University of South Africa, P.O. Box 511, Groenkloof, Pretoria, 0027, South Africa.
AIDS Behav. 2013 May;17 Suppl 1(0 1):S51-9. doi: 10.1007/s10461-012-0329-4.
A community-based needs assessment among men who have sex with men (MSM) in South Africa found that 27 % (n = 280/1,045) of MSM had never been tested for HIV. The most frequently reported reasons for not having been tested were the perception of not being at risk (57 %) and fear of being tested (52 %). This article explores factors associated with these two reasons among the untested MSM. In multiple logistic regressions, the perception of not being at risk of HIV infection was negatively associated with being black, coloured or Indian, being sexually active, knowing people living with HIV, and a history of sexually transmitted infections (STIs) in the past 24 months (adj. OR = .24, .32, .38, and .22, respectively). Fear of being tested for HIV was positively associated with being black, coloured or Indian, preferred gender expression as feminine, being sexually active, a history of STIs, and experience of victimization on the basis of sexual orientation (adj. OR = 2.90, 4.07, 4.62, 5.05, and 2.34, respectively). Results suggest that HIV prevention programs directed at South African MSM will be more effective if testing and treatment of STIs are better integrated into HIV testing systems. Finally, social exclusion on the basis of race and sexual orientation ought to be addressed in order to reach hidden, at-risk, populations of MSM.
南非对男男性行为者（MSM）进行的一项基于社区的需求评估发现，27%（n=1045 名中的 280 名）的 MSM 从未接受过 HIV 检测。未接受检测的最常见原因是认为自己没有感染风险（57%）和担心检测（52%）。本文探讨了未接受检测的 MSM 中这两个原因相关的因素。在多项逻辑回归中，感染 HIV 风险的认知与黑种人、混血儿或印度人、性活跃、认识 HIV 感染者以及过去 24 个月内有性传播感染史（STIs）呈负相关（调整后的比值比[adj.OR]分别为.24、.32、.38 和.22）。对 HIV 检测的恐惧与黑种人、混血儿或印度人、喜欢女性化的性别表达、性活跃、有 STIs 史以及基于性取向遭受迫害的经历呈正相关（adj.OR 分别为 2.90、4.07、4.62、5.05 和 2.34）。结果表明，如果将 STIs 的检测和治疗更好地纳入 HIV 检测系统，针对南非 MSM 的 HIV 预防计划将更加有效。最后，应该解决基于种族和性取向的社会排斥问题，以接触到隐藏的、处于风险中的 MSM 人群。
