北京市男男性行为者安全套使用社会规范与无保护性肛交关系的研究

目的 了解北京市男男性行为者(MSM)无保护性肛交发生情况及其与社区安全套使用社会规范的关系.方法 2009年9-10月采用应答驱动抽样方法(RDS)在北京市MSM中开展调查,问卷采用计算机辅助调查员访谈式,内容包括人口学、性行为学特征及安全套使用社会规范,使用RDSAT和SAS进行统计学分析.结果 500名MSM平均年龄30.6岁,96.0%为汉族,高中及以上文化程度者占68.5%,72.8%未婚.61.2%最近6个月男性性伴数量＞1;42.0%的调查对象最近一次发生过无保护性肛交.多因素统计分析表明,差异有统计学意义的变量包括安全套使用社会规范计分低(AOR=1.2,95%CI:1.1-1.3),肛交中非主动角色(AOR=2.0,95%CI:1.3-3.2)和近12个月饮酒次数＞3次/月(AOR=1.6.95%CI:1.1-2.5).MSM社区安全套使用社会规范量表内部一致性检验克朗巴赫系数为0.93.结论 北京市MSM无保护性肛交行为发生率较高,应充分发挥MSM社区内社会规范的作用,减少无保护性肛交行为的发生.

Abstract：

Objective To understand the prevalence of and factors associated with unprotected anal intercourse(UAI)among men who have sex with men(MSM)in Beijing.Methods Five hundred MSM were recruited for a survey using Respondent Driven Sampling (RDS)method, from September to October in 2009. A computer-assisted, interviewer-administered questionnaire was used to gather information including demographics, sexual behaviors and condom use social norms(a scaled number). Variables were evaluated by using RDSAT and SAS software.Results Mean age of the participants was 30.6 years, with 96.0% of them as Han ethnicity and68.5% having had at least high school or higher education level. 72.8% of them were unmarried, with 61.7% of them identified themselves as homosexual, 61.2% had ＞ 1 male partners in the past six months, and the prevalence of UAI was 42.0%. Significant bivariate predictors of UAI would include condom use social norms score, role for anal sex with male sex partner, number of male sexual partners in the past 6 months and amount of alcohol consumed. In multivariable analysis, UAI was associated with a higher condom use social norms score(AOR= 1.2, 95%CI: 1.1-1.3), receptive anal intercourse(AOR=2.0, 95%CI: 1.3-3.2)and drinking alcohol more than 3 times per month in the past 12 months(AOR=1.6, 95%CI: 1.1-2.5). Conclusion The prevalence of UAI was high in the MSM community in Beijing, suggesting that efforts should be targeting on how to make the condom use a social norm and being promoted.     

Porn Sex versus Real Sex: Sexual Behaviors Reported by a U.S. Probability Survey Compared to Depictions of Sex in Mainstream Internet-Based Male–Female Pornography

Using data from a 2014 U.S. nationally representative probability survey and a 2014 content analysis of 2562 male–female videos from two popular pornographic websites, this study aimed to: (1) compare the prevalence of survey respondents’ event-level sexual behaviors with those depicted in mainstream pornography online videos; (2) compare event-level condom use with condom use prevalence in pornographic videos; (3) compare event-level orgasm with prevalence of orgasms in pornographic videos; and (4) assess whether respondents’ partnered use of pornography was associated with the sexual behaviors in which they report engaging. We found that kissing, male orgasm, female orgasm, and condom use were significantly less prevalent in the pornographic videos than in survey respondents’ most recent sexual experiences. Conversely, penile–anal intercourse and fellatio were significantly more prevalent in the pornographic videos than in participants’ reports of their most recent sexual experience. There were no significant differences between the prevalence of cunnilingus or sex toy use represented in the videos as compared to survey respondents’ reports. Finally, we found that individuals who reported partnered pornography use during their most recent sexual experience were more likely to report having engaged in oral sex, penile–anal intercourse, and sex toy use and were also more likely to report female orgasm during their most recent sexual experience.

