Holt Martin, Lee Evelyn, Prestage Garrett P, Zablotska Iryna, de Wit John, Mao Limin
National Centre in HIV Social Research, The University of New South Wales, Sydney, Australia.
AIDS Care. 2013;25(1):28-37. doi: 10.1080/09540121.2012.686598. Epub 2012 May 29.
To assess the changing health promotion needs of human immunodeficiency virus (HIV)-positive gay men in Australia, we analysed the social and behavioural characteristics of HIV-positive men in the Australian Gay Community Periodic Surveys. We looked at change over time in the characteristics of HIV-positive men (from 2000-2001 to 2008-2009) and compared HIV-positive men with their HIV-negative peers within each time period. Multivariate logistic regression analysis was used to assess independent changes over time within each HIV status group. A total of 21,620 responses were included in the analyses; 10,537 in 2000-2001 and 11,083 in 2008-2009. Between the two time periods, HIV-positive and HIV-negative men became more similar in the following areas: paid employment, sexual identity, number of male sex partners, the likelihood of having a regular male partner and having a seroconcordant regular male partner. The two groups diverged in these areas: age, ethnicity, educational level, social engagement with gay men, types of relationship with regular male partners, likelihood of unprotected anal intercourse with casual male partners and likelihood of HIV disclosure to casual male partners. Workforce participation and educational attainment have improved among HIV-positive gay men since 2000, but they still lag behind their HIV-negative peers in these areas. Because HIV-positive men are an ageing cohort, support services will need to increasingly address issues of HIV, sexuality and ageing with HIV-positive men. The increase in unprotected anal intercourse and HIV disclosure with casual partners means that education and support services will increasingly need to address effective HIV disclosure and non-condom-based risk reduction strategies with both HIV-positive and HIV-negative gay men.
为评估澳大利亚感染人类免疫缺陷病毒(HIV)的男同性恋者不断变化的健康促进需求,我们分析了澳大利亚男同性恋社区定期调查中HIV阳性男性的社会和行为特征。我们研究了HIV阳性男性特征随时间的变化(从2000 - 2001年至2008 - 2009年),并在每个时间段内将HIV阳性男性与其HIV阴性同龄人进行比较。采用多变量逻辑回归分析来评估每个HIV状态组随时间的独立变化。分析共纳入21,620份回复;2000 - 2001年有10,537份,2008 - 2009年有11,083份。在这两个时间段之间,HIV阳性和HIV阴性男性在以下方面变得更加相似:有偿就业、性取向、男性性伴侣数量、有固定男性伴侣的可能性以及有血清学一致的固定男性伴侣的可能性。两组在以下方面存在差异:年龄、种族、教育水平、与男同性恋者的社交参与度、与固定男性伴侣的关系类型、与随意男性伴侣发生无保护肛交的可能性以及向随意男性伴侣披露HIV感染情况的可能性。自2000年以来,HIV阳性男同性恋者的劳动力参与率和教育程度有所提高,但在这些方面仍落后于他们的HIV阴性同龄人。由于HIV阳性男性群体正在老龄化,支持服务将需要越来越多地解决HIV阳性男性的HIV、性取向和老龄化问题。与随意伴侣发生无保护肛交以及披露HIV感染情况的增加意味着教育和支持服务将越来越需要针对HIV阳性和HIV阴性男同性恋者解决有效的HIV披露和基于不使用避孕套的风险降低策略。