男男性行为者和女性(MSMW)向性伴侣隐瞒 HIV 感染者身份的影响。
The effect of partner sex: nondisclosure of HIV status to male and female partners among men who have sex with men and women (MSMW).
机构信息
Department of Sociology, University of California Los Angeles, 264 Haines Hall, 375 Portola Plaza, Los Angeles, CA 90095, USA.
出版信息
AIDS Behav. 2011 Aug;15(6):1140-52. doi: 10.1007/s10461-010-9851-4.
A common concern within HIV prevention is that HIV positive MSMW do not disclose their HIV status to female partners who are thus at increased risk for HIV infection. The present study uses unique data to examine whether MSMW disclose more often to male rather than female partners. Data were collected on most recent male and/or female primary partner and four most recent casual partners from 150 MSMW (50 African American, 50 Latino, 50 White). MSMW reported on 590 partners (31% female; 69% male). Disclosure was coded as disclosure before sex, disclosure after sex, or nondisclosure. A series of multinomial logistic regressions with partners clustered within respondents were conducted to evaluate effects of respondent characteristics and partner characteristics on timing of disclosure. In bivariate and multivariate analyses there were no significant differences in odds of disclosure to male and female partners before or after sex. Although MSMW were substantially less likely to disclose to HIV negative partners before sex compared to HIV positive partners regardless of sex, when we fully interacted the multivariate model by partner sex, the odds of disclosure to HIV negative male partners compared to HIV positive male partners before sex were significantly higher than the odds of disclosure to HIV negative female partners compared to HIV positive female partners. Patterns of mutual nondisclosure and nonreciprocal disclosure were observed with both primary and casual partners. The paper makes additional methodological contributions to the measurement and analysis of disclosure.
艾滋病毒预防领域的一个常见关注点是,艾滋病毒阳性的男男性行为者(MSMW)不会向女性伴侣透露其艾滋病毒状况,而女性伴侣因此感染艾滋病毒的风险增加。本研究利用独特的数据,检验了 MSMW 是否更倾向于向男性而不是女性伴侣透露其艾滋病毒状况。从 150 名 MSMW 中收集了最近的男性和/或女性主要伴侣以及最近的四个偶然伴侣的数据(50 名非裔美国人、50 名拉丁裔、50 名白人)。MSMW 报告了 590 名伴侣(31%为女性;69%为男性)。披露情况被编码为性前披露、性后披露或未披露。对受访者内的伴侣进行了一系列多项逻辑回归分析,以评估受访者特征和伴侣特征对披露时间的影响。在单变量和多变量分析中,性前和性后向男性和女性伴侣披露的可能性没有显著差异。尽管 MSMW 在性前向 HIV 阴性伴侣披露的可能性明显低于 HIV 阳性伴侣,无论其性别如何,但当我们通过伴侣性别充分交互多变量模型时,与 HIV 阳性男性伴侣相比,与 HIV 阴性男性伴侣性前披露的可能性明显高于与 HIV 阳性女性伴侣相比,与 HIV 阴性女性伴侣性前披露的可能性。与主要和偶然伴侣都观察到相互不披露和非互惠披露的模式。本文对披露的测量和分析做出了额外的方法学贡献。