Aidala Angela A, Lee Gunjeong, Garbers Samantha, Chiasson Mary Ann
Center for Applied Public Health, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
AIDS Educ Prev. 2006 Feb;18(1):12-32. doi: 10.1521/aeap.2006.18.1.12.
As an ever-increasing number of people infected with HIV are living longer, healthier lives, concerns about continued transmission are growing along with an awareness of the need to develop "prevention for positives." This study of HIV-positive adults in New York City is the first examination of patterns of sexual behavior in a large, representative cohort of HIV-infected individuals followed over an extended time period. A total of 968 HIV-positive adults were interviewed every 6-12 months between 1994 and 2002 and reported considerable variability in sexual behaviors over time. Many persons were not sexually active at all for months at a time; some continued to have multiple partners. Over one third of the cohort had one or more periods when they had engaged in unprotected sex with a partner who was HIV-negative or status unknown (unsafe sex) and one in five reported exchanging sex. Periods of unsafe sex alternated with periods of safer sex. Predictors of sexual risk varied by gender, and among men who had sex with men, and men sexually active with women only. Contextual factors such as partner relations, housing status, and receipt of HIV services were as important as individual attributes as predictors of unsafe sex and sex exchange. The variability observed in sexual risk behavior reported over time provides new insight into the importance of engaging persons living with HIV in ongoing prevention programs.
随着越来越多的艾滋病毒感染者寿命延长、生活更加健康，对持续传播的担忧日益增加，同时也越发意识到需要开展“针对阳性者的预防”。这项针对纽约市艾滋病毒呈阳性成年人的研究，首次对一大群具有代表性的艾滋病毒感染者在较长时间段内的性行为模式进行了考察。1994年至2002年间，每隔6至12个月对总共968名艾滋病毒呈阳性的成年人进行一次访谈，结果显示性行为随时间有很大变化。许多人有好几个月完全没有性行为；有些人则继续有多个性伴侣。超过三分之一的队列成员有过一个或多个时期，在此期间他们与艾滋病毒呈阴性或感染状况不明的伴侣进行无保护性行为（不安全的性行为），五分之一的人报告有性交易行为。不安全的性行为时期与较安全的性行为时期交替出现。性风险的预测因素因性别而异，在男同性恋者以及只与女性有性行为的男性中也有所不同。诸如伴侣关系、住房状况和接受艾滋病毒服务等背景因素，与个人特征一样，都是不安全性行为和性交易的重要预测因素。随着时间推移所报告的性风险行为的变化，为让艾滋病毒感染者参与持续预防项目的重要性提供了新的见解。
