Bouhnik Anne-Déborah, Préau Marie, Schiltz Marie-Ange, Lert France, Obadia Yolande, Spire Bruno
Health and Medical Research National Institute (INSERM), Research Unit 379, Social Sciences Applied to Medical Innovation, Institut Paoli Calmettes, Marseille, France.
AIDS. 2007 Jan;21 Suppl 1:S43-8. doi: 10.1097/01.aids.0000255084.69846.97.
We investigated factors associated with unprotected sex in regular partnerships among homosexual men living with HIV.
We used data from a French national representative sample of people living with HIV (ANRS-EN12-VESPA survey). This analysis included men in a regular partnership with another man for at least twelve months. Unprotected sex was defined as reporting at least one episode of sexual intercourse without a condom with this regular partner in the previous 12 months. Separate analyses were conducted in sero-nonconcordant couples and in HIV-positive seroconcordant couples.
285 and 193 homosexual men respectively reported a regular sero-nonconcordant and seroconcordant partner. Unprotected sex was reported by a higher number of respondents within seroconcordant (46.7%) than within sero-nonconcordant couples (15.6%). In both seroconcordant and sero-nonconcordant partnerships, unprotected sex was significantly more frequent when episodes of unprotected sex with casual partners were reported. In seroconcordant couples, those who had more than four casual partners were also more likely to practise unprotected sex with their regular partner. Among sero-nonconcordant couples, binge drinking and absence of disclosure of one's HIV-positive status to the partner were also independently associated with unprotected sex.
A limited number of sero-nonconcordant homosexual couples persist in reporting risky sexual behaviour. Prevention messages should encourage communication and HIV disclosure. The relationship between unprotected sex with both casual and regular partners also calls attention about the underlying psycho-social and interactional factors that may influence sexual behaviours of people living with HIV in regular relationships, independently of the status of the partner.
我们调查了感染艾滋病毒的男同性恋者在固定伴侣关系中发生无保护性行为的相关因素。
我们使用了来自法国全国具有代表性的艾滋病毒感染者样本数据（ANRS-EN12-VESPA调查）。该分析纳入了与另一名男性保持至少十二个月固定伴侣关系的男性。无保护性行为的定义是在过去12个月内报告至少有一次与该固定伴侣发生无避孕套性交的情况。对血清学不一致的伴侣和艾滋病毒阳性血清学一致的伴侣分别进行了分析。
分别有285名和193名男同性恋者报告有血清学不一致和血清学一致的固定伴侣。血清学一致的伴侣中报告有无保护性行为的受访者数量（46.7%）高于血清学不一致的伴侣（15.6%）。在血清学一致和血清学不一致的伴侣关系中，当报告与临时性伴侣有无保护性行为时，无保护性行为明显更频繁。在血清学一致的伴侣中，有四个以上临时性伴侣的人也更有可能与他们的固定伴侣进行无保护性行为。在血清学不一致的伴侣中，暴饮和未向伴侣披露自己的艾滋病毒阳性状态也与无保护性行为独立相关。
少数血清学不一致的男同性恋伴侣仍在报告危险的性行为。预防信息应鼓励沟通和艾滋病毒披露。与临时性伴侣和固定伴侣的无保护性行为之间的关系也引起了人们对潜在的心理社会和互动因素的关注，这些因素可能会影响处于固定关系中的艾滋病毒感染者的性行为，而与伴侣的状况无关。
