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This study examined the relationship between HIV risk behaviors, partner characteristics, and undiagnosed seropositivity among
men who have sex with men and women (MSMW) and men who have sex with men only (MSMO). BESURE-MSM2 is a venue-based cross-sectional
HIV surveillance study conducted among MSM in 2008. Stratified log-binomial regression was used to assess adjusted prevalence
ratios of undiagnosed seropositivity among 103 MSMW and 296 MSMO (N = 399). Among MSMO, race/ethnicity, age, having had a sexually transmitted infection, concurrency, and having a black/African
American male partner were associated with undiagnosed seropositivity. Among MSMW, having five or more male partners, having
a main male partner, and having a main female partner were associated with undiagnosed seropositivity. Our findings underscore
the importance of partner characteristics in understanding HIV transmission. HIV programs for men with both male and female
partners are needed to address the unique partnership dynamics of MSMW. 相似文献
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We conducted a cross-sectional survey of MSM using a time-location-sampling design in San Francisco during 2007–2008. The
investigation focused on the selection of sexual partners, partner preferences, perceptions of HIV risk, and social mixing
with respect to race/ethnicity. The sample of 1,142 MSM was 56% White, 22% Latino, 14% Asian, and 9% Black and reported on
3,532 sexual partnerships. Black MSM had a significant, three-fold higher level of same race sexual partnering than would
be expected by chance alone (i.e., in the absence of selective forces with respect to race among partners). Black MSM were
reported as the least preferred as sexual partners, believed at higher risk for HIV, counted less often among friends, were
considered hardest to meet, and perceived as less welcome at the common venues that cater to gay men in San Francisco by other
MSM. Our findings support the hypothesis that the sexual networks of Black MSM, constrained by the preferences and attitudes
of non-Blacks and the social environment, are pushed to be more highly interconnected than other groups with the potential
consequence of more rapid spread of HIV and a higher sustained prevalence of infection. The racial disparity in HIV observed
for more than a decade will not disappear until the challenges posed by a legacy of racism towards Blacks in the US are addressed. 相似文献
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Emily Greene Victoria Frye Gordon Mansergh Grant N. Colfax Sharon M. Hudson Stephen A. Flores Donald R. Hoover Sebastian Bonner Beryl A. Koblin 《AIDS and behavior》2013,17(3):889-899
The role men who have sex with men and women (MSMW) play in heterosexual HIV transmission is not well understood. We analyzed baseline data from Project MIX, a behavioral intervention study of substance-using men who have sex with men (MSM), and identified correlates of unprotected vaginal intercourse, anal intercourse, or both with women (UVAI). Approximately 10 % (n = 194) of the men reported vaginal sex, anal sex, or both with a woman; of these substance-using MSMW, 66 % (129) reported UVAI. Among substance-using MSMW, multivariate analyses found unemployment relative to full/part-time employment (OR = 2.28; 95 % CI 1.01, 5.17), having a primary female partner relative to no primary female partner (OR = 3.44; CI 1.4, 8.46), and higher levels of treatment optimism (OR = 1.73; 95 % CI 1.18, 2.54) increased odds of UVAI. Strong feelings of connection to a same-race gay community (OR = 0.71; 95 % CI 0.56, 0.91) and Viagra use (OR = 0.31; 95 % CI 0.10, 0.95) decreased odds of UVAI. This work suggests that although the proportion of substance-using MSM who also have sex with women is low, these men engage in unprotected sex with women, particularly with primary female partners. This work highlights the need for further research with the substance using MSMW population to inform HIV prevention interventions specifically for MSMW. 相似文献
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Isabel Sathane Roberta Horth Peter Young Celso Inguane Rassul Nalá Angelica E. Miranda Tim Lane H. Fisher Raymond Beverley Cummings Willi McFarland 《AIDS and behavior》2016,20(10):2296-2308
Using respondent-driven sampling (RDS), an integrated biological behavioral survey among men that have sex with men (MSM) enrolled 457 participants in Maputo [63.0 % were MSM who had sex with women (MSMW)], 538 in Beira (36.2 % MSMW) and 330 in Nampula-Nacala (54.8 % MSMW) in 2011. Analysis suggests that MSM who have sex only with men (MSMO) had increased odds of having HIV (aOR 2.7) compared to MSMW. HIV among MSMO associated with age, self-reported STI (aOR 4.2), having a single male anal partner (aOR 3.8) and having transactional sex with a man (aOR 3.5) in the past year. Among MSMW, HIV associated with age, lower education (aOR 32.5), being uncircumcised (aOR 3.1) and having transactional sex with a woman (aOR 6.0) in the past year. Findings confirm that MSMO and MSMW have distinct HIV risks in Mozambique; HIV programs for MSM in Southern Africa should take such differences into consideration. 相似文献