     

泰安市男男性行为大学生艾滋病感染及相关行为状况

了解泰安市大中专院校大学生男男性行为者(men sho have sex with men,MSM)的艾滋病病毒(HIV)感染状况及其相关危险行为,为制定适宜的健康干预措施提供依据.方法 采用横断面调查研究,对泰安市大中专院校在校MSM人群通过自愿咨询检测(VCT)的方式获得方便样本,采用自填式问卷调查收集人口学特征和行为学信息,并采集血液样本进行HIV、梅毒和单纯疱疹病毒Ⅱ型(HSV-Ⅱ)的血清学检测.结果 共有127例男男性行为者参与研究.性行为角色以“肛交性行为的被插入方”为主的占42.5%.最常用的寻找性伴的方式是网络(89.0%),其中69人通过男同交友软件Blued,占54.3%.有79.4%的被试存在多性伴,近6个月与固定性伴、临时性伴发生无保护肛交的比例分别为60.4%(55/91),50.7%(37/73).最近一次肛交的安全套使用率仅为61.4%,未使用安全套的原因主要是认为和性伴彼此忠诚(18.4%)、身边没有(18.4%)、认为自己不会感染HIV(16.3%).大学生艾滋病知识知晓率为96.1%,但8题全部答对的比例仅为58.3%.大学生HIV感染率为3.1%,4.7%曾感染过梅毒,HSV-Ⅱ血清阳性率为3.1%.单因素分析显示,主要性行为方式以“肛交性行为的插入方”角色为主、使用Blued软件作为寻找性伴的主要方式、与固定性伴发生无保护性行为是HIV感染的危险因素,但Logistic回归分析均无统计学意义.结论 泰安市大中专院校学生MSM艾滋病流行已经显现.急需采取针对性措施提高感染风险意识,改变普遍存在的高危性行为.     

Sexual Risk Behaviors in Adolescent Sexual Minority Males: A Systematic Review and Meta-Analysis

Although adolescent sexual minority males (ASMM) are at increased risk for human immunodeficiency virus (HIV) in the United States (US), studies that estimate sexual risk behaviors that contribute to HIV risk in ASMM are limited. We completed a systematic review and meta-analysis to compile available data and estimate the prevalence of risk behaviors in this population. We searched four databases for key terms related to ASMM, defined as males aged 14 through 19 who identified as gay or bisexual, reported sex with a male in their lifetime, and/or were considered sexual minority by the study. Articles eligible for inclusion were in English, from US studies, and reported quantitative data on sexual risk behaviors among ASMM. We extracted data from eligible articles and meta-analyzed outcomes reported in three or more articles using random effects. Of 3864 articles identified, 21 were eligible for data extraction. We meta-analyzed nine outcomes. Sixty-two percent of adolescent males self-identifying as gay or bisexual ever had sex with a male, and 67% of participants from ASMM studies recently had sex. Among ASMM who had sex in the last 6 months or were described as sexually active, 44% had condomless anal intercourse in the past 6 months, 50% did not use a condom at last sex, and 32% used alcohol or drugs at their last sexual experience. Available data indicate that sexual risk behaviors are prevalent among ASMM. We need more data to obtain estimates with better precision and generalizability. Understanding HIV risk in ASMM will assist in intervention development and evaluation, and inform behavioral mathematical models.     

Men Who Have Met Sex Partners via the Internet: Prevalence, Predictors, and Implications for HIV Prevention

This study examined the prevalence of Internet use for meeting sexual partners among men who have sex with men. The study also examined HIV risk behaviors among men who reported meeting a sexual partner via the Internet. A sample of 609 men was surveyed while attending a gay pride festival in Atlanta, GA. Participants completed a questionnaire assessing demographic information, Internet use, gay acculturation, AIDS knowledge, attitudes about condoms, global substance use, and sexual behavior. A substantial majority of men (75%) reported using the Internet to access gay-oriented web sites. One third of the sample (34%) reported having met a sexual partner via the Internet. Men meeting sex partners online reported higher rates of methamphetamine use. Men meeting sexual partners over the Internet reported having sex with more male partners in the previous 6 months (M = 8.38, it SD = 19.39) compared with men not meeting partners in this manner (M = 3.13, SD = 4.99, p < .001). Men meeting partners via the Internet also reported higher rates of sexual risk behaviors including unprotected anal receptive intercourse (p < .05) and unprotected anal insertive intercourse (p < .01). The high prevalence of Internet use as a method of meeting sexual partners suggests that sexual networks may be forming over the Internet. The Internet therefore provides opportunities for new HIV primary prevention interventions.     

