Amirkhanian Y A, Kelly J A, Kukharsky A A, Borodkina O I, Granskaya J V, Dyatlov R V, McAuliffe T L, Kozlov A P
Faculty of Sociology, St. Petersburg State University, Russia.
AIDS. 2001 Feb 16;15(3):407-12. doi: 10.1097/00002030-200102160-00014.
Russia is experiencing one of the sharpest increases in HIV incidence in the world. Almost no research has examined patterns of risk behavior among Russian men who have sex with men (MSM).
A total of 434 MSM were surveyed in all of St. Petersburg's gay-identified clubs during June 2000. Men completed questionnaires about their sexual practices, AIDS risk knowledge, safer sex attitudes, behavior change intentions, perceived safer sex norms, and fatalism.
Most MSM were bisexual; 79% had female partners in their lives and 37% had female partners in the previous 3 months. Sexually transmitted disease treatment was reported by 32% of the men, 23% had sold sex to gain money, and knowledge about critical HIV risk-reduction steps was low. Of all men surveyed, 38% had unprotected anal sex in the previous 3 months, consistent condom use was reported by only 30% of men, and most recent anal intercourse occasions 37% of particpants'. Regression analyses showed that high-risk behavior was predicted by poor safer sex attitudes, weak behavior change intentions, low knowledge about AIDS risk, perceived peer norms that did not support safer sex, and having a boyfriend.
To avert a widespread epidemic, HIV prevention interventions for Russian MSM are critically needed. Factors predicting risk were consistent with those found among MSM in other countries early in the HIV epidemic. However, unique cultural factors, including frequent bisexual behavior, the 'newness' of openly gay communities in Russia and lack of community experience in dealing with AIDS, require HIV prevention program tailoring.
俄罗斯正经历着全球艾滋病发病率最急剧的增长之一。几乎没有研究调查过俄罗斯男男性行为者（MSM）的风险行为模式。
2000年6月，在圣彼得堡所有同性恋者聚集的俱乐部对总共434名男男性行为者进行了调查。这些男性填写了关于他们性行为、艾滋病风险知识、安全性行为态度、行为改变意图、感知到的安全性行为规范以及宿命论的问卷。
大多数男男性行为者是双性恋；79%的人一生中曾有女性伴侣，37%的人在过去3个月内有女性伴侣。32%的男性报告曾接受过性传播疾病治疗，23%的人曾通过出卖性服务赚钱，对关键的降低艾滋病风险措施的知晓率较低。在所有接受调查的男性中，38%的人在过去3个月内有无保护的肛交行为，只有30%的男性报告始终坚持使用避孕套，在最近一次性肛交中，37%的参与者……回归分析表明，安全性行为态度差、行为改变意图薄弱、对艾滋病风险知晓率低、感知到的同伴规范不支持安全性行为以及有男朋友，这些因素预示着存在高风险行为。
为避免艾滋病广泛流行，迫切需要针对俄罗斯男男性行为者的艾滋病预防干预措施。预示风险的因素与在艾滋病流行早期其他国家男男性行为者中发现的因素一致。然而，包括频繁的双性恋行为、俄罗斯公开的同性恋社区“新出现”以及缺乏应对艾滋病的社区经验等独特文化因素，要求对艾滋病预防项目进行调整。
