receptive), and to engage in sexual activities in public venues. They were also more likely to agree with the statement "I think most guys in relationships have condom-free sex." MSM who sought partners on the net were more likely to be from specific geographic regions, including non-urban regions. Demographic characteristics, HIV status, and use of drugs were not significantly different between men who found partners on the internet and those who did not in multivariable modeling. DISCUSSION: MSM who sought to meet partners online had significantly more sexual partners, were more likely to be from specific geographic regions of the province and to have participated in seeking sexual partners in venues known to be associated with HIV and STI acquisition. This study confirms from a community-based sample of MSM that programming for prevention and treatment of HIV and STI need to be available and offered in the cyber setting, to ensure effective messaging and interventions reach this population.     

Mutual HIV Disclosure among HIV-Negative Men Who have Sex with Men in Beijing, China, 2010

HIV is rising rapidly among Chinese men who have sex with men (MSM). Discussion of HIV status between sexual partners is potentially a key prevention behavior. It is unclear if HIV-negative Chinese MSM talk about HIV and disclose their HIV status with sexual partners. Understanding the correlates of disclosure among this population could provide insight into developing disclosure-based interventions. We conducted a respondent driven sampling based study of 500 MSM in Beijing. A total of 332 men had a previous HIV-negative test result and thus considered themselves to be HIV-negative and were included in our analysis of disclosure. Equal numbers of these men reported talking about HIV and disclosing their HIV status to at least one sexual partner. MSM who disclosed were more likely to be living with a main partner. No other demographic characteristics were associated with disclosure in bivariate analysis. We also used data on up to three sexual partners per participant to examine disclosure on the partnership level. Main partnerships, meeting partners at bars/clubs, sometimes using alcohol before sex in a partnership, and usually having sex at home compared to other venues were associated with disclosure. Using generalized estimating equation analysis to characterize individuals from their partnership data, we found only having at least one main partnership and knowing people who were infected with HIV to be associated with a participant being a discloser. Interventions that wish to harness discussion of HIV and HIV status among Chinese MSM will need to focus on moving these discussions towards having them with casual partners.     

艾滋病病毒感染者和病人生存质量调查及相关因素分析

目的调查与评价艾滋病病毒感染者和病人的生存质量,分析影响其生存质量的因素。方法采用世界卫生组织生存质量简表（WHOQOL—BREF中文版）加上艾滋病相关条目。对300例艾滋病病毒感染者和病人与112例健康的配偶／固定性伴及吸毒同伴进行调查。结果艾滋病病毒感染者和病人各方面得分均显著低于健康的配偶／固定性伴及吸毒同伴（P〈0．01）,健康的配偶,固定性伴及吸毒同伴的生存质量的心理领域和社会关系领域显著得分低于全国其他城市常模人群（P〈0．01）。文化程度、CD4细胞计数及家庭年收入与艾滋病病毒感染者和病人生存质量呈正相关,吸毒及HIV检测前及与配偶,固定性伴发生性关系的频次与艾滋病病毒感染者和病人的生存质量呈负相关。结论艾滋病病毒感染者和病人总体生存质量较差,其性伴或吸毒同伴的生存质量的心理领域和社会关系领域得分也低于全国其他城市常模人群。     

Use of the Internet to Meet Sexual Partners,Sexual Risk Behavior,and Mental Health in Transgender Adults

The purpose of this study was to examine the use of the internet to meet sexual partners among transgender individuals and examine correlates of this use, including sexual risk behavior, discrimination experiences, and mental health. A sample of 166 transgender adults (112 male-to-female transgender women and 54 female-to-male transgender men) were recruited in community venues and anonymously completed measures assessing these variables. Most participants (64.5 %) were HIV-negative, 25.2 % were HIV-positive, and 10.3 % did not know their HIV status. Overall, 33.7 % of participants reported having met a sexual partner over the internet, which did not differ significantly between transgender women and men. Among these individuals, transgender women reported significantly more lifetime internet sexual partners (median = 3) than transgender men (median = 1). Use of the internet to meet sexual partners was associated with lower self-esteem but not with depression, anxiety, somatic distress or discrimination experiences. Among transgender women, use of the internet to meet sexual partners was associated with each of the 11 sexual risk behaviors examined, including having multiple partners, sex under the influence of drugs, number of unprotected anal or vaginal sex acts, and history of commercial sex work. The use of the internet to meet partners was not associated with sexual risk behavior among transgender men (0/11 variables assessed). Although the internet is a common mode of meeting sexual partners among some transgender adults, it may also be a potential venue for prevention interventions targeting transgender individuals at particularly high risk for HIV acquisition.     

