Department of Epidemiology and Biostatistics, The George Washington University, Washington, DC, USA.
J Acquir Immune Defic Syndr. 2012 May 1;60(1):83-90. doi: 10.1097/QAI.0b013e318247925e.
Men who have sex with men (MSM) have higher rates of HIV and other sexually transmitted infections than women and heterosexual men. This elevated risk persists across age groups and reflects biological and behavioral factors; yet, there have been few direct comparisons of sexual behavior patterns between these populations.
We compared sexual behavior patterns of MSM and male and female heterosexuals aged 18-39 using 4 population-based random digit dialing surveys. A 1996-1998 survey in 4 US cities and 2 Seattle surveys (2003 and 2006) provided estimates for MSM; a 2003-2004 Seattle survey provided data about heterosexual men and women.
Sexual debut occurred earlier among MSM than heterosexuals. MSM reported longer cumulative lifetime periods of new partner acquisition than heterosexuals and a more gradual decline in new partnership formation with age. Among MSM, 86% of 18- to 24-year-olds and 72% of 35- to 39-year-olds formed a new partnership during the previous year, compared with 56% of heterosexual men and 34% of women at 18-24 years, and 21% and 10%, respectively, at 35-39 years. MSM were also more likely to choose partners >5 years older and were 2-3 times as likely as heterosexuals to report recent concurrent partnerships. MSM reported more consistent condom use during anal sex than heterosexuals reported during vaginal sex.
MSM have longer periods of partnership acquisition, a higher prevalence of partnership concurrency, and more age disassortative mixing than heterosexuals. These factors likely help to explain higher HIV/sexually transmitted infections rates among MSM, despite higher levels of condom use.
男男性行为者（MSM）的艾滋病毒和其他性传播感染率高于女性和异性恋男性。这种高风险在各个年龄段都存在，反映了生物学和行为因素；然而，这三个群体之间的性行为模式很少进行直接比较。
我们使用四项基于人群的随机拨号调查，比较了 18-39 岁的 MSM 与男性和女性异性恋者的性行为模式。1996-1998 年在美国四个城市和西雅图的两项调查（2003 年和 2006 年）为 MSM 提供了估计；2003-2004 年西雅图的一项调查提供了关于异性恋男性和女性的数据。
MSM 的性初潮比异性恋者更早。MSM 报告的累积终生获得新伴侣的时间比异性恋者长，并且随着年龄的增长，新伴侣关系的形成逐渐减少。在 MSM 中，86%的 18-24 岁者和 72%的 35-39 岁者在去年建立了新的伴侣关系，而 18-24 岁的异性恋男性和女性中分别为 56%和 34%，35-39 岁的分别为 21%和 10%。MSM 也更有可能选择年龄大于 5 岁的伴侣，并且与异性恋者相比，他们报告最近同时有多个伴侣的可能性是异性恋者的 2-3 倍。MSM 在肛交中使用安全套的比例比异性恋者在阴道性交中使用安全套的比例更高。
MSM 获得伴侣的时间更长，伴侣关系的同时存在更为普遍，年龄的不匹配程度也高于异性恋者。这些因素可能有助于解释尽管 MSM 使用安全套的水平较高，但他们的艾滋病毒/性传播感染率仍然较高。
