Nunn Amy, Dickman Samuel, Cornwall Alexandra, Rosengard Cynthia, Kwakwa Helena, Kim Daniel, James George, Mayer Kenneth H
Division of Infectious Diseases, Alpert Medical School of Brown University, The Miriam Hospital, Providence, USA.
AIDS Care. 2011 Nov;23(11):1392-9. doi: 10.1080/09540121.2011.565030. Epub 2011 Jun 14.
African Americans face disproportionately higher risks of HIV infection. Concurrent sexual relationships, or sexual partnerships that overlap in time, are more common among African Americans than individuals of other races and may contribute to racial disparities in HIV infection. However, little is known about attitudes, norms and practices among individuals engaged in concurrent partnerships. Little is also known about the processes through which structural, behavioral, and social factors influence concurrent sexual relationships. We recruited 24 heterosexual African American men involved in concurrent sexual relationships from a public health clinic in Philadelphia. We conducted in-depth interviews exploring these men's sexual practices; social norms and individual attitudes about concurrency; perceived sexual health risks with main and non-main partners; and the social, structural, and behavioral factors contributing to concurrent sexual relationships. Twenty-two men reported having one main and one or more non-main partners; two reported having no main partners. Respondents generally perceived sexual relationships with non-main partners as riskier than relationships with main partners and used condoms far less frequently with main than non-main partners. Most participants commented that it is acceptable and often expected for men and women to engage in concurrent sexual relationships. Social factors influencing participants' concurrent partnerships included being unmarried and trusting neither main nor non-main partners. Structural factors influencing concurrent partnerships included economic dependence on one or more women, incarceration, unstable housing, and unemployment. Several men commented that individual behavioral factors such as alcohol and cocaine use contributed to their concurrent sexual partnerships. Future research and interventions related to sexual concurrency should address social and structural factors in addition to conventional HIV risk-taking behaviors.
非裔美国人面临着不成比例的更高的艾滋病毒感染风险。同时存在的性关系，即时间上重叠的性伴侣关系，在非裔美国人中比其他种族的人更为常见，这可能导致艾滋病毒感染方面的种族差异。然而，对于处于同时存在的性伴侣关系中的个人的态度、规范和行为知之甚少。对于结构、行为和社会因素影响同时存在的性关系的过程也了解甚少。我们从费城的一家公共卫生诊所招募了24名参与同时存在的性关系的异性恋非裔美国男性。我们进行了深入访谈，探讨这些男性的性行为；关于同时存在关系的社会规范和个人态度；与主要和非主要伴侣发生性行为时感知到的性健康风险；以及导致同时存在的性关系的社会、结构和行为因素。22名男性报告有一个主要伴侣和一个或多个非主要伴侣；两名男性报告没有主要伴侣。受访者普遍认为与非主要伴侣的性关系比与主要伴侣的性关系风险更大，与主要伴侣使用避孕套的频率远低于与非主要伴侣。大多数参与者表示，男性和女性同时存在性关系是可以接受的，而且通常也是被期望的。影响参与者同时存在的性伴侣关系的社会因素包括未婚以及对主要和非主要伴侣都不信任。影响同时存在的性伴侣关系的结构因素包括在经济上依赖一个或多个女性、被监禁、住房不稳定和失业。几名男性表示，诸如饮酒和使用可卡因等个人行为因素促成了他们同时存在的性伴侣关系。未来与性伴侣同时存在情况相关的研究和干预措施除了应对传统的艾滋病毒风险行为外，还应解决社会和结构因素。