某区男男性行为人群性伴网络特征与高危行为分析

[目的]了解男男性行为（MSM）人群性伴网络特征及该人群中高危性行为的发生情况,探讨性病（STDs）、人类免疫缺陷病毒（HIV）在该人群中传播及向普通人群传播的模式,为开展性病、艾滋病预防控制提供依据。[方法]通过艾滋病自愿咨询检测门诊、同性恋人群活动场所、同性恋QQ群内动员、＂滚雪球＂等途径寻找MSM人群,招募151人,采用面对面匿名问卷调查方式收集信息。[结果]151名被调查者中最近6个月有30人（19.9%）与异性发生过性行为,高危性行为的发生率为53.3%;与同性性活动情况,其中91人（60.3%）有同性固定性伴,76人（50.3%）与非固定同性性伴的人发生过多次男男性行为（简称有多次男性伴）,77人（51.0%）发生过偶遇性行为（简称有偶遇男性伴）,10人（6.6%）从事商业性行为。而在与固定性伴、多次男性伴、偶遇男性伴、商业性行为中高危性行为的发生率依次是69.2%、57.9%、50.6%、70.0%。与固定男性伴高危性行为的发生率高于与偶遇男性伴高危性行为的发生率（P=0.014）。最近6个月有2种及以上性伴类型占58.9%。30名已感染HIV者中有多次男性伴及偶遇男性伴类型的比例分别为53.3%和63.3%;有过多次男性伴、偶遇男性伴性行为者中发生高危性行为的比例分别为50.0%和63.2%。感染HIV者与固定男性伴发生高危性行为的率低于未感染HIV者（P=0.029）。[结论]MSM人群性伴网络复杂多样,高危性行为发生率高。不仅使HIV在该人群中容易传播,且该人群已成为向普通人群传播HIV的＂桥梁＂人群。     

244名HIV感染者/AIDS病人及其性伴的性行为特征分析

目的了解艾滋病感染者和病人及其性伴的性行为现状及特征,为进行干预提供依据。方法在云南省澜沧县对已确诊的HIV/AIDS进行问卷调查。结果 52.87%的感染者有临时性伴,HIV/AIDS与固定性伴、非商业非固定性伴和商业异性性伴性生活频率比感染前明显下降,性生活中安全套坚持使用率分别为40.00%、25.00%和62.50%;78例HIV/AIDS的性伴中检出13例HIV阳性,部分性伴存在多性伴现象。结论澜沧县部分HIV/AIDS及其性伴存在多性伴现象、性生活活跃,今后要进一步加强艾滋病经性途径传播的宣传和干预,减少HIV经性传播。     

Psychosocial Correlates of HIV Sexual Protective Behavior Among Puerto Rican Women Residing in the Bronx,New York

In this study, correlates of HIV sexual protective behavior, in the form of condom use, were examined within a population of urban women identified as at increased heterosexual risk for HIV infection. Hierarchical regression analyses were used to analyze data collected via structured interviews for 187 Puerto Rican women recruited from the waiting areas of a comprehensive health clinic in the Bronx, New York. Increased condom use with primary partners was associated with higher levels of mastery, more non-Hispanic acculturation, and greater adherence to traditional female gender roles. Increased condom use with nonprimary partners was associated with higher HIV/AIDS prevention self-efficacy. Thus, primary versus nonprimary relationships appeared to represent distinct contexts for HIV sexual risk behavior, with implications for different intervention strategies based upon relationship contexts for Latina women.     