重庆市不同性取向的男男性接触者HIV高危性行为分析

目的了解比较重庆市男同性恋或双性恋者HIV高危行为情况,为行为干预提供理论依据。方法在2006年6-9月依托同性恋活动场所和志愿者组织以滚雪球的方式招募被调查对象,采用匿名面对面询问方式进行问卷调查,对其中男同性恋和男双性恋者的性行为进行比较分析。结果共调查561人,其中50.6%、45.5%分别自我认同为同性恋或双性恋者。男同性恋与男双性恋者中,20～29岁组分别占50.4%、33.9%;在婚比例分别为12.7%、46.5%(均P<0.01)。同性恋者首次性行为是男性性伴的比例(67.3%)高于双性恋者(32.5%),与男性首次性行为的年龄(25.5岁)低于双性恋者(28.2岁)。最近6个月同性恋者与男性肛交的比例(87.3%)高于双性恋者(78.8%)(P<0.05);且肛交时每次都用安全套的比例均很低,分别为22.9%和18.4%。最近6个月同性恋、双性恋者与女性发生性行为的比例分别为16.9%、49.8%(P<0.01);且从未使用安全套的比例较高,分别为50.0%和57.5%。同性恋、双性恋者通过付钱方式得到男性提供的性服务的比例分别为7.7%、4.1%,与这种男性发生肛交时每次都用安全套的比例分别为63.6%、25.0%(均P<0.05)。结论男双性恋者有较高比例的已婚率和女性性伴,男同性恋者与男性发生性行为的比例更高,且两者的无保护性肛交的频率很高,应加强对该人群的监测和综合干预。     

北京市大学在校生男男性行为者HIV感染状况及其相关危险陛行为调查

目的 了解北京市大学在校生男男性行为者的HIV感染状况及其相关危险性行为.方法 研究对象主要通过网络招募,采用自填式问卷调查.问卷内容包括人口学信息与艾滋病相关危险行为等.问卷完成后采集血液样本进行HIV血清学检测.单因素分析采用X2检验,多因素分析采用logistic同归.结果 研究成功招募157人.平均年龄为(22.7±2.8)岁,少数民族占12.1%,77.7%自我认同为同性恋.98.1%曾有肛交行为,73.9%报告肛交是常采用的性行为方式.157人中近6个月有58.6%发生过无保护肛交,有58.0%口交时从不使用安全套,其中59.2%存在多性伴(性伴数≥2)行为.近50.0%认为自己不可能感染HIV或者风险很小,检测发现HIV阳性率为2.5%.logistic回归分析结果 显示,曾与陌生人发生性行为(OR=13.10)、了解"肛交时做主动方比做被动方感染HIV风险小"(OR=3.37)以及曾去同性恋酒吧(OR=2.49)是近6个月发生多性伴行为的独立危险因素.结论 大学在校生男男性行为者无保护肛交和多性伴行为较普遍.亟需开展有针对性的干预活动,预防HIV在该人群中传播.

Abstract：

Objective To assess the prevalence of HIV and risky sexual behaviors among university students who have sex with men(MSM)in Beijing.Methods MSM students in the universities were mainly recruited via internet.Questionnaires were self-administered to collect social demographic information and AIDS-related risky sexual behaviors.After completing the questionnaire,blood sample was collected to determine HIV infection through serological testing.X2 test and logistic regression were employed for univariate and multivariate analysis,respectively.Results A total of 157 students were recruited with mean age of 22.7±2.8 years old,12.1%of them were minorities and 77.7% were self-identified as homosexual.98.1% had engaged in anal intercourse(AI)in their lifetime and 73.9%reported that AI was common sexual behavior they often practised.In the past 6 months,58.6% had ever had unprotected anal intercourse(UAI),58.0% never used condoms during oral intercourse,and 59.2% had multiple sex partners(≥2).Nearly half of them believed that they were at low or no risk of contracting HIV and the prevalence of HIV infection was 2.5%.Data from logistic regression analysis showed that ever having had sex with a casual partner in a lifetime (OR=13.10).understanding that serving an insertive role had less risk than being receptive during the AI (OR=3.37),and ever having been to a gay bar(OR=2.49)was independently related to having multiple sex partners in the past 6 months.Conclusion Despite the extensive programs on education,behaviors regarding UAI and ever having had multiple sex partners were silll commonly seen among university MSM students.Interventions were needed to prevent HIV transmission in this population.     