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Reback CJ Grant DL Fletcher JB Branson CM Shoptaw S Bowers JR Charania M Mansergh G 《AIDS and behavior》2012,16(7):1993-2002
Text-messaging interventions present a novel approach for targeting high-risk men who have sex with men (MSM) who may not respond to or may be difficult to reach for face-to-face or site-based interventions. Project Tech Support (N?=?52) was an open label pilot study testing the feasibility and utility of a text-messaging intervention to reduce methamphetamine use and high-risk sexual behaviors among out-of-treatment MSM. Participants in the two-week intervention received social support and health education text messages transmitted in real-time. At follow-up, there were significant decreases in frequency of methamphetamine use and unprotected sex while on methamphetamine (both p?0.01), and a significant increase in self-reported abstinence from methamphetamine use (13.3?% vs. 48.9?%; p?0.001). Additionally, participants reported reductions of unprotected anal intercourse with HIV-positive partners (p?0.01); with HIV-negative partners, participants reported fewer insertive and receptive episodes (both p?0.05). Findings demonstrate that text messaging is a promising intervention for reaching and potentially changing HIV high-risk behaviors among out-of-treatment, methamphetamine-using MSM. 相似文献
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A common concern within HIV prevention is that HIV positive MSMW do not disclose their HIV status to female partners who are
thus at increased risk for HIV infection. The present study uses unique data to examine whether MSMW disclose more often to
male rather than female partners. Data were collected on most recent male and/or female primary partner and four most recent
casual partners from 150 MSMW (50 African American, 50 Latino, 50 White). MSMW reported on 590 partners (31% female; 69% male).
Disclosure was coded as disclosure before sex, disclosure after sex, or nondisclosure. A series of multinomial logistic regressions
with partners clustered within respondents were conducted to evaluate effects of respondent characteristics and partner characteristics
on timing of disclosure. In bivariate and multivariate analyses there were no significant differences in odds of disclosure
to male and female partners before or after sex. Although MSMW were substantially less likely to disclose to HIV negative
partners before sex compared to HIV positive partners regardless of sex, when we fully interacted the multivariate model by
partner sex, the odds of disclosure to HIV negative male partners compared to HIV positive male partners before sex were significantly
higher than the odds of disclosure to HIV negative female partners compared to HIV positive female partners. Patterns of mutual
nondisclosure and nonreciprocal disclosure were observed with both primary and casual partners. The paper makes additional
methodological contributions to the measurement and analysis of disclosure. 相似文献
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Geoffrey Jobson Glenn de Swardt Kevin Rebe Helen Struthers James McIntyre 《AIDS and behavior》2013,17(1):12-22
Current guidelines on HIV prevention for MSM emphasise the need for ‘combination prevention’ based on context-specific understandings of HIV risk. MSM in South Africa are a population with a high risk of HIV infection, however there is little research available on the drivers of this risk. In the context of a focus on combination prevention, this paper argues that effective HIV prevention for MSM in South Africa requires an understanding of the factors at multiple ‘distances’ from individuals that contribute to HIV risk. Based on qualitative research with MSM in Cape Town, South Africa, we situate HIV risk using a socio-ecological framework and identify factors at distal, proximal, and personal, levels that contribute to MSM’s high risk of HIV infection. By understanding the interactions and linkages between risk environments and the risk situations in which HIV is transmitted, HIV prevention programmes will be more effectively able to address the multiple drivers of HIV risk in this population. 相似文献
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Dustin T. Duncan Su Hyun Park John A. Schneider Yazan A. Al-Ajlouni William C. Goedel Brian Elbel Jace G. Morganstein Yusuf Ransome Kenneth H. Mayer 《AIDS and behavior》2017,21(12):3478-3485
