Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention (CDC), Entebbe, Uganda.
PLoS One. 2012;7(5):e38143. doi: 10.1371/journal.pone.0038143. Epub 2012 May 31.
Uganda's generalized HIV epidemic is well described, including an estimated adult male HIV prevalence in Kampala of 4.5%, but no data are available on the prevalence of and risk factors for HIV infection among men who have sex with men (MSM).
METHODOLOGY/PRINCIPAL FINDINGS: From May 2008 to February 2009, we used respondent-driven sampling to recruit MSM ≥18 years old in Kampala who reported anal sex with another man in the previous three months. We collected demographic and HIV-related behavioral data through audio computer-assisted self-administered interviews. Laboratory testing included biomarkers for HIV and other sexually transmitted infections. We obtained population estimates adjusted for the non-random sampling frame using RDSAT and STATA. 300 MSM were surveyed over 11 waves; median age was 25 years (interquartile range, 21-29 years). Overall HIV prevalence was 13.7% (95% confidence interval [CI] 7.9%-20.1%), and was higher among MSM ≥25 years (22.4%) than among MSM aged 18-24 years (3.9%, odds ratio [OR] 5.69, 95% CI 2.02-16.02). In multivariate analysis, MSM ≥25 years (adjusted OR [aOR] 4.32, 95% CI 1.33-13.98) and those reporting ever having been exposed to homophobic abuse (verbal, moral, sexual, or physical abuse; aOR 5.38, 95% CI 1.95-14.79) were significantly more likely to be HIV infected.
CONCLUSIONS/SIGNIFICANCE: MSM in Kampala are at substantially higher risk for HIV than the general adult male population. MSM reporting a lifetime history of homophobic abuse are at increased risk of being HIV infected. Legal challenges and stigma must be overcome to provide access to tailored HIV prevention and care services.
乌干达的 HIV 广泛流行情况已有详细描述，包括估计在坎帕拉的成年男性 HIV 流行率为 4.5%，但目前尚无男男性行为者（MSM）中 HIV 感染的流行率和危险因素的数据。
方法/主要发现：从 2008 年 5 月至 2009 年 2 月，我们使用受访者驱动抽样（RDS）招募了 18 岁及以上在过去三个月中报告与另一名男性发生过肛交的坎帕拉 MSM。我们通过音频计算机辅助自我访谈收集人口统计和与 HIV 相关的行为数据。实验室检测包括 HIV 和其他性传播感染的生物标志物。我们使用 RDSAT 和 STATA 获得了针对非随机抽样框架进行调整的人群估计数。在 11 个波次中调查了 300 名 MSM；中位年龄为 25 岁（四分位间距，21-29 岁）。总 HIV 流行率为 13.7%（95%置信区间 [CI] 7.9%-20.1%），25 岁及以上 MSM （22.4%）高于 18-24 岁 MSM（3.9%，优势比 [OR] 5.69，95% CI 2.02-16.02）。在多变量分析中，25 岁及以上 MSM（调整后的 OR [aOR] 4.32，95% CI 1.33-13.98）和那些报告曾遭受过恐同虐待（口头、道德、性或身体虐待）的 MSM（aOR 5.38，95% CI 1.95-14.79）更有可能感染 HIV。
结论/意义：坎帕拉的 MSM 感染 HIV 的风险明显高于一般成年男性人群。报告有终身恐同虐待史的 MSM 感染 HIV 的风险增加。必须克服法律挑战和耻辱感，以提供针对 HIV 的预防和护理服务。