天津市男同性恋人群高危性行为与性病网络调查

[目的]通过网络调查了解天津市男同性恋人群性传播疾病流行状况,探讨其与高危性行为的关系。[方法]对天津市某同性恋网站招募的480名同性恋者进行网上问卷调查,并为其提供免费HIV、梅毒检测。[结果]被调查者中99人曾患性病,性病组与非性病组相比更多见：多性伴、肛交、口交、卖淫、使用安全套等情况。经逐步Logistic回归分析显示：6个月内不同男性伴数、肛交、卖淫、与固定性伴性交时使用安全套为男同性恋者患性病的危险因素。62人参与免费检测,HIV阳性率4.8%,梅毒阳性率为16.1%。[结论]天津市男同性恋人群中普遍存在高危性行为,已具备性病流行环境。在干预中应针对高危性行为进行控制,倡导健康性行为,加强减少性伴和正确认识安全套防病作用的教育。     

Public health challenges of the emerging HIV epidemic among men who have sex with men in China

A large-scale national survey was conducted in 2008 across 61 cities throughout China, covering over 18,000 men who have sex with men (MSM). The prevalence of human immunodeficiency virus (HIV) was 4.9% and incidence ranged from 2.6 to 5.4 per 100 person-years. The prevalence of sexually transmitted diseases ranged from 2.0% to 29.9% among MSM in different parts of China. Syphilis status, recruitment of sexual partners mainly from gay saunas, duration of MSM experience, and unprotected sex with regular male sex partners and multiple male sex partners predicted HIV seroconversion. The prevalence of consistent condom use was low during anal sex, ranging from 29.4% to 37.3%. Within this context, this paper considers the factors surrounding HIV prevention activity, and identifies a number of public health challenges which need to be considered if optimum outcomes are to be achieved. HIV prevention targeting MSM is a delayed response. The high risk associated with gay saunas and the need for steady condom supply at these venues needs urgent consideration. In addition, approximately one-third of MSM in China reported bisexual behavior, which may be attributed to sociocultural reasons and stigma against MSM. Female sex partners of MSM are seldom aware of their exposure to high risk of HIV transmission. Finally, the primitive nature of non-government organizations for HIV prevention and issues around their sustainability pose another serious challenge for the future of HIV prevention campaigns targeting MSM in China.     

Perceptions of HPV,Genital Warts,and Penile/Anal Cancer and High-Risk Sexual Behaviors Among Men Who Have Sex with Men in Hong Kong

The prevalence of HIV and HPV is high among men who have sex with men (MSM) in China. It is unclear whether cognitive and affective responses related to HPV and HPV-related diseases are negatively associated with HIV-related risk behaviors among MSM. This cross-sectional study interviewed 449 adult Chinese MSM in Hong Kong. The prevalence of unprotected anal intercourse (UAI) and having had anal sex with more than one man in the last 6 months (multiple male sex partnerships) was 39.0 and 71.3 %, respectively. After adjusting for four significant background variables (education level, cohabitation with a man, exposure to HIV prevention materials, and HIV voluntary counseling and testing), variables negatively associated with UAI and/or multiple male sex partnerships included (1) correct HPV-related knowledge (AOR = 0.48–0.66), (2) perceived susceptibility (AOR = 0.32–0.55) and perceived severity (AOR = 0.12–0.60) related to HPV and HPV-related diseases, and (3) fear towards contracting genital warts and penile/anal cancer (AOR = 0.40–0.55). Perceived high chance of contracting HPV was positively associated with multiple partnerships (AOR = 4.74). It is possible to reduce HIV-related risk behaviors by increasing levels of knowledge, cognitions, and fear related to HPV and related diseases. It is important to integrate prevention of HIV with prevention of sexually transmitted infections. Such interventions are warranted.     

