东北某地男同性恋者性行为及HIV感染流行病学研究

目的：了解男同性恋者HIV感染的流行状况及潜在危险因素。方法：采用匿名横断面调查设计，对进出酒吧的男同性恋者进行问卷调查，并收集尿液进行HIV抗体检测。结果：共收集尿液标本153份，其中2例经尿ELISA初筛及尿WB确认试剂检测均为阳性，HIV感染率为1．31％。首次性行为年龄中位数为18岁。所有调查对象均与男性发生过性行为，67．1％的调查对象既与男性又与女性发生过性行为。89．9％（187／208）的调查对象在半年内有肛交性行为，无保护肛交性行为的发生率为84．5％。79．8％在近半年内肛交时曾主动插入过对方，58．7％曾接受过对方插入。31．9％的调查对象有性病史。多因素分析显示有性病史者肛交时安全套使用率显著低于无性病史者，OR值为13．5，95％CI为1．75－103．50。结论：同性恋人群中已经有较高的HIV感染率，并且艾滋病相关的危险行为普遍存在，如不采取有效措施加强控制，艾滋病极有可能在同性恋人群中广泛流行。     

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。     

MSM中HIV感染者无保护肛交行为及其影响因素分析

目的了解男男性行为人群（MSM）中艾滋病病毒（HIV）感染者的无保护肛交性行为的状况,分析其影响因素,为开展针对性干预活动防止＂二代传播＂提供信息。方法对＂全国男男性行为人群艾滋病综合防治试点＂工作数据库中,HIV感染者的信息进行分析,描述研究对象的社会人口学和高危性行为特点,并分析无保护肛交性行为的影响因素。结果共获得MSM中HIV感染者的有效样本754人,梅毒检出率为28.9%。最近6个月内无保护肛交发生率为67.4%。与无保护肛交发生有关的危险因素是在当地居住时间超过6个月,经常到浴池、公园等场所寻找性伴,以及最近1年内未接受过艾滋病相关服务。结论 MSM中HIV感染者的无保护肛交行为发生率、梅毒感染率高,构成艾滋病进一步传播流行的风险,亟待在该人群中开展针对性行为干预。     

沈阳市男男性行为人群HIV感染率及其影响因素分析

目的了解沈阳市男男性行为人群（MSM）艾滋病病毒（HIV）感染率及其影响因素,进一步做好MSM的艾滋病防治工作。方法采用同伴推动法（RDS）招募900名MSM,由经过专业培训的调查员进行面对面的问卷调查,主要内容包括社会人口学特征、艾滋病知识知晓水平、性行为状况、接受干预服务情况和HIV/梅毒感染状况,并抽取静脉血检测HIV及梅毒,对影响HIV感染的相关因素进行χ2检验。结果调查了900名MSM,艾滋病知识知晓率达到91.3%。86.9%的调查对象最近6个月有同性肛交性行为,最近6个月与男性发生肛交性行为时每次都使用安全套的比例为57.5%。HIV感染率为9.3%,梅毒感染率为11.0%。分析显示,年龄较大、文化程度在初中及以下、最近6个月与男性发生肛交性行为时未坚持使用安全套、梅毒感染是感染HIV的危险因素。结论 MSM人群高危性行为发生率、HIV和梅毒感染率均高,可能成为当前HIV流行的重要人群和重要因素,应采取积极有效的宣传教育和行为干预活动。     