四川省某市卖淫妇女的高危行为及HIV知识调查

目的 :了解卖淫妇女感染 HIV的高危行为及 HIV知识水平 ,为作好艾滋病的预防工作提供依据。方法 :对四川省某市妇教所内 4 6名卖淫妇女进行问卷调查。结果 :被调查对象的平均年龄为 2 8.5 7± 9.4 5岁 ,有婚姻史者 6 5 .2 % ,来自农村者占 6 4 .4 % ;文化程度以小学及以下者居多 ,共计 6 7.4 % ;从事性工作的原因以“为经济所逼”为主 ,占 6 3.0 %。首次性行为的平均年龄为 18.6 7± 2 .77岁 ,而首次商业性性行为平均年龄为 2 7.89± 9.12岁 ;有固定性伴者 37人 ,月接客数为10～ 2 9个、 30～ 5 0个的比例分别为 4 4 .4 %和 2 8.9% ;避孕套的使用情况显示 ,与固定性伴发生性行为时从不使用的比例为6 7.5 % ,而与商业性性伴的性行为 ,从不使用的比例为 8.7% ,二者差异有统计学意义。知晓艾滋病病名者达 93.2 % ,但仅17人知道艾滋病可预防而不可治愈。结论 :卖淫妇女的不安全性行为发生率高 ,其 HIV知识相对匮乏 ,仍需加强对她们进行 HIV / AIDS的知识宣传及提高避孕套使用率的行为教育。     

Determinants of condom use and heterosexual multiple sexual partnership in French Antilles and French Guiana

BACKGROUND: After Subsaharan Africa, the Caribbean is the world's region most affected by HIV/AIDS. The French-American departments (Guadeloupe, Martinique, Guiana), FAD, are located in the heart of this region. Although lower than in other states of the Caribbean, AIDS incidence is much more higher than in France (up to 15 times more in Guiana). Transmission is mostly heterosexual. The frequency, particularly among men, of multiple sexual partnerships frequently taking place concurrently, and the persistence of this activity in older age, contribute to the level of the HIV epidemic and its characteristics. The purpose of this article is to identify, in the FAD, the determinants of condom use among persons with multiple sexual partners (either at last intercourse or during a concurrent relationship), taking into account the variety of multiple sexual partnership situations. METHOD: Data are taken from an HIV/AIDS KABP survey, based on a probability sample of men and women aged 18 to 69 years, resident in FAD. In total, 3104 interviews were conducted by telephone in 2004: around 1000 in each department. RESULTS: Among men and women who report two or more partners in the past five years, there is substantial heterogeneity in level of condom use at last intercourse, depending on the duration and type of the relationship: 73% of respondents reported condom use with a casual partner and 14% with a cohabiting partner. Men and women who were engaged in concurrent partnerships in the past five years were at higher risk of infection: 7% reported an STI versus 4% among those who had two or more partners, but not at the same time. Women, older persons, people with a lower level of education and those engaged in concurrent partnerships reported a lower level of condom use, thus increasing their vulnerability to HIV/AIDS. CONCLUSION: Although HIV/AIDS prevention has increased among male and women engaged in multiple sexual partnerships, there is still a lack of consistent condom use in this population. These results highlight the need for more diversified prevention programs, taking into account sociodemographic factors and the diversity of situations involving multiple sexual partnership.     

Estimating the sexual mixing patterns in the general population from those in people acquiring gonorrhoea infection: theoretical foundation and empirical findings.

STUDY OBJECTIVES--To describe mathematically the relationship between patterns of sexual mixing in the general population and those of people with gonorrhoea infection, and hence to estimate the sexual mixing matrix for the general population. DESIGN--Integration of data describing sexual behaviour in the general population, with data describing sexual behaviour and mixing among individuals infected with gonorrhoea. Use of these data in a simple mathematical model of the transmission dynamics of gonorrhoea infection. SETTING--The general population of London and a genitourinary medicine (GUM) clinic in west London. PARTICIPANT--These comprised 1520 men and women living in London who were randomly selected for the national survey of sexual attitudes and lifestyles and 2414 heterosexual men and women who presented to the GUM clinic with gonorrhoea. MAIN RESULTS--The relationship between sexual mixing among people with gonorrhoea and sexual mixing in the general population is derived mathematically. An empirical estimate of the sexual mixing matrix for the general population is presented. The results provide tentative evidence that individuals with high rates of acquisition of sexual partners preferentially select other individuals with high rates as partners (assortative mixing). CONCLUSIONS--Reliable estimates of sexual mixing have been shown to be important for understanding the evolution of the epidemics of HIV infection and other sexually transmitted diseases. The possibility of estimating patterns of sexual mixing in the general population from information routinely collected in gonorrhoea contact tracing programmes is demonstrated. Furthermore, the approach we describe could, in principle, be used to estimate the same patterns of mixing, using contact tracing data for other sexually transmitted diseases, thus providing a way of validating our results.     