A National Study of Lesbian,Gay, Bisexual (LGB), and Non-LGB Youth Sexual Behavior Online and In-Person

Online and in-person sexual behaviors of cisgender lesbian, gay, queer, bisexual, heterosexual, questioning, unsure, and youth of other sexual identities were examined using data from the Teen Health and Technology study. Data were collected online between August 2010 and January 2011 from 5,078 youth 13–18 years old. Results suggested that, depending on sexual identity, between 4–35 % of youth had sexual conversations and 2–24 % shared sexual photos with someone online in the past year. Among the 22 % of youth who had oral, vaginal, and/or anal sex, between 5–30 % met one of their two most recent sexual partners online. Inconsistent condom use was associated with increased odds of meeting one’s most recent partner online for heterosexual adolescent men. For gay and queer adolescent men, having an older partner, a partner with a lifetime history of sexually transmitted infections (STI), and concurrent sex partners were each significantly associated with increased odds of having met one’s most recent sex partner online. None of the examined characteristics significantly predicted meeting one’s most recent sexual partner online versus in-person for heterosexual; bisexual; or gay, lesbian, and queer women. The Internet is not replacing in-person exploration and expression of one’s sexuality and meeting sexual partners online appears to be uncommon in adolescence across sexual identities. Healthy sexuality programming that acknowledges some youth are meeting partners online is warranted, but this should not be a main focal point. Instead, inclusive STI prevention programming that provides skills to reduce risk when engaging in all types of sex is critical.     

Sexually Explicit Online Media and Sexual Risk Among Men Who Have Sex with Men in the United States

This study aimed to describe sexually explicit online media (SEOM) consumption among men who have sex with men (MSM) in the United States and examine associations between exposure to unprotected anal intercourse (UAI) in SEOM and engagement in both UAI and serodiscordant UAI. MSM in the U.S. who accessed a men-seeking-men website in the past year (N = 1,170) were recruited online for a cross-sectional, Internet-based survey of sexual risk and SEOM consumption. In the 3 months prior to interview, more than half (57 %) of the men reported viewing SEOM one or more times per day and almost half (45 %) reported that at least half of the SEOM they viewed portrayed UAI. Compared to participants who reported that 0–24 % of the SEOM they viewed showed UAI, participants who reported that 25–49, 50–74, or 75–100 % of the SEOM they viewed portrayed UAI had progressively increasing odds of engaging in UAI and serodiscordant UAI in the past 3 months. As SEOM has become more ubiquitous and accessible, research should examine causal relations between SEOM consumption and sexual risk-taking among MSM as well as ways to use SEOM for HIV prevention.     

Sexual Risk Behavior of Men Who have Sex with Men: Comparison of Behavior at Home and at a Gay Resort

This study compared sexual behavior of gay and bisexual men (N = 551) while at their primary residence to their behavior while vacationing at a gay resort community. Participants reported behavior for the days they spent in the resort and for their last 60 days in their home residences. Overall, 11 times more non-main partners were reported for unprotected anal intercourse (UAI) per day while in the resort as for the “at home” period. Regression analysis identified negative attitudes toward condoms, less concern about AIDS, and daily number of non-main, male partners at home with whom UAI occurred as significant predictors of the daily number of non-main male partners with whom holidaymakers engaged in UAI while in the resort area. The results suggest that sexual risk taking by men who have sex with men (MSM) while on holiday may be elevated over that at home and that prevention efforts need to be promoted in gay resorts. Behavioral surveillance research would be helpful in better characterizing the current social contexts of sexual risk taking by MSM. Theory-based studies of the nature of risk-taking and sexual decision-making on “gay holiday” could inform the development of empirically proven and conceptually grounded interventions.     

Patterns and risk factors of inconsistent condom use among men who have sex with men in Viet Nam: Results from an Internet-based cross-sectional survey

Survey data from men who have sex with men (MSM) in Asian cities indicate drastic increases in HIV prevalence. It is unknown which factors are most important in driving these epidemics. The objective of this study was to identify patterns of condom use among MSM Internet users living in Viet Nam, as well as risk factors associated with inconsistent condom use and non-condom use. A national Internet-based survey of sexual behaviours was administered in 2011. Results showed that 44.9% of MSM reported not using a condom during their last anal sex encounter with a male partner. MSM were less likely to report condom use during anal sex with long-term partners than with casual partners. Twenty-three and a half per cent of MSM surveyed had ever taken an HIV test and received the results. Study findings highlight the urgent need for targeted strategies focused on increasing the rate of consistent condom use during anal sex with male partners among MSM in Viet Nam.     

