杭州市同性恋浴池MSM人群既往HIV检测行为相关因素分析

目的 了解杭州市同性恋浴池MSM人群HIV既往检测行为的相关影响因素。方法 2015年10月至2016年1月,在杭州市同性恋浴池开展时间-场所抽样调查,招募最近6个月与同性发生口交或肛交性行为的同性恋浴池MSM,主要收集最近6个月HIV检测行为及相关信息。运用SPSS 22.0软件分析HIV最近6个月HIV检测行为、性行为和安全套使用情况等相关因素,数据分析采用χ²检验、logistic回归法分别进行单因素和多因素分析。结果 共招募480人,实际调查465名MSM。最近6个月接受HIV检测的比例为47.3%（220/465）。多因素logistic分析结果表明,已婚（OR=0.35,95% CI：0.18~0.69）,接受同伴教育（OR=4.31,95% CI：1.32~14.09）,最近6个月有同性肛交性行为（OR=1.85,95% CI：1.08~3.14）,最近6个月有非婚异性性行为（OR=4.12,95% CI：2.45~6.91）可能是促进检测的相关因素。结论 已婚、最近6个月发生过同性肛交性行为、非婚异性性行为、接受过同伴教育可能是促进浴池MSM人群进行检测的相关因素。因此,需加强对浴池MSM的同伴教育,提高其高危行为后的检测意识,促进其进行检测。     

An Invisible Population: Older Lesbian,Gay, Bisexual,and Transgender Individuals

Abstract

The main purpose of an Antiarrhythmic Emergency Use clinical trial is to provide alternative treatment to patients who manifest life-threatening arrhythmias and who are intolerant or refractory to marketed drugs. Such large scale, open-labelled programs involve heterogeneous patient populations without comparable control groups. This paper will discuss problems associated with the research practices and suggest an approach to manage and analyze data from Antiarrhythmic Emergency Use clinical trials.     

同性恋浴池MSM人群HIV感染状况及影响因素调查

目的了解同性恋浴池男男性行为人群（MSM）艾滋病病毒（HIV）感染情况及其影响因素,为在该人群中开展有效预防干预提供信息和依据。方法依托天津市在某同性恋浴池内设立的艾滋病咨询检测点,对2011年3-9月在该检测点检测的浴客进行问卷调查,同时进行HIV快速检测。结果在接受调查的601人中,在婚者占57.9%,艾滋病知识总知晓率高达85.8%,近6个月发生无保护肛交比例为66.0%（396人）,HIV感染率为16.6%（100人）。多因素分析显示,与感染相关的因素有年龄[比值比（OR）=6.00,95%可信区间（CI）：2.17～16.57]、最近6个月与同性发生肛交性行为（OR=3.16,95%CI：1.19～8.400）、参与群交（OR=11.08,95%CI：1.12～110.12）及向同性卖淫（OR=7.25,95%CI：3.17～16.67）。结论同性恋浴池浴客HIV感染率显著高于一般男男性行为者,年龄、与同性发生肛交性行为、参与群交以及向同性卖淫,是与HIV感染相关的主要因素。应加强对同性恋浴池MSM人群的干预工作     

Correlates of Unprotected Receptive Anal Intercourse Among Gay and Bisexual Men: Kampala, Uganda

We conducted a respondent-driven sampling survey (N = 215) to characterize correlates of risk for HIV infection among gay and bisexual men in Kampala, Uganda. We used RDSAT software to produce population estimates for measures and created exportable weights for multivariable analysis. Overall, 60.5% of gay/bi men identify as gay and 39.5% as bisexual; 91.6% are Ugandans. Unprotected receptive anal intercourse (URAI) was associated with identifying as gay, being younger and having had an HIV test in the past 6 months. Perceptions of being low risk to acquire or transmit HIV infection were paradoxically associated with higher likelihood of URAI. Programs to address risk of HIV infection among gay and bisexual men in Kampala need to address perceptions of risk among gay identified men.     