东北某地男同性恋者艾滋病病毒/艾滋病的知识态度行为调查

目的　了解男同性恋者艾滋病相关知识、态度及危险行为状况 ,为行为干预提供线索。 方法　 采用横断面调查设计 ,对进出某酒吧的男同性恋者进行问卷调查。 结果　 文化程度普遍较高 ,但对艾滋病知识缺乏 ,知识的来源主要通过报纸、杂志和电视。安全套使用率低 ,每次性行为均使用安全套的比例为 1 4 4% ,不使用安全套的原因主要是自己或性伴侣不喜欢用或性行为时身边无安全套。随着艾滋病知识的增加 ,每次都用安全套的比例呈现上升趋势 ,从未使用安全套的比例则呈现明显下降的趋势。 1 1 7%做过艾滋病病毒 (HIV)检测 ,无人获得过HIV检测阳性结果。不做HIV检测的原因主要是自认为感染的可能性不大 ,认为自己是阴性或不想考虑阳性的事。首次性行为年龄中位数为 1 8岁 ;性伴侣数较多 ,平均为 1 0 3个。 40 5 %的调查对象在半年内有过女性性伴侣 ,96 6 %在半年内有过男性性伴侣 ,84 5 %半年内有无保护肛交史。 结论　 该市男同性恋者艾滋病相关知识缺乏 ,危险性行为普遍存在 ,安全套使用率低 ,艾滋病极有可能在此人群中流行 ,应尽快采取措施加强预防     

东北某地男同性恋者艾滋病病毒／艾滋病的知识态度行为调查

目的 了解男同性恋者艾滋病相关知识、态度及危险行为状况，为行为干预提供线索。方法 采用横断面调查设计，对进出某酒吧的男同性恋者进行问卷调查。结果 文化程度普遍较高，但对艾滋病知识缺乏，知识的来源主要是通过报纸、杂志和电视。安全套使用率低，每次性行为均使用安全套的比例为14.4%，不使用安全套的原因主要是自己或性伴侣不喜欢用或性行为时身边无安全套。随着艾滋病知识的增加，每次都用安全套的比例呈现上升趋势，从未使用安全套的比例则呈现明显下降的趋势。11.7%做过艾滋病病毒（HIV）检测，无人获得过HIV检测阳性结果。不做HIV检测的原因主要是自认为感染的可能性不大，认为自己是阴性或不想考虑阳性的事。首次性行为年龄中位数为18岁；性伴侣数较多，平均为10.3个。40.5%的调查对象在半年内有过女性性伴侣，96.6%在半年内有过男性性伴侣，84.5%半年内有无保护肛交史。结论 该市男同性恋者艾滋病相关知识缺乏，危险性行为普遍存在，安全套使用率低，艾滋病极有可能在此人群中流行，应尽快采取措施加强预防。     

广州市1315名男男性行为人群的行为特征及艾滋病流行状况

目的了解广州地区男男性行为人群(MSM)艾滋病及其相关高危行为流行情况,为开展艾滋病防治提供依据。方法对2009年参加艾滋病自愿咨询检测的MSM人群的行为进行调查,并对艾滋病病毒(HIV)和梅毒检测相关资料进行分析。结果共调查1 315名MSM,平均年龄27岁,其中20~30岁的占60.61%;首次与男性发生性行为平均年龄23岁,25岁以下的占65.20%;最近3个月有多个性伴的占41.22%,最近一次与男性发生性行为时使用安全套的只有66.68%;56.20%最近一个月与男性发生性行为时每次都使用安全套。HIV感染率为5.40%,梅毒检出率为6.77%。被动肛交者安全套使用率显著低于主动者,文化程度低者HIV感染率和梅毒感染率更高。结论广州地区MSM中艾滋病流行比较严重,不安全性行为较高,艾滋病有通过MSM向普通人群扩散的危险。     

中国部分城市男男性行为人群性行为特征及HIV感染状况的研究

目的 为了解中国部分城市男男性行为人群的性行为特征及HIV感染情况.方法 采用应答驱动抽样和定向抽样的方法,对符合要求的男男性行为人群进行知情同意、问卷调查、标本采集和检测.结果 符合要求的调查对象635人,HIV感染率为1.6%.在同性恋倾向者和双性恋倾向者中,HIV感染率分别为1.5%和1.9%;HIV感染率最高的年龄组为35～49岁组,为5.8%.最近半年内平均男男性伴数为5.52人;52.9%的调查对象最近6个月男男性行为时未能每次都使用安全套.结论 尽管该人群HIV知晓率较高,但是无保护性行为仍较为常见,多性伴和双性性行为发生比例较高,是今后艾滋病预防控制工作的重点人群.     

