Substance use, medications for sexual facilitation, and sexual risk behavior among traveling men who have sex with men

OBJECTIVES: The objective of the study was to examine correlates of sexual risk behavior among men who have sex with men (MSM) traveling for leisure. STUDY DESIGN: MSM (N = 304) visiting popular tourist areas completed a brief survey assessing sexual behavior and substances used while on vacation, including the use of erectile dysfunction medications (e.g., Viagra). RESULTS: Forty-seven percent of the respondents were sexually active during their vacation, with a mean of 1.33 unprotected anal sex acts during their brief stay (mean = 3.6 days). More than half of the sexually active men reported sex with a partner of unknown HIV status. Individuals reporting substance use or taking erectile dysfunction medications reported higher rates of sexual risk behaviors. CONCLUSION: Many MSM travelers report behaviors that may put their health at risk, including substance use and unprotected sexual activity. Interventions designed to reduce risk behaviors among MSM tourists are needed.     

HIV, sexual risk, and ethnicity among men in England who have sex with men

OBJECTIVES: To examine ethnic group differences in HIV testing history and sexual HIV risk behaviours that may account for such differences, among men in England who have sex with men (MSM), in order to inform HIV prevention planning priorities. METHODS: A self completion survey in the summer of 2001 was carried out in collaboration with community based health promoters. Three recruitment methods were used: "gay pride" festivals, health promoter distributed leaflets, internet version advertised with gay service providers. The leaflet was produced with an alternative cover for targeted recruitment of black men. RESULTS: In a sample of 13,369 MSM living in England, 17.0% were from minority ethnic groups and 5.4% had tested HIV positive. Compared to the white British majority, Asian men were 0.32 times as likely to be living with diagnosed HIV infection, while black men were 2.06 times as likely to be doing so. Among men who had not tested HIV positive, Asian men were less likely to have sex with a known HIV positive partner, while black men were more likely to have insertive unprotected anal intercourse both with a partner they knew to be HIV positive and with a partner whose HIV status they did not know. CONCLUSIONS: Among MSM in England, HIV prevalence is higher among black men and lower among Asian men compared with the white British majority. Increased sexual HIV risk behaviour, especially exposure during insertive anal intercourse, accounts for some of this difference. HIV prevention programmes for MSM and African people should both prioritise black MSM.     

Associations between substance use and sexual risk among very young men who have sex with men

OBJECTIVE: To determine if an association exists in young men who have sex with men (MSM) between being under the influence of alcohol or drugs during sex and participation in sexual behaviors which increase the risk of human immunodeficiency virus (HIV). STUDY DESIGN: A total of 3492 young MSM were interviewed through the Young Men's Survey, an anonymous, cross-sectional, multisite, venue-based survey conducted from 1994 through 1998 at 194 public venues frequented by MSM aged 15 to 22 years in 7 US cities. RESULTS: The majority of young MSM reported both receptive and insertive anal intercourse, and of these, approximately half reported not using condoms. Report of unprotected receptive anal intercourse at least once in the prior 6 months was associated with being under the influence of alcohol (adjusted odds ratio [AOR]=1.5; 95% confidence interval [CI]=1.2-1.8), cocaine (AOR=1.6; 95% CI=1.1-2.2), amphetamines (AOR=1.5; 95% CI=1.1-2.0) or marijuana during sex (AOR=1.3; 95% CI=1.1-1.6). Report of unprotected insertive anal intercourse at least once in the prior 6 months was associated with being under the influence of alcohol (AOR=1.2; 95% CI=1.0-1.5), cocaine (AOR=1.5; 95% CI=1.1-2.0) or amphetamines (AOR=1.9; 95% CI=1.4-2.6). CONCLUSIONS: HIV prevention strategies for young MSM need to incorporate substance use risk reduction.     