The objective of this study was to examine the association between financial hardship, condomless anal intercourse and HIV risk among a sample of men who have sex with men (MSM). Users of a popular geosocial networking application in Paris were shown an advertisement with text encouraging them to complete a anonymous web-based survey (n = 580). In adjusted multivariate models, high financial hardship (compared to low financial hardship) was associated with engagement in condomless anal intercourse (aRR 1.28; 95% CI 1.08–1.52), engagement in condomless receptive anal intercourse (aRR 1.34; 95% CI 1.07–1.67), engagement in condomless insertive anal intercourse (aRR 1.30; 95% CI 1.01–1.67), engagement in transactional sex (aRR 2.36; 95% CI 1.47–3.79) and infection with non-HIV STIs (aRR 1.50; 95% CI 1.07–2.10). This study suggests that interventions to reduce financial hardships (e.g., income-based strategies to ensure meeting of basic necessities) could decrease sexual risk behaviors in MSM. 相似文献
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Monique J. Brown Julianne M. Serovich Judy A. Kimberly Jinxiang Hu 《AIDS and behavior》2017,21(9):2650-2658
Vengeance has been shown to be a risk factor for HIV nondisclosure. Research examining the associations between vengeance, condomless sex, and HIV nondisclosure is lacking. The aim of the current study was to explore the association between vengeance, condomless sex and disclosure (behavior, attitude and intention) among men who have sex with men (MSM) living with HIV. Participants included 266 MSM who were a part of a disclosure intervention study. Men were recruited from local and state AIDS service organizations (ASOs), HIV-related venues and forums, and at local eating and drinking establishments in Tampa, Florida, and Columbus and Dayton, Ohio metropolitan statistical areas (MSAs). Advertisements were also placed in local daily newspapers. Vengeance was operationalized into three groups based on percentiles (least, more, and most vengeful) and as a continuous variable. Crude and multivariable logistic regression models were used to examine the association between vengeance and condomless sex in the past 30 days. Simple and multiple linear regression models were used to determine the association between vengeance and HIV disclosure. After adjusting for demographic and geographic characteristics, participants who were “most vengeful” had, on average, an approximate six-point decrease (β: ?5.46; 95% CI ?9.55, ?1.36) in disclosure intention compared to MSM who were “least vengeful.” Prevention and intervention programs geared towards improving disclosure among MSM should address vengeance. 相似文献
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We performed a systematic review to estimate the proportion of men who have sex with men (MSM) in Asia who are bisexual and compare prevalence of HIV and sexual risk between men who have sex with men and women (MSMW) and men who have sex with men only (MSMO). Forty-eight articles based on 55 unique samples were identified from nine countries in Asia. Bisexual behaviour was common among MSM (pooled prevalence 32.8 %). Prevalence of HIV (pooled OR 0.90; 95 % CI 0.77–1.05), recent syphilis infection (pooled OR 0.99; 95 % CI 0.93–1.06) and unprotected anal intercourse (pooled OR 0.80; 95 % CI 0.57–1.11) were similar between MSMW and MSMO, but heterogeneity was high. MSMW had lower odds of reporting a prior HIV test than MSMO (OR 0.82; 95 % CI 0.70–0.95; p = 0.01, I2 = 0 %). Targeted interventions are needed to increase uptake of HIV testing among MSMW. Increased reporting of disaggregated data in surveillance and research will help improve understanding of risk in MSMW and inform targeted interventions. 相似文献
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African American men who have sex with men and women (MSMW), but who do not form a sexual identity around same-sex behavior,
may experience risk for HIV infection and transmission. This paper reports cross-sectional survey findings on sexual behaviors
and substance use of urban non-gay- or non-bisexual-identified African American MSMW (n = 68), who completed behavior assessment surveys using audio-computer assisted self-interviewing technology. Overall, 17.6%
reported being HIV-positive. In the past 3 months, 70.6% had unprotected insertive sex with a female, 51.5% had unprotected
insertive anal sex (UIAS) with a male, 33.8% had unprotected receptive anal sex (URAS) with a male, 25% had UIAS with a transgender
female, and 10.3% had URAS with a transgender female. Findings indicated a bridging potential for HIV and sexually transmitted
infections across groups, such that 38.2% reported concurrent unprotected sex with female and male partners and 17.6% reported
concurrent unprotected sex with female and transgender female partners. In the past 3 months, 70.6% used alcohol before sex
and 85% used drugs before sex. Men who used drugs before sex had a tenfold increased likelihood for unprotected sex with male
partners, and men who injected drugs had a nearly fivefold increased likelihood for unprotected sex with a transgender female.
