Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA.
AIDS Behav. 2012 Apr;16(3):608-17. doi: 10.1007/s10461-011-9911-4.
In the US, Latino MSM are disproportionately affected by HIV, yet there is a paucity of data for this risk group. To this end, we examined data on Latino and non-Latino white MSM who participated across six cities in a 2-year randomized behavioral intervention study-Project EXPLORE. At baseline, Latinos reported significantly more serodiscordant unprotected anal intercourse (SDUA) than non-Latinos. Longitudinal predictors of SDUA included marijuana, poppers, amphetamines and heavy drinking, as well as lower self-efficacy, poorer communication skills, weaker safe-sex norms and more enjoyment of risky sex. For HIV infection, Latinos had significantly higher seroconversion rate over follow-up than non-Latinos. Longitudinal predictors of seroconversion among Latinos included poppers and SDUA. Intervention effects did not significantly differ between Latino and non-Latinos. Findings support HIV intervention work with Latino MSM that includes skills training/counseling to address attitudes about safe sex and impact of substance use on HIV-risk behavior and acquisition.
在美国,拉丁裔男男性行为者(MSM)受到 HIV 的不成比例影响,但针对这一风险群体的数据却很少。为此,我们研究了参与为期两年的随机行为干预研究-探索项目的六个城市的拉丁裔和非拉丁裔白人 MSM 的数据。在基线时,拉丁裔报告的与 CD4 结果不一致的无保护肛交(SDUA)显著多于非拉丁裔。SDUA 的纵向预测因素包括大麻、啪啪剂、安非他命和大量饮酒,以及较低的自我效能感、较差的沟通技巧、较弱的安全性行为规范和更多享受高危性行为。对于 HIV 感染,拉丁裔在随访期间的血清转化率显著高于非拉丁裔。拉丁裔血清转化率的纵向预测因素包括啪啪剂和 SDUA。干预效果在拉丁裔和非拉丁裔之间没有显著差异。这些发现支持针对拉丁裔 MSM 的 HIV 干预工作,包括技能培训/咨询,以解决关于安全性行为的态度以及物质使用对 HIV 风险行为和获得的影响。