Drumright Lydia N, Little Susan J, Strathdee Steffanie A, Slymen Donald J, Araneta Maria Rosario G, Malcarne Vanessa L, Daar Eric S, Gorbach Pamina M
Department of Medicine, Antiviral Research Center, University of California, San Diego, CA 92093, USA.
J Acquir Immune Defic Syndr. 2006 Nov 1;43(3):344-50. doi: 10.1097/01.qai.0000230530.02212.86.
To examine within-subjects and combined between- and within-subjects associations between substance use and unprotected anal intercourse (UAI) among men who have sex with men (MSM) with recent HIV infection.
One hundred ninety-four MSM who were recently infected with HIV completed a computer-assisted questionnaire regarding sexual behaviors and substance use with their last 3 partners. Associations between UAI and substance use were assessed using conditional logistic regression (CLR) to assess associations among the 116 MSM reporting UAI with some but not all partners and generalized linear mixed effects models (GLMMs) to examine a combination of within- and between-subjects associations in the entire sample (N = 194).
In multivariate CLR models and GLMMs, UAI was associated with the use of methamphetamine (odds ratio [OR] = 4.9 and OR = 3.5, respectively), marijuana (OR = 4.0 and OR = 2.2, respectively) and erectile dysfunction medications (EDMs) when used with a main partner (OR = 13.8 and OR = 10.1, respectively).
Results indicate that a direct association may exist between specific substances and UAI and provide evidence that the use of methamphetamine and EDMs may contribute to HIV transmission.
在近期感染艾滋病毒的男男性行为者（MSM）中，研究物质使用与无保护肛交（UAI）之间的个体内关联以及个体间和个体内的综合关联。
194名近期感染艾滋病毒的男男性行为者完成了一份计算机辅助问卷，内容涉及他们与最近3名性伴侣的性行为和物质使用情况。使用条件逻辑回归（CLR）评估116名报告与部分但并非所有性伴侣发生无保护肛交的男男性行为者中无保护肛交与物质使用之间的关联，并使用广义线性混合效应模型（GLMMs）研究整个样本（N = 194）中个体内和个体间关联的组合。
在多变量CLR模型和GLMMs中，无保护肛交与甲基苯丙胺的使用有关（优势比[OR]分别为4.9和3.5）、与大麻的使用有关（OR分别为4.0和2.2），以及与主要性伴侣一起使用时与勃起功能障碍药物（EDMs）的使用有关（OR分别为13.8和10.1）。
结果表明特定物质与无保护肛交之间可能存在直接关联，并提供证据表明甲基苯丙胺和勃起功能障碍药物的使用可能导致艾滋病毒传播。