Internet Use,Recreational Travel,and HIV Risk Behaviors in Men Who Have Sex With Men

Previous studies have documented higher rates of HIV risk behavior in gay and bisexual men traveling for leisure. Most of these studies collected data in high-risk tourist areas known for promoting alcohol and other substance use. The present study sampled a broader range of men by collecting data at a Gay Pride celebration, and asking participants about vacation experiences over the past 12 months. We also collected information about men’s use of the Internet to find sexual partners before they traveled. Overall, two-thirds of participants reported recreational travel in the previous year. Of these men, 17% reported having sex with a new partner during their most recent vacation. Forty-three percent of the respondents were sexually active during their vacation. Sexually-active participants reported a mean of 2.01 unprotected anal sex acts during their brief vacation stay (M = 6.2 days). Close to half of the sexually-active men reported having sex with a partner of unknown HIV status. Alcohol and drug use were associated with unprotected sex. Men who used the Internet to set up dates prior to travel reported significantly more sexual partners and were significantly more likely to report having sex with a new partner. Many gay and bisexual men on vacation report behaviors that may place their health at risk, including substance use and unprotected sexual activity. Interventions designed to reduce risk behaviors in this population are needed.     

Actor–Partner Effects of Demographic and Relationship Factors Associated with HIV Risk Within Gay Male Couples

Recent research has investigated the association of relationship factors and dynamics with sexual behaviors and HIV risk among gay male couples. However, few studies with gay male couples have used the Actor–Partner Interdependence Model framework to examine whether factors influence an individual and his partner’s sexual risk behaviors. None of these studies analyzed whether relationship factors had influenced the sexual risk behaviors of both partners within the couple. Our cross-sectional study used dyadic data from 142 gay male couples to assess actor–partner effects of relationship commitment, trust, and investment in one’s sexual agreement for HIV risk. Multilevel modeling was used to examine which actor–partner effects of these factors were predictive of individuals and their partners having had UAI within and outside the relationship. Results indicated that participants’ likelihood of having had UAI within and outside of the relationship significantly decreased with: (1) actor effects of value in and commitment to a sexual agreement, and quality of alternatives to the relationship and (2) partner effects of participant’s age, dependability of trust, quality of alternatives to the relationship, and investment of relationship commitment. No significant actor–partner effects were detected for having had UAI within the relationship. Our findings suggest that future HIV prevention strategies should take into account how relationship factors influence an individual and his main partners’ sexual risk behaviors and in turn, the couple’s risk for HIV. However, more research is needed to examine how actor–partner effects of relationship factors influence a variety of sexual risk behaviors within gay male couples.     

2011年玉林市MSM人群AIDS相关知识、性行为特征及HIV／梅毒感染状况调查

[目的]了解玉林市部分男男同性性行为人群（MSM）艾滋病相关知识知晓及性行为情况,为预防艾滋病、梅毒传播提供依据。[方法]2011年8月,对玉林市部分MSM人群进行问卷调查,并检测HIV、梅毒抗体。[结果]调查92人,艾滋病知识知晓率为82．60％。55人（59．78％）的调查对象最近6个月有同性肛交性行为。55人中,最近6个月与男性发生肛交性行为时每次都使用安全套比例为43．64％;最近6个月有17．39％的调查对象与女性发生过性行为,与女性发生性行为时每次都使用安全套比例为31．25％。HIV阳性率为3．26％,梅毒阳性率为6．52％。[结论]玉林市MSM人群危险性行为普遍存在,安全套使用率低,HIV、梅毒感染率较高。     

