Risk factors for AIDS and HIV seropositivity in homosexual men

The authors compared cases of acquired immunodeficiency syndrome (AIDS) diagnosed in San Francisco, California, during 1983-1984 with human immuno-deficiency virus (HIV) antibody-negative neighborhood and clinic controls, looking for risk factors for clinical AIDS. They also compared antibody-positive with antibody-negative neighborhood and clinic controls for risk factors for HIV infection. Odds ratios were 52.0 for AIDs and 7.8 for seropositivity for more than 100 sexual partners versus 0-5 partners when antibody-negative neighborhood controls were compared with cases and with antibody-positive neighborhood controls, respectively. Odds ratios were only 2.9 and 3.4 when antibody-negative clinic controls were compared with cases and with antibody-positive clinic controls, respectively. Odds ratios of 4.6-7.3 for rectal receptivity with most or all partners versus none or one partner were statistically significant, independent of the number of partners. Douching before sex was independently associated with odds ratios of 2.2-2.8. There was no evidence for oral-genital, oral-anal, or other sexual transmission of AIDS. In multivariate analysis, independent odds ratios of 2.4-6.0 for prior syphilis and 10.8-27.9 for prior giardiasis were statistically significant or marginally significant in all comparisons. There was a moderate association with nitrite use. No other drugs were consistently associated with clinical AIDS or HIV seropositivity. Odds ratios associated with AIDS and seropositivity were closely comparable except for number of partners.     

Reliability of self-reported sexual behavior risk factors for HIV infection in homosexual men

This study was undertaken to determine the reliability of self-reported sexual behavior using the test and retest technique when used with self-reported sexual behavior. The subjects were 116 asymptomatic homosexual men who participated in another study (an examination of behavioral and demographic determinants of HIV antibody status). The subjects were asked to complete two questionnaires. The first contained demographic and sexual behavior questions. The second, administered an average of 6 weeks later, used a subset of the questions in the first questionnaire. The reliability of the test-retest procedure was measured by the Kappa statistic, which assesses the proportion of agreement between two data items, accounting for the amount of agreement expected by chance. The highest degree of reliability as measured by Kappa was found with demographic information, smoking history, and sexual orientation. Self-reported sexual behaviors for the previous 6 months generally had the next highest degree of reliability as measured by Kappa. Questions examining change over the previous 5 years had the lowest reliability. Behavior changes during the time between questionnaires, subjectivity of the answer categories, and social desirability of the answers are three factors that may result in a lack of reliability in this self-reported sexual behavior questionnaire. This raises methodological concerns about the measurement of behavioral risk factors for AIDS and the ability to assess meaningfully subjective reports of behavioral change.     

Behavioral, health and psychosocial factors and risk for HIV infection among sexually active homosexual men: the Multicenter AIDS Cohort Study.

We examined whether 644 homosexual men who engaged in receptive anal intercourse were at particularly elevated risk for seroconversion if they also possessed specific behavioral, health or psychosocial vulnerability characteristics. Of 11 potential factors examined, heavy drinking, moderate to heavy drug use, and younger age were significantly related to seroconversion. These variables were also associated with an increased number of sexual partners, anonymous sex, and failure to use condoms.     

Behavioral risk factors for HIV infection among homosexual men at a Boston community health center.

Social and behavioral factors associated with human immunodeficiency virus (HIV) infection were analyzed using cross-sectional data from homosexual and bisexual male clients of a Boston community health center. Partners from California, and a previous period of greater sexual activity (a "high period"), were independently associated with positive HIV antibody status, as were the frequency of receptive anogenital contact, both during the "high period" and during the last six months.     

Communication with sexual partners about the risk of HIV/AIDS infection in seamstress apprentices in Benin

Communication with sexual partners on the risk of HIV/AIDS infection and its relation to risk-taking was examined in a group of young single women who have been removed from school and apprenticed to a seamstress in Cotonou, Benin. Twenty women aged 15 to 24 were interviewed. Results showed that more than half the women had already discussed HIV/AIDS with their partners. This discussion, always initiated by the woman, progresses until the ultimate goal is achieved: discussion of practicing safer sex. Women who openly communicated with their partners possessed certain common characteristics (e.g. they were born in Cotonou, seeking marriage or financial assistance, had a perception of risk, had discussions with friends). Those who communicated the most reported that practicing safer sex consisted of using a condom, which still remains an occasional practice at best.     

