Niccolai Linda M, Odinokova Veronika A, Safiullina Liliya Z, Bodanovskaya Zinaida D, Heimer Robert, Levina Olga S, Rusakova Maia M
Yale School of Public Health Division of Epidemiology of Microbial Diseases, Center for Interdisciplinary Research on AIDS, New Haven, CT, USA.
AIDS Care. 2012;24(5):665-72. doi: 10.1080/09540121.2011.630356. Epub 2012 Jan 31.
In Russia, sexual transmission of HIV is increasing and street-based female sex workers (FSW) have a high HIV prevalence, but the role of male clients of FSW in HIV transmission and bridging to the general population has not been studied. Sixty-two male clients completed structured interviews during February-March of 2010 in St. Petersburg Russia. Descriptive analyses focused on condom use with different types of sex partners, substance use, and STI/HIV testing histories. The median lifetime and past 12 month numbers of FSW partners were 10 and 3, respectively. A majority of clients (74%) reported having non-FSW partners during the past 12 months, and nearly half (47%) reported having regular sex partners. Consistent condom use was reported in 61% of relationships with FSW partners and in 43% of relationships with non-FSW partners. A majority of clients (58%) was classified as active or potential bridgers based on having both FSW and non-FSW partners and reporting inconsistent condom use with their non-FSW partners. A majority (61%) also reported concurrent partnerships with FSW and non-FSW partners. Nearly half (48%) of last contacts with FSW partners involved consumption of alcohol by the client. Noninjection and injection drug use in the past 30 days were reported by 15% and 7% of clients, respectively. Twenty-nine percent reported history of a sexually transmitted infection (STI) and 74% reported a previous HIV test; active/potential bridgers were significantly less likely than unlikely bridgers to have ever been tested for HIV. These data signal the potential for HIV/STI transmission among male clients of street-based FSW in St. Petersburg Russia due to their variety of partner types, sub-optimal condom use, and concurrent partnerships. Larger studies are needed to confirm these findings, further explore the roles of alcohol and drug use, and identify effective strategies and interventions for HIV prevention.
在俄罗斯，艾滋病毒的性传播呈上升趋势，街头女性性工作者（FSW）的艾滋病毒感染率很高，但FSW的男性客户在艾滋病毒传播以及与普通人群的关联方面所起的作用尚未得到研究。2010年2月至3月期间，62名FSW的男性客户在俄罗斯圣彼得堡完成了结构化访谈。描述性分析集中在与不同类型性伴侣的 condom 使用情况、物质使用情况以及性传播感染/艾滋病毒检测史。FSW伴侣的终生中位数和过去12个月的中位数分别为10人和3人。大多数客户（74%）报告在过去12个月中有非FSW伴侣，近一半（47%）报告有固定性伴侣。在与FSW伴侣的关系中，61%报告始终使用 condom，在与非FSW伴侣的关系中，43%报告始终使用 condom。大多数客户（58%）被归类为活跃或潜在的桥梁人群，因为他们既有FSW伴侣又有非FSW伴侣，并且报告与非FSW伴侣 condom 使用不一致。大多数（61%）还报告与FSW和非FSW伴侣存在同时性伴侣关系。与FSW伴侣的最后接触中，近一半（48%）涉及客户饮酒。分别有15%和7%的客户报告在过去30天内有非注射和注射吸毒行为。29%报告有性传播感染（STI）史，74%报告曾进行过艾滋病毒检测；活跃/潜在的桥梁人群接受艾滋病毒检测的可能性明显低于非桥梁人群。这些数据表明，由于俄罗斯圣彼得堡街头FSW的男性客户伴侣类型多样、condom 使用不理想以及存在同时性伴侣关系，他们之间存在艾滋病毒/性传播感染传播的可能性。需要进行更大规模的研究来证实这些发现，进一步探讨酒精和药物使用的作用，并确定有效的艾滋病毒预防策略和干预措施。
