van den Boom Wijnand, Stolte Ineke, Sandfort Theo, Davidovich Udi
Department of Research, Cluster Infectious Diseases, Public Health Service Amsterdam, Amsterdam, Netherlands.
AIDS Care. 2012;24(2):167-73. doi: 10.1080/09540121.2011.603285. Epub 2011 Aug 23.
Among HIV-negative men who have sex with men (MSM), any incident of unprotected anal intercourse (UAI) between casual partners is usually regarded as risky for HIV transmission. However, men are increasingly using knowledge of their casual partner's HIV-status to reduce HIV risk during UAI (i.e., serosorting). Since familiarity between casual partners may lead to higher levels of UAI and serosorting, we examined how often men have UAI and practice serosorting with three types of casual partnerships that differ in their degree of familiarity. We included 240 HIV-negative men of the Amsterdam Cohort Study among MSM. We distinguished three types of casual partnerships: one-night stand ("met by chance and had sex only once"); multiple-time casual partner ("met and had sex with several times") and the "regular" casual partner ("sex buddy"). Serosorting was defined as UAI with an HIV-concordant partner. Generalised estimating equations analyses were used to examine the association between type of casual partnership and sexual risk behaviour. Analyses revealed that men with a sex buddy were more likely to have UAI than men with a one-night stand (OR [95%CI] 2.39 [1.39-4.09]). However, men with a sex buddy were also more likely to practice serosorting than men with a one-night stand (OR [95%CI] 5.20 [1.20-22.52]). Men with a sex buddy had more UAI but also reported more serosorting than men with a one-night stand. As a result, the proportion of UAI without serosorting is lower for men with a sex buddy, and therefore men might have less UAI at risk for HIV with this partner type. However, the protective value of serosorting with a sex buddy against HIV transmission needs to be further established. At this time, we suggest that a distinction between the one-night stand and the sex buddy should be incorporated in future studies as men behave significantly different with the two partner types.
在与男性发生性行为的艾滋病毒阴性男性（男男性行为者）中，偶然伴侣之间任何无保护肛交（UAI）事件通常都被视为有感染艾滋病毒的风险。然而，男性越来越多地利用其偶然伴侣的艾滋病毒感染状况知识来降低无保护肛交期间的艾滋病毒风险（即血清型分类）。由于偶然伴侣之间的熟悉程度可能导致更高频率的无保护肛交和血清型分类，我们研究了男性与三种熟悉程度不同的偶然伴侣发生无保护肛交和进行血清型分类的频率。我们纳入了阿姆斯特丹男男性行为者队列研究中的240名艾滋病毒阴性男性。我们区分了三种偶然伴侣类型：一夜情（“偶然相遇且只发生过一次性行为”）；多次偶然伴侣（“相遇并发生过几次性行为”）和“固定”偶然伴侣（“性伴侣”）。血清型分类被定义为与艾滋病毒感染状况一致的伴侣发生无保护肛交。使用广义估计方程分析来研究偶然伴侣类型与性风险行为之间的关联。分析显示，有性伴侣的男性比有一夜情的男性更有可能发生无保护肛交（比值比[95%置信区间]2.39[1.39 - 4.09]）。然而，有性伴侣的男性也比有一夜情的男性更有可能进行血清型分类（比值比[95%置信区间]5.20[1.20 - 22.52]）。有性伴侣的男性比有一夜情的男性有更多的无保护肛交行为，但也报告了更多的血清型分类行为。因此，有性伴侣的男性中未进行血清型分类的无保护肛交比例较低，因此与这种伴侣类型发生性行为时，男性感染艾滋病毒的无保护肛交风险可能较小。然而，与性伴侣进行血清型分类对艾滋病毒传播的保护作用需要进一步确定。目前，我们建议在未来的研究中应区分一夜情和性伴侣，因为男性与这两种伴侣类型的行为存在显著差异。
