Department of Epidemiology and Biostatistics, The George Washington University, School of Public Health and Health Services, Washington, District of Columbia 20037, USA.
AIDS Patient Care STDS. 2011 Aug;25 Suppl 1:S47-53. doi: 10.1089/apc.2011.9876. Epub 2011 Jun 17.
We assessed changes in sexual behaviors from baseline to 12-month follow-up among a multisite cohort of HIV-positive racial/ethnic minority young men who have sex with men enrolled in an outreach, linkage, and retention study. In the 3 months prior to their baseline interview, more than three-quarters of participants (78.5%) reported sex with at least one man (mean: 2.3 partners). Among sexually active participants, 44.2% had one partner; 50.5% had 2-9 partners; and 5.3% had 10 or more partners. Over three-quarters (77.5%) reported engaging in sex with at least one steady partner, 43.5% with at least one casual partner, and 29.5% with both casual and steady partners. Exchanging sex for money, drugs, or other needs was reported by 13.2%. Use of condoms during oral and anal sex increased significantly from baseline to 12-month follow-up (oral sex: 29.1-42.5%, p=0.02; anal sex: 67.8-76.2%, p=0.05). While unprotected anal sex significantly decreased among individuals who were new to care (34.8-18.3%, p<0.0001), it significantly increased among individuals who were previously in care (26.7-37.5%, p=0.03). Overall, exchange sex decreased from 13.3% at baseline to 5.0% at 12 months (p=0.001). Despite reductions in unprotected sexual encounters and exchange sex through one year of follow-up, many participants continued to engage in high-risk sexual behaviors. Retention within this study appeared to be associated with decreases in high-risk sexual behaviors, especially among participants who were new to care, although more research is needed. Future studies should investigate sexual network characteristics and the prevalence of behaviors such as serosorting.
我们评估了在一项针对感染 HIV 的少数族裔男同性恋者的多地点队列研究中，从基线到 12 个月随访期间性行为的变化。在基线访谈前的 3 个月内，超过四分之三的参与者（78.5%）报告与至少一名男子发生过性行为（平均：2.3 名伴侣）。在有性行为的参与者中，44.2%有一名伴侣；50.5%有 2-9 名伴侣；5.3%有 10 名或更多伴侣。超过四分之三（77.5%）的人报告与至少一名稳定伴侣发生过性行为，43.5%的人报告与至少一名偶然伴侣发生过性行为，29.5%的人同时与偶然和稳定伴侣发生过性行为。13.2%的人报告曾为钱、毒品或其他需求而发生性行为。从基线到 12 个月随访期间，口交和肛交时使用安全套的比例显著增加（口交：29.1-42.5%，p=0.02；肛交：67.8-76.2%，p=0.05）。虽然新入组的参与者中非保护性肛交显著减少（34.8-18.3%，p<0.0001），但以前接受过治疗的参与者中非保护性肛交显著增加（26.7-37.5%，p=0.03）。总体而言，交换性交易从基线时的 13.3%降至 12 个月时的 5.0%（p=0.001）。尽管在一年的随访期间，无保护性行为和交换性交易的数量有所减少，但许多参与者仍继续进行高风险性行为。在这项研究中，保留率似乎与高危性行为的减少有关，尤其是在新入组的参与者中，尽管还需要更多的研究。未来的研究应该调查性网络特征和行为（如血清学匹配）的流行率。