固定性伴是男男性行为者的女性之相关生活、态度和认知

目的：探讨固定性伴是男男性行为者（MSM）的女性之相关生活、态度和认知,从当事人角度了解该群体面对的挑战。方法：主要依托固定性伴是MSM的女性所创办的同妻网站进行动员,调查对象限定为其固定性伴是MSM的在婚、已离异或尚未结婚的女性。针对不同亚人群共设计出三套问卷。数据收集通过互联网调查软件“问卷星”进行。结果：有效样本144例,在婚组100人,离异组33人,未婚组11人。与MSM固定性伴在经济上是“AA制”者约3/5。有婚史者认为MSM结婚的最重要原因是亲长要求,用婚姻来证明其“正常”。在知道（对方是MSM）真相前,MSM对固定性伴仅1/4有过主动亲吻行为,性交时3/10喜欢爱抚女性乳房。有婚史者中多数人通过MSM的移动互联网活动发现真相,约1/6直接发现MSM与其他男性的性交往;结婚3年后才知道真相者约2/5,在女方说出真相时,对方承认者不足3/10,MSM婚后主动说出真相者不足1/11。知道真相后她们几乎都曾试图尽多了解MSM固定性伴,少数人甚至雇用私家侦探。在婚组中与MSM有子女者3/4,已分居者约1/4;尚未离异的最重要原因首先是顾忌到子女和财产分配,认为自己生活（较）幸福者仅1/12。离异组中女方提出离异者9/10,通过法院离婚近1/10;女方“净身出户”或仅得到很少财产者占3/5;离异前的最大顾虑是对子女、自己和亲长的影响;离异的最重要原因是认为自己有权利寻找幸福婚姻和夫妻性生活严重不和谐。有婚史者在婚期间有过婚外性伴者3/10,其原因首先是解决性饥渴,恢复自信心和宣泄对MSM固定性伴的不满。该女性群体在为性伴侣状况苦恼时普遍得到过帮助,但最重要的帮助者通常是互联网上的“同妻”、亲人和女友,她们希望获得心理专家、法律专家和艾滋病性病专家帮助。她们中知道同性爱是正常     

男男性行为性病患者性行为特征分析

目的: 分析近一年曾患性传播感染(STI)的男男性行为者(men who have sex with men, MSM)性行为特征及感染STI的影响因素.方法: 对近一年曾患STI者的性行为及STI相关因素进行分析,并与未患STI者进行比较.结果: 近一年曾患STI的MSM同性性伴数、与同性性伴间的高危行为、网络寻找性伴并与网友发生性行为等方面均高于对照组.多因素分析,从事男男性工作和性交时出血与近一年患STI关系密切.结论: 应继续加强对MSM人群进行安全性行为健康教育,以降低STI和HIV感染风险.     

Associations between internet sex seeking and STI associated risk behaviours among men who have sex with men

OBJECTIVE: This exploratory study identified associations between internet sex seeking and HIV associated risk behaviours among a high risk sample of men who have sex with men (MSM). METHODS: A cross sectional survey of men attending a sex resort was conducted. Of 164 men asked to participate, 91% completed a self administered questionnaire. The questionnaire assessed demographic variables and (using a 3 month recall period) men's HIV associated sexual risk behaviours. Potential confounding variables were assessed and controlled, as needed, by multivariate analysis. RESULTS: Men currently resided in 14 states. One sixth reported being HIV positive. 57% of the men reported using the internet to seek sex. Differences in critical behaviours (unprotected anal sex and number of partners) were not found. However, compared to those not seeking sex by internet, men using the internet to meet sex partners were more likely to report fisting (adjusted odds ratio = 3.3, p = 0.04), having group sex (prevalence ratio (PR) = 1.2, p = 0.0001), using poppers during sex (PR = 1.94, p = 0.0001), and using ecstasy during sex (PR = 2.7, p = 0.04). Internet sex seeking men were also significantly more likely to report meeting sex partners in bathhouses (PR = 2.2, p = 0.0001), bars (PR = 1.5, p = 0.001), parks (PR = 3.2, p = 0.006), and circuit parties (PR = 8.9, p = 0.007). CONCLUSION: Among MSM attending a sex resort, those using the internet to seek sex partners may have modestly elevated risks for acquiring or transmitting sexually transmitted infections. Subsequent studies should investigate the utility of using the internet as forum for promoting safer sex behaviours among high risk MSM.     

Differences in HIV risk behaviors among black and white men who have sex with men

OBJECTIVES: Surveillance findings consistently indicate that black men who have sex with men (MSM) experience a disproportionate burden of HIV/AIDS compared with white MSM. This study tested the hypothesis that black MSM engage in greater levels of HIV risk behaviors than white MSM and sought to determine if self-reported HIV serostatus moderated any of the observed differences. METHODS: A cross-sectional study of MSM was conducted by recruiting men from gay-identified venues in a large metropolitan area of the southern United States. Data were collected by face-to-face interview. RESULTS: The hypothesis was only supported for one measure of HIV risk behavior: The average number of main (steady) sex partners in the past year was significantly greater among black men (P < 0.0001). However, black and white MSM did not significantly differ in unprotected sex with serodiscordant partners. Racial differences in sexual risk behavior were found only for HIV-negative men and indicated greater protective behavior for black men. DISCUSSION: These findings suggest that fewer black MSM, compared with white MSM, engage in HIV sexual risk behaviors but only among HIV-negative men. Identifying the epidemiologic dynamics driving HIV infection among black MSM that go beyond individual-level risk behaviors may be warranted.     