黑龙江省四市MSM人群艾滋病相关高危行为及其影响因素分析

目的了解黑龙江省四市男男性行为人群（MsM）艾滋病相关高危行为及其影响因素,为制定针对性干预策略提供建议。方法采用同伴推动法和分类滚雪球抽样法招募MSM,进行一对一问卷调查,并采血检测艾滋病病毒（HIV）、梅毒、丙型肝炎病毒（HCV）抗体。以不安全性行为为应变量,人口学特征、艾滋病知识知晓情况、干预服务覆盖情况、高危性行为情况等因素为自变量,进行多因素逐步向前Logistic回归分析。结果共调查1353名MSM。最近6个月,83．8％的MSM与男性发生过肛交性行为,56．7％有2个以上男性伴,无保护肛交率55．4％;7．5％发生过商业性行为,无保护肛交率44．7％;22．1％与女性发生过性行为,无保护率70．2％。最近1年干预服务覆盖率80．6％。月收入高于2000元、从浴池、公园类场所寻找性伴、艾滋病知识不知晓、首次与男性性行为年龄小于25岁,是发生多男性伴行为的危险因素;月收入低于2000元、干预未覆盖、首次与男性发生性行为年龄小于18岁、浴池、公园类场所寻找性伴,是与男性发生无保护肛交行为的危险因素;初中及以下低文化、非同性恋取向、艾滋病知识不知晓、有多男性伴行为,是与男性发生商业性行为的危险因素;已婚、与男性有无保护肛交行为是与女性发生无保护性行为的危险因素。结论四市MsM人群干预覆盖率低,促成HIV传播的高危性行为情况较严重,急需在相关方面加强。四市目前所开展的干预服务促进了男男性行为的安全套使用,但使用水平较低,且对多男性伴行为、商业性性行为、与女性性行为的安全性均无明显影响,需要在干预的有效性上下功夫,在干预内容上加以完善。     

上海市MSM人群HIV和梅毒的感染率及其影响因素

目的了解上海市男男性行为(Men who have sex with men,MSM)人群艾滋病病毒(Human immuno-deficiency virus,HIV)和梅毒的感染率及其影响因素。方法 2011年3-12月,对MSM人群开展一次大规模的横断面调查,调查内容包括人口学特征、艾滋病知识、性行为状况、既往性病史及接受HIV有关干预措施,采集血样标本进行HIV和梅毒抗体检测。结果对招募到的790名MSM进行问卷调查、HIV和梅毒抗体检测。HIV、梅毒及HIV和梅毒双重感染的感染率及95%可信区间(Confidence interval,CI)分别为7.59%(95%CI:5.74～9.44)、18.35%(95%CI:15.65～21.05)、2.15%(95%CI:1.14～3.16)。多因素Logistic回归显示,HIV感染的独立危险因素为:外地户籍、月收入<2 000元者、性伴数>3个、肛交时肛门或阴茎破损出血、既往有性病史、未接受过艾滋病自愿咨询检测、未检测过HIV抗体。结论上海市MSM人群的HIV及梅毒感染率较高,建议今后HIV预防控制工作中应强调同性和异性性行为时都坚持使用安全套,降低性伴数,推广艾滋病自愿咨询检测和HIV抗体检测,以控制性病在MSM人群中的传播。     

High levels of unprotected sex with men and women among men who have sex with men: a potential bridge of HIV transmission in Beijing, China.