Serosorting sexual partners and risk for HIV among men who have sex with men

OBJECTIVE: The purpose of the current study was to assess whether men who have sex with men (MSM) who limit their unprotected anal sexual partners to those who are of the same HIV status (serosort) differ in their risk for HIV transmission than MSM who do not serosort. METHODS: Cross-sectional surveys administered at a large Gay Pride festival in June 2006 (80% response rate) were collected from MSM. Univariate and multivariate logistic regressions were used to identify predictors of serosorting. Analyses were conducted in 2006. RESULTS: Participants were self-identified as HIV-negative MSM (N=628); about one third of them engaged in serosorting (n=229). Men who serosort were more likely to believe that it offered protection against HIV transmission, perceived themselves as being at no relatively higher risk for HIV transmission, and had more unprotected anal intercourse partners. Over half the sample reported their frequency of HIV testing as yearly or less frequently; this finding did not differ between serosorters and nonserosorters. CONCLUSIONS: Men who identify as HIV-negative and serosort are no more likely to know their HIV status than men who do not serosort and are at higher risk for exposure to HIV. Interventions targeting MSM must address the limitations of serosorting.     

Infectiousness of HIV between male homosexual partners

To estimate the risk of transmission of HIV per receptive anal sexual contact, 329 homosexually-active men, representing 155 sexual partnerships, were enrolled into a study. Information on HIV infection status and sexual behavior within and outside the primary relationship was collected. Of these 329 men, 24 had AIDS and 31 had ARC. Of the 155 couples, 35 consisted of partners that were both HIV +; 62 of partners that were both HIV-; and 58 were discordant. A binomial model was fit to data obtained in the first visit to estimate per contact risk of HIV transmission. Assuming a constant risk of transmission per sexual contact between infected and uninfected partners, the estimated risk is about 5 to 30 per 1000 receptive anal exposures to ejaculate. Although the average risk of HIV transmission per sexual contact appears to be low, there appears to be great variability in infectivity. To model this variability over time and across individuals, more complex models must be fit to longitudinal studies of sexual partners.     

HIV infection and sexual behaviour among homosexual and bisexual men in Bratislava

OBJECTIVE: To determine sexual behaviour and HIV prevalence in a sample of homosexual and bisexual men in Bratislava. PATIENTS AND METHODS: Participants were recruited at gay discotheque in Bratislava in February and June 1996. Saliva samples were collected for testing the presence of anti-HIV antibodies and a questionnaire regarding sexual practice was completed. RESULTS: In the study 170 men (1st discotheque) and 124 men (2nd discotheque) were enrolled. The prevalence of antibodies against HIV was 5.4% and 1.6%, respectively. A group of 119 attenders (mean age: 25 years) was voluntarily questioned about their sexual lifestyle and related behaviour. Sexual orientation of participants was following: 66.4% homosexuals, 20.2% bisexuals, 13.4% others. Most responders were single and did not ever been married (86.55% vs. 12.6%, respectively). The figures of sexual intercourse were: steady partners: 45.38%, non-steady partners: 49.58%. More individuals were using condoms (70.58% vs. 15.97%, respectively), while only 28.57% were using them by each chance sexual intercourse. 6.7% responders suffered from an other STD and 3.36% were intravenous drug users. CONCLUSION: The HIV prevalence (5.4% and 1.6%) was relatively low. Considering the high prevalence of unsafe sexual practice further spread of HIV infection among homosexual men in Slovakia is to be expected.     

同性交友方式对男男性行为人群高危性行为及感染HIV的相关影响

目的 了解同性交友方式对MSM的高危性行为及HIV感染的相关影响。方法 采用横断面调查方法,2018年4-11月在宁波市采用滚雪球的非概率抽样法招募MSM,收集其人口学特征、交友方式、同性社交软件使用、高危性行为发生情况等相关信息,研究对象均需进行HIV抗体检测。分类资料采用χ²检验,采用多因素logistic回归分析MSM的HIV感染相关因素。结果 共调查MSM 735人,同性社交软件交友者、QQ或微信交友者和场所交友者分别为447人（60.8%）、237人（32.3%）和51人（6.9%）。同性社交软件交友者最近6个月性行为次数≥ 1次/周和发生多性伴的分别有75人（16.8%）和187人（41.8%）;最近1次和最近6个月发生无保护肛交行为的分别有54人（12.1%）和234人（52.3%）;HIV感染率为12.1%（54/447）。感染时间<2年的HIV/AIDS中,同性社交软件使用时间<2年的比例为68.6%（24/35）。多因素logistic回归分析结果显示,与QQ或微信交友者比较,同性社交软件交友者更易感染HIV（OR=3.03,95% CI：1.30~7.07）。结论 宁波市MSM中,同性社交软件交友者比例较高,存在较高危险性行为和HIV感染风险。应针对同性社交软件交友者加强监测和干预。     