Intrafamilial Transmission of Hepatitis C Virus Infection

Background: The role of intrafamilial HCV transmission is still controversial. Methods: An overall sample of 2856 consecutive HCV-infected patients was studied. All index cases were interviewed to identify potential risk factors for transmission and underwent the following tests: HBsAg, anti-HBc, HIV, and, qualitative HCV-RNA and genotyping. Results: Coinfection with HBsAg was recorded in 4.7%, and with HIV in 2.6% of the HCV-infected index cases. Anti-HCV was detected in 2.1% of the members of their original families, and in 13.8% of 2662 sexual partners. The overall rate of infection for offspring was 2.3%, but the risk was significantly higher when the index case was female. The risk for sexual partners was significantly higher when the risk factor for the index case was intravenous drug (IVD) use rather than blood transfusion. Logistic regression analysis showed that female gender and drug addiction in sexual partners of index case were independent factors significantly associated with HCV transmission to sexual partners. Conclusions: Among all family members of index cases, sexual partners of IVD users were at greatest risk of HCV infection. Sexual transmission may not be the main route of transmission though, since IVD use in the sexual partners themselves was independently associated with HCV infection.     

Adolescent sexual behavior and associated variables

Proportionally more adolescents are having sexual intercourse and at younger ages. It has been reported that 11.6 million teens in the US between ages 13-19 years have had sexual intercourse. Many, however, do not use contraception, even though the prevalence of condom use has increased over the last ten years. The authors analyzed survey data to identify sexual activity among adolescents by grade, gender, number of partners, and contraceptive use, and to determine the association of intercourse with condom use, alcohol consumption, smoking, and AIDS/HIV education. 56.8% of 568 9th-12th grade respondents reported having had sexual intercourse: 33.5% in 9th grade, 58.9% in 10th grade, 68.5% in 11th grade, and 71.6% in 12th grade. Although more males than females reported having had sexual intercourse, no significant difference was found between males and females in each grade level on the number of lifetime sex partners or sex partners for the previous three months. 25% reported using alcohol during last sexual intercourse, 5% indicated using both alcohol and other drugs, and 22% reported that no contraception was used or that they were not sure if anything was used. Sexually active respondents were significantly more likely to consume alcohol and to smoke. The authors also found no significant difference for use of condoms between those who had AIDS/HIV education and those who had not, except that those who had AIDS/HIV education were less likely to have multiple partners. 42.5% of all sexually active respondents reported using a condom. Only 38.5% of those exposed to AIDS/HIV education in schools reported using a condom during last intercourse compared to 30% of those not exposed to such education.     

The other side of the bridge: exploring the sexual relationships of men who have sex with men and their female partners in Mumbai,India

Behaviourally bisexual men have been identified as a ‘bridge’ population of HIV transmission to heterosexual women in India. Little is known about the sexual relationships that these men have with their female sex partners. The primary objective of this study was to explore the sexual practices and relationship dynamics between married and unmarried behaviourally bisexual men and their female sex partners in Mumbai, India. In 2009, semi-structured qualitative interviews were conducted with 32 men who reported sex with men and women. Participants discussed a variety of sexual practices and arrangements with female sex partners. Irrespective of marital status and sexual identity, many said that they had satisfying sexual experiences and feelings of affection for female sex partners. However, sexual incompatibility between married partners was also reported. Explanations of bisexual concurrency were discussed in terms of both sexual satisfaction and sexual preference. Self-perceived HIV risk related to same-sex sexual behaviour motivated many men to use condoms with female partners. Expectations of unprotected marital sex and perceptions of partner risk were barriers to condom use. HIV-prevention programmes for this population may benefit from tailored risk-reduction counselling that attends to the variations of these sexual and social relationship dynamics.     

云南省1990-1998年性传播HIV感染的流行病学调查

目的；为了解云南省性传播ＨＩＶ感染的流行情况，试图为艾滋病的预防和控制提供一些依据。方法：对云南省１９９０￣１９９８年性传播人类免疫缺陷病毒（ＨＩＶ）检出情况进行调查分析。结果：发现性病患者，嫖客，暗娼和多性伴者感染ＨＩＶ检出率均逐年增加，尤其从１９９７，１９９８年上升速度较为显著。结论：提示当今云南省艾滋病的性传播日趋严重，应进一步对ＨＩＶ性传播的问题引起高度重视并加强防范。     

The Potential for Bridging of HIV Transmission in the Russian Federation: Sex Risk Behaviors and HIV Prevalence among Drug Users (DUs) and their Non-DU Sex Partners