China is experiencing an emerging HIV epidemic among men who have sex with men (MSM). We investigated sexual risk, risk perception, HIV and condom knowledge, and utilization of prevention services in the first large sample of MSM recruited in Beijing. Four hundred eighty-two MSM were sampled from September 2001 to January 2002. Forty-nine percent of participants reported unprotected anal intercourse with men during the previous 6 months. However, only 15% perceived they are at risk for HIV and many had misconceptions about HIV transmission routes and limited knowledge about condoms. Less than one quarter obtained free condoms (24%) and condom lubricants (19%) in the past 2 years. Multiple logistic regression analysis showed that unprotected insertive anal intercourse was associated with not having a Beijing residence card, having six or more male sexual partners, not having sex with women, having a lifetime history of sexually transmitted diseases (STDs), and having never tested for HIV. Unprotected receptive anal intercourse was independently associated with having six or more male sexual partners, not having sex with women, having a lifetime history of STDs, having never tested for HIV, and having less exposure to HIV prevention services. In addition, 28% reported having sex with both men and women during the previous 6 months, and 11% had unprotected intercourse with both men and women. This finding suggests that MSM are a potential bridge of HIV transmission to heterosexual women (or vice versa) and that addressing the HIV prevention needs of MSM may benefit the wider population.     

HIV trends and related risk factors among men having sex with men in mainland China: findings from a systematic literature review

The purpose of this study was to assess trends in the HIV epidemic and risk factors for HIV infection among men having sex with men (MSM) in mainland China. A literature review was conducted. Data from studies regarding HIV prevalence, syphilis infection and risk behavior, were pooled into three chronological stages. The independent correlates of HIV infection were gathered in order to guide the development of future interventions. HIV prevalences were 2.5% (95%CI 1.8-3.7), 1.8% (95%CI 1.1-2.9) and 3.3% (95%CI 2.0-5.3) before 2004, during 2004 to 2005 and 2006 to 2007, respectively. About two-thirds of MSM had multiple male sex partners during the previous six months (P6M), and more than one third of MSM engaged in unprotected anal intercourse (UAI) during last sex. Only UAI among commercial sex workers declined significantly. More than one quarter of MSM had female partners in P6M and the proportion having multiple female partners declined. The rates of unprotected vaginal sex had a downward trend. The prevalence of injecting drug use was low and remained the same. The number of lifetime male sexual partners and the frequency of anal sex in P6M were independently associated with HIV infection; UAI was correlated to the number of male partners, buying sex from males, being part of a mobile population, prior HIV testing and having a prior sexually transmitted disease (STD). We conclude intervention programs targeting UAI and multiple partners are urgently needed to control the HIV epidemic among MSM in mainland China.     

Age-related risk for HIV infection in men who have sex with men: examination of behavioral, relationship, and serostatus variables.

The study examined behavioral, relationship, and serostatus variables that potentially contribute to HIV infection risk in three age groups of men who have sex with men (MSM). MSM recruited in West Hollywood, California self-administered a questionnaire measuring unprotected insertive anal intercourse (UIAI) and unprotected receptive anal intercourse (URAI) with primary and nonprimary partners. The following relationship/serostatus variables were also assessed: recency of HIV testing, knowledge of own HIV serostatus, perception of partner's serostatus, seroconcordance (self and partner seronegative), and self-reported monogamy status. The prevalence of UIAI and URAI was higher with primary than nonprimary partners. These sexual risk behaviors with primary partners were substantially more prevalent among men younger than 25 years of age than among men aged 25 to 30 or over age 30. UIAI and URAI with nonprimary partners were uncommon in each age group, and there were no significant age differences on the serostatus and relationship variables. The findings suggest that young MSM may be at elevated risk for contracting HIV by virtue of their sexual risk behavior with primary partners. Targeted interventions for MSM need to address sexual risk in the context of primary relationships.     

