Siegel Karolynn, Schrimshaw Eric W, Karus Daniel
Center for the Psychosocial Study of Health & Illness, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
J Natl Med Assoc. 2004 Feb;96(2):215-23.
Adults over age 50 comprise 11% of yearly AIDS cases, yet little is known about their sexual risk behaviors and drug use following diagnosis with HIV/AIDS. The present questionnaire study examines potential racial differences in sexual risk and drug use behaviors among 59 HIV-infected gay/bisexual and heterosexual men over age 50 who were recruited from HIV-related organizations in New York City between 1996-1998. The majority (59%) of older men reported unprotected sex since diagnosis, and 36% had done so in the past six months. African-American gay/bisexual men (n=12) were significantly more likely than white gay/bisexual men (n=32) to report unprotected vaginal/anal sex in the past six months (67% versus 22%, p<0.01), since diagnosis (42% versus 9%, p<0.05), and to report a history of intravenous drug use (50% versus 3%, p<0.01), but did not differ from heterosexual African-American men (n=15). No differences were found in reports of unprotected oral sex or recent use of hard drugs (i.e., crack, cocaine, heroin). These findings suggest that interventions targeting older African-American men (both gay/bisexual and heterosexual) with HIV/AIDS are needed to reduce risk behaviors and prevent HIV transmission in this population.
50岁以上的成年人占每年艾滋病病例的11%，然而对于他们在被诊断为感染艾滋病毒/艾滋病后的性风险行为和药物使用情况却知之甚少。本问卷调查研究调查了1996年至1998年间从纽约市与艾滋病毒相关组织招募的59名50岁以上感染艾滋病毒的男同性恋者/双性恋者和异性恋男性在性风险和药物使用行为方面潜在的种族差异。大多数（59%）老年男性报告自诊断以来有过无保护性行为，36%的人在过去六个月内有过此类行为。非裔美国男同性恋者/双性恋者（n = 12）比白人男同性恋者/双性恋者（n = 32）在过去六个月内报告无保护阴道/肛交的可能性显著更高（67%对22%，p < 0.01），自诊断以来（42%对9%，p < 0.05），并且报告有静脉注射吸毒史的可能性也更高（50%对3%，p < 0.01），但与非裔美国异性恋男性（n = 15）没有差异。在无保护口交报告或近期使用硬性毒品（即强效可卡因、可卡因、海洛因）方面未发现差异。这些发现表明，需要针对感染艾滋病毒/艾滋病的老年非裔美国男性（包括男同性恋者/双性恋者和异性恋者）开展干预措施，以减少风险行为并预防该人群中的艾滋病毒传播。