The HIV epidemic that began in Russia in the mid-1990s has been concentrated mostly among drug users (DUs). Recent evidence of increasing HIV cases among non-DUs attributed to sexual behavior raises potential concern about a more generalized epidemic. The purpose of this analysis is to examine the potential for HIV transmission from DUs to their non-DU sex partners. Analyses are conducted using data collected during 2005–2008 in St. Petersburg, Russia. A total of 631 DUs were recruited into the sample with an HIV prevalence of 45%. A majority (84%) of DUs reported being sexually active in the past 6 months, and the DU status of their sex partners was reported as follows: 54% DU, 40% non-DU, and 6% unknown DU status. In 41% of partnerships with an HIV-negative or unknown status partner not known to be DU (potential bridging partnerships), the last reported intercourse was unprotected. Female DUs with potential bridging partnerships were more likely than male DUs to be younger and report homelessness and to have multiple or new sex partners. Many non-DU sex partners of DUs enrolled in the study reported new sex partners in the past 6 months (66%), unprotected intercourse at last sex (60%), and multiple sex partners in the past 6 months (48%). HIV prevalence in this group was 15% (eight out of 53). The high prevalence of HIV among DUs, their sexual contact with non-DUs, and the high-risk sexual behaviors of this potential bridging population together indicate the real potential for an increasingly generalized epidemic. The degree to which there will be further transmission from non-DU sex partners of DUs who exhibit high levels of sex risk behaviors to other non-DU sex partners deserves further study.     

The Potential for Bridging of HIV Transmission in the Russian Federation: Sex Risk Behaviors and HIV Prevalence among Drug Users (DUs) and their Non-DU Sex Partners

The HIV epidemic that began in Russia in the mid-1990s has been concentrated mostly among drug users (DUs). Recent evidence of increasing HIV cases among non-DUs attributed to sexual behavior raises potential concern about a more generalized epidemic. The purpose of this analysis is to examine the potential for HIV transmission from DUs to their non-DU sex partners. Analyses are conducted using data collected during 2005–2008 in St. Petersburg, Russia. A total of 631 DUs were recruited into the sample with an HIV prevalence of 45%. A majority (84%) of DUs reported being sexually active in the past 6 months, and the DU status of their sex partners was reported as follows: 54% DU, 40% non-DU, and 6% unknown DU status. In 41% of partnerships with an HIV-negative or unknown status partner not known to be DU (potential bridging partnerships), the last reported intercourse was unprotected. Female DUs with potential bridging partnerships were more likely than male DUs to be younger and report homelessness and to have multiple or new sex partners. Many non-DU sex partners of DUs enrolled in the study reported new sex partners in the past 6 months (66%), unprotected intercourse at last sex (60%), and multiple sex partners in the past 6 months (48%). HIV prevalence in this group was 15% (eight out of 53). The high prevalence of HIV among DUs, their sexual contact with non-DUs, and the high-risk sexual behaviors of this potential bridging population together indicate the real potential for an increasingly generalized epidemic. The degree to which there will be further transmission from non-DU sex partners of DUs who exhibit high levels of sex risk behaviors to other non-DU sex partners deserves further study.     

HIV感染的吸毒人群的艾滋病知识和行为调查

目的了解有吸毒史的艾滋病病毒（HIV）感染者的艾滋病知晓情况、吸毒行为、性行为特征,为HIV/AIDS干预提供合理依据。方法采用横断面调查,于2009年4～8月,对澜沧县109名有吸毒史的HIV感染者进行面对面的调查,用SPSS13.0进行统计分析。结果 109名吸毒者中,20～40岁年龄组占74.31%,小学和初中分别占38.53%和33.03%,农民67.89%,少数民族66.06%。艾滋病知识总体知晓率为84.40%,不同文化程度、婚姻状况的人艾滋病知识知晓率差异有统计学意义（χ^2值分别为8.49,9.18;P值分别为0.037,0.027）;2009年4～8月期间,有7人曾共用注射器吸毒;46人与固定性伴有性行为,其中32.61%的人坚持使用安全套;4人与非商业非固定性伴有不安全性行为;8人与异性商业性伴有过性行为,5人未坚持使用安全套。结论有吸毒史的HIV感染者共用针具行为、多性伴和不安全性行为仍然存在,提示应采取宣传教育和行为干预并重的预防措施。