Chen Sanny Y, Gibson Steven, Weide Darlene, McFarland Willi
San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 500, San Francisco, CA 94102-6033, USA.
J Acquir Immune Defic Syndr. 2003 Jun 1;33(2):166-70. doi: 10.1097/00126334-200306010-00008.
Increasing trends in high-risk sexual behavior are noted among men who have sex with men (MSM) worldwide. Less information is available on unprotected sex between persons of different HIV serostatus.
From 1999 through 2001, volunteers of a community-based organization conducted interviews of 10,579 MSM at gay-oriented venues in San Francisco and in neighborhoods with high-volume MSM pedestrian traffic. The questionnaire recorded demographic and risk behavior information, including self-reported and partners' HIV serostatus.
Potentially serodiscordant unprotected anal intercourse (UAI) with at least 2 anal sex partners was reported by 12.7% and increased from 11.0% in 1999 to 16.2% in 2001. Stratifying by self-reported HIV serostatus, 20.8% of HIV-positive respondents, 12.1% of HIV-negative respondents, and 13.4% of MSM who did not know or report their own HIV serostatus had potentially serodiscordant UAI. Older MSM of white race were more likely to report potentially serodiscordant UAI among HIV-positive respondents, whereas younger MSM of white race were more likely to report potentially serodiscordant UAI among HIV-negative respondents. Among those with unknown HIV serostatus, MSM of color were more likely to engage in potentially serodiscordant UAI.
Recent increases in UAI among MSM in San Francisco are not only the result of increases in UAI between persons of the same HIV serostatus. Prevention messages must address disclosure of HIV serostatus to sexual partners specifically tailored to groups according to age, community, and HIV serostatus.
全球范围内，男男性行为者（MSM）中高危性行为呈上升趋势。关于不同HIV血清学状态者之间无保护性行为的信息较少。
1999年至2001年期间，一个社区组织的志愿者在旧金山的同性恋场所和男男性行为者行人流量大的社区对10579名男男性行为者进行了访谈。问卷记录了人口统计学和风险行为信息，包括自我报告的和性伴侣的HIV血清学状态。
12.7%的人报告称与至少2名肛交性伴侣发生了潜在血清学不一致的无保护肛交（UAI），且这一比例从1999年的11.0%上升至2001年的16.2%。按自我报告的HIV血清学状态分层，20.8%的HIV阳性受访者、12.1%的HIV阴性受访者以及13.4%不知道或未报告自己HIV血清学状态的男男性行为者发生了潜在血清学不一致的无保护肛交。在HIV阳性受访者中，年龄较大的白人男男性行为者更有可能报告潜在血清学不一致的无保护肛交，而在HIV阴性受访者中，年龄较小的白人男男性行为者更有可能报告潜在血清学不一致的无保护肛交。在HIV血清学状态未知的人群中，有色人种男男性行为者更有可能进行潜在血清学不一致的无保护肛交。
旧金山男男性行为者中近期无保护肛交行为的增加不仅是相同HIV血清学状态者之间无保护肛交行为增加的结果。预防信息必须针对根据年龄、社区和HIV血清学状态专门为不同群体量身定制的向性伴侣披露HIV血清学状态的问题。
