The George Washington University School of Public Health and Health Services, Department of Epidemiology and Biostatistics, Washington, DC 20037, USA.
AIDS Patient Care STDS. 2010 Oct;24(10):615-22. doi: 10.1089/apc.2010.0111.
The District of Columbia (DC) has among the highest HIV/AIDS rates in the United States, with 3.2% of the population and 7.1% of black men living with HIV/AIDS. The purpose of this study was to examine HIV risk behaviors in a community-based sample of men who have sex with men (MSM) in DC. Data were from the National HIV Behavioral Surveillance system. MSM who were 18 years were recruited via venue-based sampling between July 2008 and December 2008. Behavioral surveys and rapid oral HIV screening with OraQuick ADVANCE ½ (OraSure Technologies, Inc., Bethlehem, PA) with Western blot confirmation on positives were collected. Factors associated with HIV positivity and unprotected anal intercourse were identified. Of 500 MSM, 35.6% were black. Of all men, 14.1% were confirmed HIV positive; 41.8% of these were newly identified HIV positive. Black men (26.0%) were more likely to be HIV positive than white (7.9%) or Latino/Asian/other (6.5%) men (p<0.001). Black men had fewer male sex partners than non-black, fewer had ever engaged in intentional unprotected anal sex, and more used condoms at last anal sex. Black men were less likely to have health insurance, have been tested for HIV, and disclose MSM status to health care providers. Despite significantly higher HIV/AIDS rates, black MSM in DC reported fewer sexual risks than non-black. These findings suggest that among black MSM, the primary risk of HIV infection results from nontraditional sexual risk factors, and may include barriers to disclosing MSM status and HIV testing. There remains a critical need for more information regarding reasons for elevated HIV among black MSM in order to inform prevention programming.
哥伦比亚特区（DC）的艾滋病毒/艾滋病发病率居美国之首，其人口中有 3.2%和黑人男性中有 7.1%感染了艾滋病毒/艾滋病。本研究的目的是检验在 DC 以社区为基础的男男性接触者（MSM）样本中艾滋病毒的风险行为。数据来自全国艾滋病毒行为监测系统。18 岁以上的 MSM 通过 2008 年 7 月至 12 月期间的基于地点的抽样招募。收集行为调查和使用 OraQuick ADVANCE ½（OraSure 技术公司，Bethlehem，PA）的快速口腔艾滋病毒筛查，对阳性者进行 Western blot 确认。确定了与艾滋病毒阳性和无保护的肛交相关的因素。在 500 名 MSM 中，35.6%是黑人。所有男性中，14.1%被确认为艾滋病毒阳性；其中 41.8%为新发现的艾滋病毒阳性。黑人男性（26.0%）比白人（7.9%）或拉丁裔/亚洲裔/其他（6.5%）男性更容易感染艾滋病毒（p<0.001）。黑人男性的男性性伴侣比非黑人男性少，有意无保护肛交的行为较少，最近一次性交时使用避孕套的情况较多。黑人男性更不可能有医疗保险，接受过艾滋病毒检测，也不太可能向医疗服务提供者披露 MSM 身份。尽管艾滋病毒/艾滋病发病率较高，但 DC 的黑人 MSM 报告的性风险低于非黑人 MSM。这些发现表明，在黑人 MSM 中，艾滋病毒感染的主要风险源自非传统的性风险因素，可能包括披露 MSM 身份和艾滋病毒检测的障碍。需要更多有关黑人 MSM 艾滋病毒感染率升高的原因的信息，以便为预防规划提供信息。
