Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
AIDS Behav. 2011 Jan;15(1):22-9. doi: 10.1007/s10461-010-9683-2.
We examined racial/ethnic differences in reported seroadaptive and serodisclosure behaviors among the partnerships of MSM recruited for a cross-sectional survey using time-location sampling (TLS) in San Francisco during 2007-2008. The sample (N = 1,199) consisted of 12.2% Asian/Pacific Islander (API), 52.4% White, 6.8% Black, 20.2% Latino, and 8.5% of "other" race/ethnicity. Pure serosorting was most common (about 20%) among HIV-negative men while seropositioning was most used (about 15%) by HIV-positive men. Reported seroadaptive behaviors did not differ significantly across races/ethnicities among both HIV-negative and HIV-positive men. However, HIV-positive Black and Latino men were significantly more likely to report no preventive, seroadaptive behavioral strategy (i.e., unprotected insertive anal intercourse with unknown status or serodiscordant partners). Among men who reported engaging in seroadaptive behaviors, they reported not discussing HIV status with a third of their partners-a major concern in that lack of disclosure undermines the effectiveness and means to practice serosorting. Partnerships of API and Black men were least likely to involve serodisclosure behaviors. Our study confirms that seroadaptive behaviors are common preventive strategies reported by MSM of all races/ethnicities, and does not find strong evidence that racial/ethnic differences in seroadaptive behaviors are enhancing disparities in HIV prevalence. The implications are that condom promotion and safe sex messages are not the only prevention measures adopted by MSM and that public health professionals should be well aware of current trends within the MSM community in order to better assist HIV prevention efforts.
我们考察了 2007-2008 年期间在旧金山通过时间地点抽样(TLS)招募的男男性行为者(MSM)伴侣报告的性适应和性披露行为中的种族/民族差异。该样本(N=1199)包括 12.2%的亚洲/太平洋岛民(API)、52.4%的白人、6.8%的黑人、20.2%的拉丁裔和 8.5%的“其他”种族/民族。在 HIV 阴性男性中,纯血清筛选最为常见(约 20%),而在 HIV 阳性男性中,血清定位最为常用(约 15%)。报告的性适应行为在 HIV 阴性和 HIV 阳性男性中在不同种族/民族之间没有显著差异。然而,HIV 阳性的黑人和拉丁裔男性更有可能报告没有采取任何预防、性适应行为策略(即与未知状况或血清不一致的伴侣进行无保护的插入性肛交)。在报告采取性适应行为的男性中,他们报告有三分之一的伴侣没有讨论 HIV 状况——这是一个主要问题,因为缺乏披露会破坏实施血清筛选的有效性和手段。报告进行性适应行为的男性中,API 和黑人男性的伴侣最不可能涉及性披露行为。我们的研究证实,性适应行为是所有种族/民族的 MSM 报告的常见预防策略,并且没有强有力的证据表明性适应行为中的种族/民族差异正在加剧 HIV 流行率的差异。这意味着避孕套推广和安全性行为信息不是 MSM 采用的唯一预防措施,公共卫生专业人员应该充分了解 MSM 社区中的当前趋势,以便更好地协助 HIV 预防工作。
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