Gupta Amita, Mehta Shruti, Godbole Sheela V, Sahay Seema, Walshe Louise, Reynolds Steven J, Ghate Manisha, Gangakhedkar Raman R, Divekar Anand D, Risbud Arun R, Mehendale Sanjay M, Bollinger Robert C
Division of Infectious Disease, Johns Hopkins School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA.
J Acquir Immune Defic Syndr. 2006 Dec 1;43(4):483-90. doi: 10.1097/01.qai.0000243097.27029.b7.
To determine HIV/sexually transmitted infection (STI) prevalence, trends, and risk behaviors of men who have sex with men (MSM) and compare these with those of non-MSM attending STI clinics in Pune, India over a 10-year period.
Cross-sectional.
From 1993 through 2002, men attending 3 STI clinics in Pune underwent HIV/STI screening. Demographic, risk behavior, clinical, and laboratory data were collected using standardized questionnaires and laboratory procedures.
Of 10,785 men screened, 708 (6.6%) were MSM. Among these 708 MSM, 189 (31.7%) had 10 or more lifetime partners, 253 (35.7%) were married, 163 (23.1%) had sex with a hijra (eunuch), and 87 (13.3%) had exchanged money for sex. A total of 134 (18.9%) were HIV-positive, 149 (21.5%) had genital ulcer disease (GUD), 37 (5.8%) had syphilis, and 29 (4.3%) had gonorrhea (GC). Over the decade, neither HIV nor GC prevalence changed among MSM (P = 0.7), but syphilis and GUD decreased significantly (P < 0.0001). Compared with non-MSM, MSM were more likely to initiate sexual activity at age <16 years, to have >10 lifetime partners, to have sex with a hijra, and to use condoms regularly, but they did not differ significantly in HIV prevalence and had a lower prevalence of GC, GUD, and syphilis. Independent factors associated with HIV among MSM were employment (adjusted odds ratio [AOR] = 3.08; P = 0.02), history of GUD (AOR = 1.86; P = 0.003), and syphilis (AOR = 2.09; P = 0.05).
Same-sex and high-risk sexual behaviors are prevalent among men attending STI clinics in India. Although syphilis and GUD rates decreased, HIV prevalence remained high during the decade, highlighting the importance of additional targeted efforts to reduce HIV risk among all men, including MSM, in India.
确定印度浦那男男性行为者（MSM）的艾滋病毒/性传播感染（STI）患病率、趋势及风险行为，并与在10年期间前往STI诊所就诊的非MSM进行比较。
横断面研究。
1993年至2002年期间，在浦那3家STI诊所就诊的男性接受了艾滋病毒/STI筛查。使用标准化问卷和实验室程序收集人口统计学、风险行为、临床和实验室数据。
在接受筛查的10785名男性中，708名（6.6%）为MSM。在这708名MSM中，189名（31.7%）有10个或更多性伴侣，253名（35.7%）已婚，163名（23.1%）与海吉拉（阉人）发生过性行为，87名（13.3%）有过性交易。共有134名（18.9%）艾滋病毒呈阳性，149名（21.5%）患有生殖器溃疡疾病（GUD），37名（5.8%）患有梅毒，29名（4.3%）患有淋病（GC）。在这十年间，MSM中的艾滋病毒和GC患病率均未发生变化（P = 0.7），但梅毒和GUD患病率显著下降（P < 0.0001）。与非MSM相比，MSM在16岁之前开始性活动、有10个以上性伴侣、与海吉拉发生性行为以及经常使用避孕套的可能性更大，但他们的艾滋病毒患病率无显著差异，且GC、GUD和梅毒患病率较低。与MSM中的艾滋病毒相关的独立因素包括就业（调整后的优势比[AOR] = 3.08；P = 0.02）、GUD病史（AOR = 1.86；P = 0.003）和梅毒（AOR = 2.09；P = 0.05）。
在印度前往STI诊所就诊的男性中，同性性行为和高风险性行为普遍存在。尽管梅毒和GUD发病率有所下降，但在这十年间艾滋病毒患病率仍然很高，这凸显了在印度对包括MSM在内的所有男性加强针对性努力以降低艾滋病毒风险的重要性。