年轻男男性行为者首次同性性行为及其意愿的关联因素分析

目的 了解年轻男男性行为者(YMSM)首次同性性行为状况,分析首次同性性行为意愿的关联因素.方法 采用"滚雪球"抽样法于2016年9月至2019年9月在绵阳市招募YMSM作为调查对象,对其进行首次同性性行为状况及关联因素等的问卷调查.结果 共收取有效问卷344份,YMSM发生首次同性性行为时的年龄为(18.1±2.0)...     

深圳市男男性接触人群梅毒合并HIV感染状况及其危险因素分析

目的：了解深圳市近6个月内发生过同性临时性行为的MSM人群梅毒合并HIV感染状况及其相关影响因素。方法：运用滚雪球法和同伴推动抽样法招募MSM进行问卷调查和血清学检测,采用χ2检验和Logistic回归分析梅毒HIV合并感染的相关影响因素。结果：共调查434例MSM,梅毒和HIV感染率分别为16.4%和12.2%,梅毒合并HIV感染率为7.3%。年龄越大（OR=4.0,P=0.0007）、高中/中专文化者（OR=6.5,P=0.0081）、性角色以被动方为主者（OR=12.1,P=0.0017）、多个同性肛交性伴者（OR=1.5,P=0.0455）、不能坚持每次使用安全套者（OR=2.9,P=0.0236）,其梅毒合并HIV感染风险越高。结论：需要采取更大努力来应对该人群的梅毒和HIV双重感染问题。     

Commercial sex work and risk of HIV infection among young drug-injecting men who have sex with men in San Francisco

OBJECTIVE: The objective of this study was to investigate the relationship between sex work and HIV infection among young injection drug-using men who have sex with men (MSM-IDU). STUDY DESIGN: This study was a cross-sectional analysis of behavioral and serologic data collected from 227 street-recruited MSM-IDU in San Francisco, California, between January 2000 and November 2001. RESULTS: Sixty-eight percent of participants reported being paid by another man for sex. HIV prevalence was 12% (95% confidence interval, 8-16%); 42% of seropositive participants were unaware of their infection. HIV was independently associated with higher number of paying male partners and history of gonorrhea and inversely associated with number of female partners, education, and syringe-sharing. Consistent condom use overall was 41%, but varied significantly by type of partner. CONCLUSIONS: Among MSM-IDU in San Francisco, sex work with men is strongly associated with HIV infection and the prevalence of condom use is low. HIV prevention among MSM-IDU must be tailored to address the excess risk associated with sex work.     

Evidence of heterosexual bridging among syphilis-positive men who have sex with men

OBJECTIVE: To explore whether heterosexual bridging among syphilis-positive men who have sex with men (MSM) contributes to increased infection rates among adolescent women in Baltimore City, Maryland. METHODS: Interview data for patients with primary, secondary and early-latent syphilis from January 2001 to July 2005 were linked with their corresponding field records for named exposed contacts to assess prevalence of male bisexual activity and risk profiles of potential male bisexual bridgers and their female sex partners. RESULTS: None of the women with syphilis reported having known heterosexual relationships with a bisexual man. However, 3.9% and 11.0% of the male sex partners of adolescent females and women aged >25 years with syphilis, respectively, self-reported as MSM or named male sex partners. Likewise, 10.3% of syphilis-positive MSM named female sex partners and 3.0% of syphilis-positive men who did not self-identify as MSM named both male and female sex partners. CONCLUSIONS: Sexual network links exist between syphilis-positive MSM and heterosexual women, but the extent of bisexual behaviour among men is not detectable by self-identification and disclosure to female sex partners.     

MSM性工作者的健康与保护

目的:了解男男性行为者(MSM)中男性性工作者(money-boy,MB)群体的健康保护需求.方法:组织4个MB职场老板和15名从业MB与专家共同召开小型需求座谈会.结果:对性病诊疗的重要已经成为共识,性病感染者就诊受到性病规范服务的调节.口交保护措施、多型号安全套和国产润滑剂质量提高是MB的需求,而性顾客对MB是否采取安全性行为有重要影响.结论:MB的健康干预是一个系统工作,需要调动社会力量加强宣传,共同促进健康保护工具的质量提高和品种的多样化,同时要加强性病诊疗规范化服务的培训和督导,建立起服务促进平台,促进性病诊疗工作的质量提高.