Schönnesson Lena Nilsson, Atkinson John, Williams Mark L, Bowen Anne, Ross Michael W, Timpson Sandra C
Venhälsan (Gay Men's Health Clinic), Södersjukhuset, Karolinska Institute, Department of Clinical Science and Education, Stockholm, Sweden.
Drug Alcohol Depend. 2008 Sep 1;97(1-2):44-53. doi: 10.1016/j.drugalcdep.2008.03.023. Epub 2008 May 20.
The purpose of this cross-sectional study was to classify a sample of HIV-seropositive African-American crack cocaine smokers into homogenous HIV drug use and sexual risk groups using a two step multivariate cluster analysis. Two hundred and fifty-eight crack cocaine smokers participated in the study. Cluster analysis revealed three distinct HIV risk groups. The highest risk group, the largest one, was characterized by frequent, daily crack use, multiple sex partners, trading sex, and inconsistent condom use. The consistent condom use group, the smallest group, was characterized by consistent condom use. The inconsistent condom use group, the second largest group, was distinguished by inconsistent condom use. Comparisons of the three HIV risk groups revealed that the highest risk group had a higher proportion of illegal sources of income, higher proportion of binged crack use, frequent, daily, alcohol use, same gender sex partners, and scored higher on depressive symptoms. Members of the consistent condom use group were more likely to have been HIV diagnosed for a shorter time, to have HIV serodiscordant casual sex partners, higher psychological motivation for condom use, and a lower frequency of vaginal sex. Members of the inconsistent condom use group were more likely to have a main sex partner, to be married, to be on public assistance, to know the HIV serostatus of their casual partner, and less likely to conceal their HIV serostatus. An alarming finding was that a large number of participants inconsistently used condoms with HIV serodiscordant sex partners. Interventions aiming to prevent the secondary spread of HIV infection in African-American crack cocaine smokers should take this variability in account and focus on the differences.
这项横断面研究的目的是通过两步多变量聚类分析，将一组感染艾滋病毒的非裔美国快克可卡因吸烟者分为艾滋病毒药物使用和性风险均一的群体。258名快克可卡因吸烟者参与了该研究。聚类分析揭示了三个不同的艾滋病毒风险群体。风险最高的群体也是人数最多的群体，其特征是频繁、每日吸食快克可卡因、有多个性伴侣、性交易以及不坚持使用避孕套。坚持使用避孕套的群体是最小的群体，其特征是始终坚持使用避孕套。不坚持使用避孕套的群体是第二大群体，其特点是不坚持使用避孕套。对这三个艾滋病毒风险群体的比较显示，风险最高的群体非法收入比例更高、快克可卡因大量使用的比例更高、频繁每日饮酒、有同性性伴侣，且抑郁症状得分更高。坚持使用避孕套群体的成员更有可能感染艾滋病毒的时间较短、有艾滋病毒血清学不一致的临时性伴侣、使用避孕套的心理动机更强，以及阴道性行为频率较低。不坚持使用避孕套群体的成员更有可能有一个主要性伴侣、已婚、接受公共援助、知道其临时性伴侣的艾滋病毒血清状况，且不太可能隐瞒自己的艾滋病毒血清状况。一个令人担忧的发现是，大量参与者在与艾滋病毒血清学不一致的性伴侣发生性行为时不坚持使用避孕套。旨在预防艾滋病毒感染在非裔美国快克可卡因吸烟者中二次传播的干预措施应考虑到这种变异性，并关注其中的差异。