Coming Out in a Hostile Social Environment

Abstract

Young people below the age of 24 years account for almost half of all new HIV infections in the United States; young men who have sex with men are disproportionately represented among this population (Centers for Disease Control, 2000). The major assertions of this article are: (1) the social context of coming out may be vital to the overall psychological health and well-being of gay youth and, in turn, to their HIV risk behavior; and (2) coming out is a multifaceted developmental process: different pathways of coming out may be related to different types and determinants of HIV risk behavior. Evidence of a milieu of stigmatization, anti-gay hatred, harassment and violence among gay youth suggests that merely addressing HIV risk with even high quality individual-level interventions that myopically focus on sexual behavior may be insufficient. Interventions targeting anti-gay attitudes and behaviors in families, schools and communities, as well as combating discriminatory social policies and institutions, may be a vital aspect of HIV prevention for gay youth.     

“告知还是不告知”:我国男同性恋HIV阳性者暴露现状和原因的质性研究

目的:探讨男同性恋HIV阳性者暴露/不暴露HIV阳性状态/性取向的现状和原因。方法:采用质性研究方法,选取2009年3月—2010年3月于北京佑安医院就诊的37名男同性恋HIV阳性者,实施深入访谈,对访谈资料进行编码,提炼出概念类属。结果:37名被试中,有31名向不同的对象暴露了自己HIV阳性状态/性取向的状况。选择暴露的原因主要有"责任"、"安全"、"获得支持"、"缓解结婚压力";不暴露的原因主要有"担心家人无法接受"、"不想给家人增加压力"、"愧疚感"、"担心受歧视"。结论:医疗或相关心理从业者应考虑男同性恋HIV阳性者的双重身份,结合中国社会文化特点提供恰当的心理干预措施。     

父母性取向支持、归因方式在男同性恋大学生内化同性恋嫌恶与焦虑间的多重中介效应

目的:考察父母性取向支持、归因方式在男同性恋大学生内化同性恋嫌恶与焦虑间的多重中介机制。方法:选取313名男同性恋大学生,使用内化同性恋嫌恶量表、父母性取向支持量表、归因方式量表、焦虑量表进行测量。结果:男同性恋大学生内化同性恋嫌恶与焦虑呈显著正相关。父母性取向支持在内化同性恋嫌恶与焦虑间存在显著的中介效应,且父母性取向支持与归因方式在内化同性恋嫌恶与焦虑间存在显著的链式中介效应。结论:增强父母的性取向支持和改善自身的归因方式,是缓解高内化同性恋嫌恶男同性恋大学生焦虑水平的有效措施。     

LGBT healthcare disparities: What progress have we made?

Nearly fifteen years have passed since this author’s publication which examined the depth of education and training for medical students and practicing physicians specific to clinical competence in the care of lesbian and gay patients in the United States. Since then, there has been an explosion of research gains which have shed a steady light on the needs and disparities of lesbian and gay healthcare. This rich literature base has expanded to include bisexual and transgender (LGBT) healthcare in peer-reviewed journals. Despite these research gains underscoring a call for action, there continues to be a dearth of cultural competency education and training for healthcare professionals focused on clinical assessment and treatment of LGBT patients. This article will focus exclusively on the current status of medical and nursing education and training specific to clinical competence for LGBT healthcare. We are long overdue in closing the clinical competency gap in medical and nursing education to reduce the healthcare disparities within the LGBT community.     

萍乡市男男同性恋性病艾滋病哨点监测结果分析

目的了解男同人群的性相关危险因素特点,找出有效的途径或策略,进一步有效控制艾滋病的流行。方法问卷调查与实验室检测。结果总共监测310名男同,其中酒吧会所监测占30.97%,网络监测占69.03%;90%被监测男同是高中以上文化程度;最近一年患性病的占14.19%;310人当中HIV感染者8例,感染率为2.58%;网络招募人中HIV感染为3.27%。艾滋病知识知晓率为98.71%;有将近15%的感染者有过商业性行为(包括3名感染者);有商业性行为的男男同性恋艾滋病感染率与没有商业性行为的男男同性恋的艾滋病感染率两者比较有明显差异;与女性发生性关系的时候有三分之一不使用安全套,每次都会使用的不到一半,最近一次与女性发生性关系有三分之一没有使用安全套。结论男同容易将艾滋病性病进行婚内、外传播;男同存在掌握相关HIV防治知识与实际防范结果背离现象;网络加大了男同交往的频率和范围,也加大了艾滋病传播风险;同性商业性行为风险性更高;男同的双性性关系及无保护性性交在艾滋病传播中起到一个非常重要的桥梁作用;今后要把宣传干预重点放在双性恋、男性性商业服务人群、男同配偶或性伴、甚至青年妇女、青年学生身上。