Lack of evidence for increased risk of hepatitis A infection in homosexual men.

In 1997, prevalence of and risk factors for hepatitis A virus (HAV) infection were evaluated in 146 homosexual and 286 heterosexual men attending a Sexually Transmitted Disease (STD) Clinic in Rome, Italy. Total HAV antibody (anti-HAV) was detected in 60.3% of homosexuals and 62.2% of heterosexuals. After adjustment for the confounding effects of age, years of schooling, number of sexual partners, use of condoms, and history of STD, homosexuals were not found to be at increased risk of previous HAV exposure than heterosexuals (OR 1.1; 95% CI 0.7-1.9). Independent predictors of the likelihood of anti-HAV seropositivity among homosexuals and heterosexuals were: age older than 35 years and positive syphilis serology which is likely a proxy of lifestyles that increase the risk of faecal-oral infections. These findings do not support a higher risk in homosexual men but could suggest a role for the vaccination of susceptible patients attending STD clinics.     

男男性行为人群HIV/AIDS性伴感染状况和溯源效率相关因素研究

目的 了解MSM HIV/AIDS的性伴感染状况和溯源效率的相关因素。方法 采用横断面调查方法,2018-2020年在宁波市对MSM HIV/AIDS开展性伴调查和HIV检测,并用限制性抗原亲和力酶联免疫法判定是否新发感染。分类资料采用χ²检验,采用多因素logistic回归分析溯源效率的相关因素。结果 共调查374例新确证MSM HIV/AIDS,动员479例性伴进行调查和HIV检测,性伴HIV阳性率为15.7%（75/479,95%CI：12.4%~18.9%）,其中新发感染者性伴HIV阳性率为31.8%（21/66,95%CI：20.3%~43.4%）。新发感染者的性伴HIV阳性者中新发现阳性性伴的比例（76.2%）高于长期感染者（48.1%）,差异有统计学意义（P=0.028）。多因素logistic回归分析结果显示,36~45岁年龄组（与18~25岁年龄组相比,OR=3.973,95%CI：1.364~11.569）、HIV主动检测（与HIV被动检测相比,OR=1.896,95%CI：1.083~3.319）、新发感染者（与长期感染者相比,OR=3.733,95%CI：1.844~7.556）的溯源效率更高。结论 MSM HIV/AIDS性伴HIV阳性率高,其中新发感染者和HIV主动检测发现的感染者性伴溯源效率较高。建议加强MSM HIV/AIDS溯源调查,重点关注艾滋病自愿咨询与检测门诊新确证的MSM HIV/AIDS。     

Histories of substance use and risk behavior: precursors to HIV seroconversion in homosexual men.

OBJECTIVES: This study compared history of substance use and episodic use in terms of HIV seroconversion. METHODS: A sample of 337 baseline HIV-negative gay men was followed for 6 years. Bivariate and survival analyses were used to compare 39 converters with nonconverters on substance use behaviors. RESULTS: Seroconverters were consistently more likely to report use of marijuana, nitrite inhalants, amphetamines, and cocaine than nonconverters. Consistent use of nitrite inhalants and amphetamines increases the relative risk of seroconversion, while episodic use does not. Both patterns of cocaine use increase seroconversion risk. CONCLUSIONS: There are three potential mechanisms for an increased risk of conversion due to consistent substance use.     