Risk factors for HIV infection among men who have sex with men

OBJECTIVES: Risk factors for HIV acquisition were examined in a recent cohort of men who have sex with men (MSM). DESIGN: A longitudinal analysis of 4295 HIV-negative MSM enrolled in a randomized behavioral intervention trial conducted in six US cities. METHODS: MSM were enrolled and assessed for HIV infection and risk behaviors semi-annually, up to 48 months. RESULTS: In multivariate analysis, men reporting four or more male sex partners, unprotected receptive anal intercourse with any HIV serostatus partners and unprotected insertive anal intercourse with HIV-positive partners were at increased risk of HIV infection, as were those reporting amphetamine or heavy alcohol use and alcohol or drug use before sex. Some depression symptoms and occurrence of gonorrhea also were independently associated with HIV infection. The attributable fractions of high number of male partners, use of alcohol or drugs before sex, and unprotected receptive anal intercourse with unknown status partners and the same with presumed negative partners accounted for 32.3, 29.0, 28.4 and 21.6% of infections, respectively. CONCLUSIONS: The challenge is to develop strategies to identify men in need. Interventions are needed to help men reduce their number of sexual partners, occurrences of unprotected anal intercourse, alcohol or drug use before sex and address other mental health issues.     

HIV risk among men who have sex with men who have experienced childhood sexual abuse: systematic review and meta-analysis

Previous research has indicated a high prevalence of childhood sexual abuse (CSA) among men who have sex with men (MSM) in the United States, and has suggested that CSA history is a risk factor for HIV infection in MSM. We conducted a systematic review to identify, synthesize, meta-analyze, and critique the current state of relevant literature. Systematic review methodology was utilized to identify 12 studies that compared MSM with a history of CSA to MSM without a history of CSA on HIV risk indicators including HIV serostatus, sexually transmitted infections (STIs), sexual behaviors, and illicit drug use. Overall, 27.3% (n = 4,263) of the MSM in all included studies (n = 15,622) reported a CSA history. Across the studies that used probabilistic sampling (n = 8,240), the estimated prevalence of CSA was 21.8% (n = 1,800). Meta-analysis indicated that MSM with CSA history were more likely to be HIV positive [odds ratio (OR) = 1.54; 95% confidence interval (CI) = 1.22-1.95)] and to engage in recent unprotected anal intercourse (OR = 1.85, 95% CI = 1.36-2.51). Studies also indicated that MSM with a history of CSA were more likely to report frequent casual male partners, substance use, and sex while under the influence of alcohol or other drugs. Trends across studies indicated a need for interventions to assess CSA history and address effects of CSA on sexual risk behavior of MSM. Inconsistencies across studies indicated a need to reach consensus among researchers and providers in defining CSA.     

Unprotected sex and associated risk factors among young Asian and Pacific Islander men who have sex with men.

Young Asian and Pacific Islander (API) men who have sex with men (MSM) are at high risk for HIV, but little is known about their risk behavior. We examined the patterns and predictors of unprotected anal intercourse among 253 API MSM aged 15-25 recruited from gay-identified venues in Seattle, Washington, and San Diego, California, from May to August 1999. Overall, 33% reported unprotected anal intercourse in the past 3 months. Multivariate analyses found that unprotected anal intercourse was associated with self-identifying as gay or bisexual, having multiple sexual partners, having sex with a steady partner, having been tested for HIV, and not perceiving peer norms supportive of safer sex. Young API MSM engage in unprotected sex at high rates. There is an urgent need to help these men reduce sexual risk behavior by implementing HIV prevention programs that address the issue of self-accepting sexual orientation, the potential problem with using HIV testing as a risk reduction strategy, the possible risk of HIV transmission in steady relationships and multiple sexual partnerships, and the importance of establishing safer sex practices as peer norms.     

Correlates of sexual risk behaviors among HIV-positive men who have sex with men.