四座城市MSM人群同性恋与非同性恋者HIV和梅毒感染状况及相关因素

目的 了解我国四城市男男同性恋人群(men who have sex with man,MSM)中,同性性取向者(同性恋)和性取向为异性或双性或未确定者(非同性恋)艾滋病病毒(human immunodeficiency virus,HIV)和梅毒感染状况,探讨MSM同性恋和非同性恋者感染HIV和梅毒的相关因素.方法 采用横断面调查的方法,以北京、哈尔滨、郑州和成都市为调查现场,通过“滚雪球”的方法在MSM人群中招募调查对象,调查内容包括社会人口学特征、性伴和性行为、HIV和梅毒抗体血清学检测.运用Epi Data 3.0软件建立数据库,使用SPSS 13.0软件进行统计分析.结果 共1 693名符合条件的MSM,其中同性恋和非同性恋者所占的比例分别为67.5％和32.5％.同性恋和非同性恋者HIV感染检出率分别为6.8％、7.1％,梅毒检出率分别为11.6％、13.3％.在同性恋者中,年龄在18 ～24岁及无收入者所占的比例为41.6％和22.1％,均高于非同性恋者(均有P＜0.001).同性恋者感染HIV和梅毒的多因素分析结果显示,居住在成都市、在浴池等洗浴场所寻找性伴、男男肛交性角色仅做被插入方者或既做插入方又做被插入方者及感染梅毒者感染HIV的危险性增加,居住在哈尔滨市、在公园公厕寻找性伴、男男肛交性角色为仅做被插入方者或既做插入方又做被插入方者、男男肛交时未坚持使用安全套、HIV感染者和近6个月性伴数≥6个者感染梅毒的危险性增加;非同性恋者感染HIV和梅毒的多因素分析结果显示,居住在成都及感染梅毒者感染HIV的危险性增加,通过互联网寻找性伴者感染HIV的危险性降低,男男肛交时未坚持使用安全套及HIV感染者感染梅毒的危险性增加.结论 MSM人群同性恋和非同性恋亚群中HIV和梅毒均呈现高流行状态,两者的社会人口学构成及其HIV及梅毒感染的相关因素不尽相同,提示,在MSM人群中控制HIV和梅毒流行需要区别不同亚群的特点开展针对性干预策略和措施.     

Coercive forms of sexual risk and associated violence perpetrated by male partners of female adolescents

CONTEXT: Partner violence is associated with STDs among female adolescents, but the mechanisms underlying this association remain unclear. Sexually coercive and deceptive behaviors of male partners that increase female STD risk may be factors in this relationship. METHODS: A sample of 356 females aged 14–20 who attended adolescent health clinics in Greater Boston between April and December 2006 were assessed for physical and sexual violence perpetrated by male partners and for exposure to sexual risk factors. Adjusted logistic regression models were used to examine the associations between intimate partner violence and standard sexual risk behaviors (e.g., multiple partnerships) and coercive or deceptive sexual risk factors (e.g., coerced condom nonuse). RESULTS: More than two‐fifths of the sample had experienced intimate partner violence. In adjusted analyses, adolescents reporting intimate partner violence were more likely than others to report standard sexual risk behaviors—multiple partners, anal sex and unprotected anal sex (odds ratios, 1.7–2.2). They also were more likely to report coercive or deceptive sexual risk factors—partner sexual infidelity, fear of requesting condom use, negative consequences of condom request, and coerced condom nonuse (2.9–5.3). CONCLUSION: The high prevalence of intimate partner violence against young women attending adolescent clinics strongly indicates the need to target this population for abuse‐related interventions. This need is underlined by the observed association between partner violence and sexual risk involving coercion or deception by male partners. Clinic‐based STD and pregnancy prevention efforts should include assessment of sexual risk factors that are beyond the control of young women, particularly for those experiencing abuse.     

HIV risk behaviors of Latin American and Caribbean men who have sex with men in Miami, Florida, USA.

OBJECTIVE: The goal of this study is to describe the sexual practices, drug use behaviors, psychosocial factors, and predictors of unprotected anal intercourse (UAI) in a sample of Hispanic men who have sex with men (MSM) born in Latin American and Caribbean (LAC) countries who currently reside in Miami-Dade County, Florida. METHODS: Hispanic MSM (N = 566) recruited from community and Internet venues completed a computer-assisted self-interview assessing sociodemographic factors, drug use, sexual behaviors, and psychosocial factors. We focused on the 470 men who were born in LAC countries, including Puerto Rico. We first examined separately, by country of origin, the sexual practices, drug use behaviors, and psychosocial factors of the sample. We then collapsed the groups and examined the factors associated with UAI in the previous 6 months for the entire sample of Hispanic MSM from LAC countries. RESULTS: In the previous 6 months, 44% of the sample engaged in UAI, and 41% used club drugs. At the multivariate level, psychological distress, higher number of sexual partners, club drug use, HIV-positive status at the time of immigration, and greater orientation to American culture were significantly associated with UAI in the previous 6 months. CONCLUSION: Many MSM born in LAC countries engage in HIV-related risk behaviors in the AIDS epicenter of Miami-Dade County, Florida. Culturally appropriate interventions should address these risk behaviors in this underserved population.