History of childhood sexual abuse and HIV risk behaviors in homosexual and bisexual men

OBJECTIVES: We examined the prevalence and frequency of childhood sexual abuse and their association with sexual risk among a sample of gay and bisexual men. Methods. Cross-sectional data were collected by survey from randomly selected gay and bisexual men who attended the 1997 and 1998 Minneapolis/St. Paul Gay, Lesbian, Bisexual, and Transgender Pride Festivals. Data included demographics, sexual activity, history of childhood sexual abuse, HIV status, history of sexually transmitted infection, use of sex-related drugs (such as crack, cocaine, Ecstasy, amyl nitrate, crystal methamphetamine, and Special K), and history of exchanging sex for payment. Results. childhood sexual abuse was reported by 15.5% of the survey respondents (n = 134). Those who reported experiencing abuse regularly were more likely to (1) be HIV positive, (2) have exchanged sex for payment, and (3) be a current user of sex-related drugs. Neither unsafe sex nor sexually transmitted infections were associated with childhood sexual abuse. CONCLUSIONS: These findings show that more than 1 in 7 gay and bisexual men in a non-clinical, festival-based setting were victims of childhood sexual abuse and that childhood sexual abuse was associated with alarmingly high rates of men who were HIV infected and antecedent risk behaviors.     

Selected aspects of AIDS among homosexual men

Summary This report is a brief summary of important points concerning AIDS and homosexual men. We present the current overall figures of the cumulative AIDS incidence for Switzerland, the United States and the world and similar figures for homosexual men in Switzerland, the United States and Europe. A brief history of the epidemic is included with focus on the role of homosexual men. The main risk factors for acquiring HIV infection among homosexual men, including large numbers of sexual partners, receptive anal intercourse and rectal douching, are mentioned with emphasis on results from «The San Francisco Men's Health Study». The development of education and prevention programs is outlined along with the role in these areas of The Swiss AIDS Foundation and Swiss Federal Office of Public Health. Decreases in high risk sexual practices and decrease in seroconversion rates are also discussed.

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Einige Aspekte von AIDS bei homosexuellen Männern

Zusammenfassung Die vorliegende Arbeit ist eine Zusammenfassung der wichtigsten Erkenntnisse über AIDS und homosexuelle Männer: Die aktuellen Daten der kumulativen AIDS-Inzidenz in der Schweiz, den USA und weltweit, insgesamt und für homosexuelle Männer, werden präsentiert; die Geschichte der AIDS-Epidemie, mit besonderem Augenmerk auf die Rolle der homosexuellen Männer, wird kurz rekapituliert. Es werden die hauptsächlichen Risikofaktoren, die zu einer Ansteckung führen können, wie die grosse Anzahl Sexualpartner, der rezeptive Analverkehr und das «rectal-douching» am Beispiel der «San Francisco Men's Health Study» vorgestellt. Die Entwicklung der Aufklärungs- und Präventionsprogramme wird aufgezeigt, sowie die Rolle, welche die AIDS-Hilfe Schweiz und das Bundesamt für Gesundheitswesen dabei spielen. Schliesslich werden der Rückgang von Risikoverhalten und der Rückgang der Serokonversionsraten diskutiert.

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Quelques aspects du SIDA chez les hommes homosexuels

Résumé Ce travail est un condensé des connaissances les plus importantes sur le SIDA et les hommes homosexuels: les données actuelles de l'incidence cumulée du SIDA en Suisse, aux USA et dans le monde, pour l'ensemble de la population et pour les hommes homosexuels sont présentées. L'histoire de l'épidémie de SIDA, avec un éclairage particulier sur le rôle des hommes homosexuels, est brièvement récapitulée. Les principaux facteurs de risque de contamination, tels que le grand nombre de partenaires sexuels, l'analisme réceptif et le «rectal-douching» sont présentés à l'exemple de la «San Francisco Men's Health Study». Le développement des programmes d'information et de prévention est esquissé, ainsi que la part qu'y ont pris l'Aide suisse contre le SIDA et l'Office fédéral de la santé publique. Enfin, la régression des comportement à risque et la baisse du taux des séroconversions sont commentées.

