Department of Psychiatry and Behavioral Medicine, College of Osteopathic Medicine, Nova Southeastern University, 4th Floor Terry Building, 3200 S. University Drive, Fort Lauderdale, FL33314, USA.
Am J Mens Health. 2013 May;7(3):186-97. doi: 10.1177/1557988312463417. Epub 2012 Oct 22.
Sexual risk behaviors account for most HIV infections in men who have sex with men (MSM), and the risk of exposure from each sexual encounter increases with age. The focus of this study was to investigate which behaviors in midlife and older MSM influence their sexual risk/protection. Cross-sectional data were collected from a community-based sample of 802 MSM aged 40 years and older from community venues (e.g., bars) who completed an anonymous questionnaire. Data from a subset of 420 MSM who were HIV-negative (aged 40-81 years) were used to investigate which behaviors were associated with greater risk for unprotected anal sex. Regression analyses indicated that erection difficulties (odds ratio [OR] = 4.7; 95% confidence interval [CI] = 1.8-12.2), practicing safe sex with outside partners but not with one's primary partner (OR = 0.54; 95% CI = 0.3-0.94), and recreational drug use (OR = 2.6; 95% CI = 1.3-5.1) were associated with higher risk for unprotected receptive anal intercourse. Younger age (OR = 0.96; 95% CI = 0.9- 0.9), not telling partners about HIV status (OR = 3.2; 95% CI = 1.5-6.5), finding partners in backrooms/sex clubs (OR = 2.8; 95% CI = 1.1- 6.8), and erection difficulties (OR = 10.3; 95% CI = 2.8-37.8) were associated with higher risk for unprotected insertive anal intercourse. These data indicate there may be certain factors specific to older MSM that influence their sexual risk taking behaviors. Programs may be more effective if they are tailored for older cohorts of MSM and address interpersonal communication, erection problems, and substance use to reduce health risks and promote healthier lifestyles.
性行为是男男性行为者（MSM）中大多数 HIV 感染的原因，而每次性接触的暴露风险会随着年龄的增长而增加。本研究的重点是调查中年和老年 MSM 的哪些行为会影响他们的性风险/保护。本研究从社区场所（如酒吧）的 802 名年龄在 40 岁及以上的社区为基础的 MSM 中收集了横断面数据，他们完成了匿名问卷。对 420 名 HIV 阴性（年龄在 40-81 岁）的 MSM 的部分数据进行了分析，以调查哪些行为与无保护肛交的风险增加有关。回归分析表明，勃起困难（比值比 [OR] = 4.7；95%置信区间 [CI] = 1.8-12.2）、与外部性伴侣安全性行为而不是与主要性伴侣安全性行为（OR = 0.54；95% CI = 0.3-0.94）以及使用娱乐性药物（OR = 2.6；95% CI = 1.3-5.1）与无保护的被动肛交风险增加有关。年龄较小（OR = 0.96；95% CI = 0.9-0.9）、不向伴侣告知 HIV 状况（OR = 3.2；95% CI = 1.5-6.5）、在后台/性俱乐部找伴侣（OR = 2.8；95% CI = 1.1-6.8）以及勃起困难（OR = 10.3；95% CI = 2.8-37.8）与无保护的主动肛交风险增加有关。这些数据表明，可能有某些特定于老年 MSM 的因素会影响他们的性行为风险行为。如果为年龄较大的 MSM 量身定制的项目能够解决人际沟通、勃起问题和物质使用问题，以降低健康风险并促进更健康的生活方式，那么这些项目可能会更有效。