Interventions to address sexual risk behaviors, especially partner concurrency, and substance use behavior for these men are
warranted. 相似文献
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Perceptions of Lifetime Risk and Actual Risk for Acquiring HIV Among Young Men Who Have Sex with Men
MacKellar DA Valleroy LA Secura GM Behel S Bingham T Celentano DD Koblin BA LaLota M Shehan D Thiede H Torian LV;Young Men's Survey Study Group 《AIDS and behavior》2007,11(2):263-270
Among young men who have sex with men (MSM) surveyed in six US cities, we evaluated the magnitude and correlates of perceived
lifetime risk for acquiring HIV, and missed opportunities to increase risk perception by providers of health-care and HIV-testing
services. Overall, approximately one quarter of young MSM perceived themselves at moderate/high risk for acquiring HIV. Adjusting
for demographic, prior testing, and behavioral characteristics, moderate/high perceived risk had the strongest association
with unrecognized HIV infection. However, half of the 267 young MSM with unrecognized infection perceived themselves at low
lifetime risk for acquiring HIV, and many young MSM with low-risk perception reported considerable risk behaviors. Providers
of health-care and HIV-testing services missed opportunities to assess risks and recommend testing for young MSM. To increase
HIV testing, prevention providers should intensify efforts to assess, and to increase when needed, perceptions of lifetime
risks for acquiring HIV among young MSM. 相似文献
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Why HIV Infections Have Increased Among Men Who Have Sex with Men and What to Do About It: Findings from California Focus Groups 总被引:3,自引:0,他引:3
Morin SF Vernon K Harcourt JJ Steward WT Volk J Riess TH Neilands TB McLaughlin M Coates TJ 《AIDS and behavior》2003,7(4):353-362
A resurgence of sexual risk taking, STDs, and HIV incidence has been reported among men who have sex with men (MSM) in several countries. We asked 113 MSM in 12 focus groups conducted in five California cities to identify factors leading to increased risk taking and assess prevention messages to reduce risk in this population. Participants perceived that HIV risk taking has increased because (1) HIV is not the threat it once was due to more effective therapies, (2) MSM communicate less about HIV, and social support for being safe has decreased, and (3) community norms have shifted such that unsafe sex is more acceptable. The prevention messages ranked most likely to motivate risk reduction encouraged individuals to seek social support from friends. Themes ranked least likely to succeed were those that described the negative consequences of HIV or reinforced existing safer sex messages. 相似文献
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Jenkins RA 《AIDS and behavior》2012,16(6):1411-1419
Research investigators have identified increasing challenges to the recruitment of men who have sex with men (MSM) for observational and intervention HIV/AIDS studies. To address these issues, program staff from the National Institute on Drug Abuse convened a meeting on April 28th to 29th, 2009 to discuss issues in MSM recruitment. The panel indicated that there was decreased community identification with HIV research, although altruistic, community-oriented motives continued to be important. Substance use adds to recruitment challenges, particularly recruitment of MSM who use stigmatized substances. Relatively new recruitment methods such as respondent driven sampling, venue-data-time sampling, and internet sampling have helped advance knowledge about the recruitment process; however, they have not mitigated the challenges to MSM recruitment. Recruitment of youth and members of racial/ethnic minority populations present additional considerations. This report summarizes the meeting's proceedings, key points of discussion, and areas for further research consideration. 相似文献
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To our knowledge, no studies have considered the bidirectional relationship between HIV infected patients’ social/sexual lives
and HAART adherence. To determine it’s potential impact the study sample consisted of 135 men starting HAART and being followed
for 6 months. Twenty percent of men enrolled in the study self-reported non-adherence. Non-adherent patients reported a greater
number and severity of adverse effects such as gastrointestinal and body changes. All participants were aware of these risks,
requested support, and were advised by the health care providers. As many as 26% of the HIV infected men, at the second visit,
reported sexual dysfunction and none received information regarding the possibility of this side effect. Of importance, patients
reporting sexual dysfunction, were more likely to report not being fully adherent to the medication (RR = 2.46 95% CI 1.3–4.7;
P = 0.04). Of most concern, none of the men reported looking for medical advice 相似文献
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N. Harawa L. Wilton L. Wang C. Mao I. Kuo T. Penniman S. Shoptaw S. Griffith J. K. Williams V. Cummings K. Mayer B. Koblin 《AIDS and behavior》2014,18(8):1548-1559
We used baseline data from a study of Black MSM/MSMW in 6 US cities to examine the association of female partnership types with disease prevalence and sexual behaviors among the 555 MSMW participants. MSMW reported more than three times as many total and unprotected sex acts with each primary as they did with each non-primary female partner. We compared MSMW whose recent female partners were: (1) all primary (“PF only”, n = 156), (2) both primary and non-primary (“PF & NPF”, n = 186), and (3) all non-primary (“NPF only”, n = 213). HIV/STI prevalence did not differ significantly across groups but sexual behaviors did. The PF only group had the fewest male partners and was the most likely to have only primary male partners; the PF & NPF group was the most likely to have transgender partners. PF & NPF men reported the most sex acts (total and unprotected) with females; NPF only men reported the fewest. Implications for HIV risk and prevention are discussed. 相似文献