对可卡因和海洛因使用者的主要伴侣性行为风险的定性分析：恋爱中的安全性是否等于健康中的安全性？
Qualitative analysis of cocaine and heroin users' main partner sex-risk behavior: is safety in love safety in health?
机构信息
Boston University School of Medicine, Boston, MA, USA.
出版信息
Addict Sci Clin Pract. 2013 Apr 23;8(1):10. doi: 10.1186/1940-0640-8-10.
BACKGROUND
In 2009, 27% of the 48,100 estimated new cases of HIV were attributed to heterosexual contact with an infected or at-risk person. Sexually active adults are less likely to use condoms in relationships with main partners than with non-regular partners, despite general knowledge that condom use reduces HIV transmission.
METHODS
The purpose of this secondary qualitative analysis was to explore and contextualize perceptions of main partnerships, HIV risk, and attitudes toward condom use within main partner relationships among a subsample of intervention-arm cocaine- and/or heroin-using patients enrolled in a negative trial of brief motivational intervention to reduce the incidence of sexually transmitted disease and unsafe sexual behaviors. The open-ended portion of these interview audiotapes consisted of questions about perceptions of risk and attitudes about condom use with main partners. Enrollees were aged 18-54, English or Spanish speaking, and included in this analysis only if they reported having a main partner. We identified codes and elaborated important themes through a standard inductive three step coding process, using HyperRESEARCH™ software.
RESULTS
Among 48 interviewees, 65% were male, half were non-Hispanic white, over 60% were 20-39 years of age, 58% had intravenous drug use (IDU), and 8% were HIV-positive. Participants defined respect, support, trust, and shared child-rearing responsibility as the most valued components of main partner relationships. Condom use was viewed occasionally as a positive means of showing respect with main partners but more often as a sign of disrespect and a barrier to intimacy and affection. Enrollees appraised their partners' HIV risk in terms of perceptions of physical health, cleanliness, and sexual and HIV testing history. They based decisions regarding condom use mainly on perceived faithfulness, length of involvement, availability of condoms, and pregnancy desirability.
CONCLUSIONS
Risk appraisal was commonly based on appearance and subjective factors, and condom use with main sexual partners was described most often as a demonstration of lack of trust and intimacy.
TRIAL REGISTRATION
NCT01379599.
背景
2009 年，估计有 48100 例新的艾滋病毒病例中，有 27%归因于与受感染或处于危险中的人发生异性接触。性活跃的成年人与主要伴侣发生性关系时使用安全套的可能性低于与非固定伴侣发生性关系时，尽管普遍认为使用安全套可以降低艾滋病毒传播的风险。
方法
本二次定性分析的目的是探讨和阐述在一项针对可卡因和/或海洛因使用者的简短动机干预试验的干预组亚组中，主要伴侣关系、艾滋病毒风险以及对主要伴侣关系中使用安全套的态度的看法，该试验旨在降低性传播疾病和不安全性行为的发生率。这些采访录音带的开放式部分包含有关风险认知和与主要伴侣使用安全套态度的问题。参与者年龄在 18-54 岁之间，会讲英语或西班牙语，且仅在报告有主要伴侣的情况下才包括在本分析中。我们使用 HyperRESEARCH™软件通过标准的归纳三步编码过程识别代码并详细阐述重要主题。
结果
在 48 名受访者中，65%为男性，一半为非西班牙裔白人，超过 60%为 20-39 岁，58%有静脉吸毒史，8%为艾滋病毒阳性。参与者将尊重、支持、信任和共同养育子女的责任定义为主要伴侣关系中最有价值的组成部分。安全套的使用偶尔被视为与主要伴侣表示尊重的一种积极方式，但更多时候被视为不尊重的标志，也是亲密和感情的障碍。参与者根据对身体状况、清洁度以及性和艾滋病毒检测史的看法来评估伴侣的艾滋病毒风险。他们主要根据伴侣的忠诚度、参与度、安全套的可用性和怀孕意愿来决定是否使用安全套。
结论
风险评估通常基于外观和主观因素，与主要性伴侣使用安全套的情况通常被描述为缺乏信任和亲密的表现。
试验注册
NCT01379599。
Zotero 插件