     

福建省HIV/AIDS病例配偶/固定性伴HIV感染情况分析

目的 分析福建省艾滋病病毒(HIV)/艾滋病(AIDS)病例配偶/固定性伴HIV感染情况和影响因素。方法 对2008年1月1日-2013年12月31日福建省新发现的HIV/AIDS病例进行回顾性调查,了解HIV/AIDS病例的配偶/固定性伴的HIV抗体阳转情况,应用单因素和多因素分析法探讨HIV/AIDS病例配偶/固定性伴HIV抗体阳转的影响因素。结果 共调查2008年1月1日-2013年12月31日福建省新发现的HIV/AIDS病例872例,其配偶/固定性伴出现HIV抗体阳转的比例为26.5%(231/872);36.6%(319/872)病例在末次随访时报告最近3个月内与配偶/固定性伴发生性行为,每次均使用安全套的比例为93.4%(298/319);配偶/固定性伴HIV抗体阳转在不同性别、文化程度、CD₄计数和安全套使用间差异均有统计学意义(均P<0.01);多因素logistic回归分析显示,先感染HIV的一方为男性(OR=0.338,95%CI=0.241~0.475,P<0.001)、大专及以上文化程度(OR=0.209,95%CI=0.067~0.654,P=0.007)、CD₄计数>350个/mm³(OR=0.521,95%CI=0.363~0.748,P<0.001)和发生性行为时每次均使用安全套(OR=0.054,95%CI=0.015~0.193,P<0.001)是配偶/固定性伴出现HIV抗体阳转的影响因素。结论 HIV/AIDS病例的配偶/固定性伴已经成为受HIV侵袭的重要人群,应进一步规范HIV抗体检测结果告知,阻断其在配偶/固定性伴间的传播。     

The risk of HIV infection in a national sample of women with injection drug-using partners.

OBJECTIVES. This study reports on a large, national cohort of women with injection drug-using sex partners. Information is provided on demographic characteristics; human immunodeficiency virus (HIV) risk factors, including unprotected sex and incidence of sexually transmitted diseases; use of noninjected drugs; HIV serostatus; and other selected health variables. METHODS. A sample of 5162 heterosexual women was recruited for a national acquired immunodeficiency syndrome (AIDS) research and demonstration project. A structured interview was administered, and the women had the option of undergoing HIV testing. Statistical analyses compared three groups on variables of interest: women with single sex partners, women with multiple partners, and women with multiple partners who exchanged sex for drugs and/or money. RESULTS. These groups differed significantly on virtually all of the demographic and risk variables examined. Women with multiple partners who exchanged sex for drugs and/or money were at higher risk for HIV than women in the other groups, even when selected demographic variables were controlled. CONCLUSIONS. Research is needed on the efficacy of prevention efforts involving these diverse groups of women at risk for AIDS.     

Behavioral interventions for the primary prevention of HIV infection among homosexual and bisexual men

Behavioral intervention is the most urgent priority in preventing the further spread of HIV. To maximize the efficacy of AIDS prevention and to most efficiently allocate resources, it is imperative that variables contributing to preventive behavior change be accurately identified, and interventions be critical evaluated prior to widespread dissemination. We review studies regarding homosexual/bisexual men in terms of: 1) epidemiological trends in HIV transmission; 2) models of behavior change organized around the initiation, consolidation, and maintenance of change, and; 3) preventive intervention outcomes. We conclude with recommendations for effective primary prevention programs.Peggy L. Peterson is affiliated with the School of Social Work, Social Development Research Group, University of Washington. Address correspondence and reprint requests to: 146 North Canal St., Suite 211, XD-50, Seattle, WA 98103.David G. Ostrow is affiliated with the University of Michigan.David J. McKirnan is affiliated with the University of Illinois at Chicago.     

Risk factors for human immunodeficiency virus (HIV) infection among homosexual and bisexual men in a region at low risk for AIDS: the northeastern part of Italy. AIDS and Related Syndromes Study Group

Prevalence and determinants of HIV infection were assessed in 127 homosexual and bisexual men in the northeastern part of Italy. The overall prevalence of HIV seropositivity was still rather low: 20% (95% confidence interval -CI- 13-27%). The most important risk factor for acquiring HIV infection turned out to be having has sexual intercourses in high-risk areas. Relative risks (RRs) for those who have travelled and had sex in North Europe and in the U.S., were, respectively, 2.7 (95% CI: 1.0-7.3) and 5.6 (95% CI: 1.2-25.9). A significantly increased risk was also seen for having a steady sexual partner (RR = 3.1, 95% CI: 1.3-7.5). Use of nitrite inhalants, high number of occasional sexual partners and habitual receptive anal intercourses were also associated with elevation of risk, whereas prostitution was not. The present study confirms the patterns of HIV spread among homosexual and bisexual men from high-risk areas to low-risk areas and prompts urgent educational intervention, in order to prevent the epidemics of AIDS among Italian homosexuals from reaching the size documented in other countries.