Program in Global Health, Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, 10833 Leconte Avenue, CHS 37-121, Los Angeles, CA 90095, USA.
AIDS Behav. 2013 May;17(4):1313-28. doi: 10.1007/s10461-012-0210-5.
Role-based sexual identities structure male same-sex partnerships and influence HIV/STI epidemiology among MSM in Latin America. We explored shifting relationships between sexual roles, identities and practices among MSM in Lima, Peru, and implications for HIV/STI prevention. Patterns of HIV/STI epidemiology reflected differential risks for transmission within role-based partnerships with relatively low prevalences of HIV, syphilis, and HSV-2 but higher prevalences of urethral gonorrhea/chlamydia among activo MSM compared with moderno and pasivo participants. Qualitative analysis of how MSM in Peru integrate sexual identities, roles, and practices identified four key themes: pasivo role as a gay approximation of cultural femininity; activo role as a heterosexual consolidation of masculinity; moderno role as a masculine reconceptualization of gay identity; and role-based identities as social determinants of partnership, network, and community formation. The concept of role-based sexual identities provides a framework for HIV prevention for Latin American MSM that integrates sexual identities, practices, partnerships, and networks.
基于角色的性身份结构了男男性行为者（MSM）的同性伴侣关系，并影响了拉丁美洲 MSM 中的 HIV/性传播感染（STI）流行病学。我们探讨了秘鲁利马 MSM 中性角色、身份和行为之间不断变化的关系，以及对 HIV/STI 预防的影响。HIV/STI 流行病学模式反映了基于角色的伴侣关系中传播的不同风险，具有相对较低的 HIV、梅毒和单纯疱疹病毒 2（HSV-2）流行率，但活跃 MSM 中的尿道淋病/衣原体流行率高于现代和被动参与者。对秘鲁 MSM 如何整合性身份、角色和行为的定性分析确定了四个关键主题：被动角色作为同性恋对文化女性气质的近似；活跃角色作为对男性气质的异性恋巩固；现代角色作为对同性恋身份的男性化重新概念化；以及基于角色的身份作为伙伴关系、网络和社区形成的社会决定因素。基于角色的性身份概念为拉丁美洲 MSM 的 HIV 预防提供了一个框架，该框架整合了性身份、行为、伴侣关系和网络。