This study examines correlates of unprotected sexual risk practices of an ethnically diverse sample of HIV-seropositive men who have sex with men (MSM) from the New York City and San Francisco metropolitan areas. Participants completed a self-report survey that assessed sexual risk behaviors and potential correlates. A total of 367 men reported sex with a casual male partner in the previous 3 months. Participants were divided into three groups based on level of HIV-transmission risk with HIV negative or unknown-status partners: no unprotected anal sex (58.9%), unprotected receptive anal sex only (14.2%), and unprotected insertive anal sex (22.6%). Multivariate logistic regression analyses indicated that men reporting unprotected anal insertive sex perceived less responsibility to protect their partners from HIV. Men reporting no unprotected anal sex also reported less use of nitrate inhalants, lower temptation for unsafe sex, and fewer HIV-negative and unknown-status partners. Men reporting unprotected receptive anal sex were less anxious than the other two groups but also reported greater depression than those not reporting unprotected anal sex and greater loneliness than those reporting unprotected anal insertive sex. Implications for interventions with HIV-positive MSM are presented.     

HIV, STIs, and sexual behaviors among men who have sex with men in Phnom Penh, Cambodia.

A probability sample of 206 men who have sex with men from 16 sites in Phnom Penh were surveyed about sexual behaviors and tested for HIV and sexually transmitted infections (STIs). HIV and syphilis prevalence was 14.4% and 5.5%, respectively. Out of the total sample, 81% reported anal sex with any male partners in the past 6 months, and 61.2% reported having had vaginal sex. In the past 6 months, 82.8% of the sample reported having male partners who paid them to have sex. Self-reported sexual orientation did not match well with self-reported sexual behavior. Significant risk factors for HIV infection were anal sex with multiple partners, unprotected vaginal sex with commercial female partners in the past month, and any STI. Complex sexual networks indicate that men who have sex with men act as a bridge between higher and lower HIV prevalence populations. Better prevention efforts structured around behaviors rather than sexual identities are needed.     

Understanding Differences in HIV Sexual Transmission among Latino and Black Men who have Sex with Men: The Brothers y Hermanos Study

HIV sexual transmission risk behaviors were examined among 1,065 Latino and 1,140 black men who have sex with men (MSM). Participants completed a computer-administered questionnaire and were tested for HIV infection. Of men who reported that their last HIV test was negative or that they had never been tested or did not get the result of their last test, 17% of black and 5% of Latino MSM tested HIV-positive in our study. In both ethnic groups, the three-month prevalence of unprotected anal intercourse (UAI) with HIV-negative or unknown serostatus partners was twice as high among men unaware of their HIV infection than men who knew they were HIV seropositive at the time of enrollment. UAI exclusively with HIV-positive partners was more prevalent among HIV-positive/aware than HIV-positive/unaware men. The findings advance understanding of the high incidence of HIV infection among black MSM in the U.S.     

Self-reported sexual behaviour and HIV risk taking among men who have sex with men in Fortaleza, Brazil.

OBJECTIVES: To describe and identify sociodemographic and behavioural characteristics and other factors related to high-risk behaviour for HIV infection of men who have sex with men (MSM) living in Fortaleza, Brazil. METHODS: A survey was carried out among 400 MSM aged 14-65 years and recruited through the snowball technique or in gay-identified venues. A semi-structured questionnaire was conducted among them. Logistic regression analysis was used to model the dichotomous outcome (high risk or low risk). RESULTS: Forty-four per cent of the participants reported engaging in high-risk sexual behaviour in the previous year. MSM less informed about AIDS, reporting more sexual partners, reporting at least one female partner in the previous year, having anal sex as the favourite way to have sex, and having great enjoyment of unprotected anal sex were more likely to be engaged in risky behaviour. Twenty-three per cent of participants reported at least one sexual contact with women during the previous year. Two-thirds of men who had unprotected sex with their female partners also had unprotected anal sex with their male partners. CONCLUSIONS: A large proportion of MSM in Fortaleza still remain at elevated risk for contracting HIV infection. The factors predictive of high-risk sexual behaviour are significant in spreading HIV infection among the MSM population and also among their female partners. The lifestyles of these men are different to those of men from other parts of Brazil or outside the country. Preventive interventions need to be culturally and socially specific in order to be effective.