Yale School of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, Connecticut, United States of America.
PLoS One. 2013 Aug 6;8(8):e69966. doi: 10.1371/journal.pone.0069966. Print 2013.
Peru's HIV epidemic is concentrated among men who have sex with men (MSM). The contribution of alcohol use disorders (AUDs) to known high-risk behaviors associated with HIV transmission in this context has not been well characterized.
Between June and October 2011, 5,148 sexually active MSM were recruited using convenience sampling in five cities to participate in a cross-sectional bio-behavioral survey. Five high-risk sexual criteria previously associated with incident HIV infection in this setting were selected a priori as the dependent outcomes. Screening for AUDs used the validated Alcohol Use Disorders Identification Test (AUDIT) and AUDS were stratified by severity. Unadjusted and adjusted odds ratios (AOR) were computed to establish the independent correlates of the five dependent outcomes.
The majority (62.8%) of participants met screening criteria for having an AUD, which were independently correlated with each of the following high-risk sexual risk behaviors in the previous 6 months: 1) >5 sexual partners [AOR = 1.76; (1.54-2.02)]; 2) sex with an HIV-infected partner [AOR = 1.29; (1.03-1.62)]; 3) having a sexually transmitted infection [AOR = 1.38; (1.13-1.68)]; 4) being a sex worker [AOR = 1.61; (1.40-1.87)]; and 5) unprotected sex during last encounter [AOR = 1.22; (1.09-1.38)]. Recent drug use was also correlated with having >5 sexual partners [AOR = 1.42 (1.19-1.71)], sex work [AOR = 1.97 (1.63-2.39)] and unprotected sex during last encounter [AOR = 1.31 (1.11-1.54)]. For each dependent variable, the association with AUDs significantly increased with increasing AUD severity.
AUDs are highly prevalent among MSM in Peru and are associated with increased HIV risk-taking behaviors that are associated with HIV transmission. Strategies that target problematic drinking such as medication-assisted therapy, behavioral counseling and structural interventions could potentially reduce risky behaviors and ultimately reduce HIV transmission among MSM in Peru.
秘鲁的艾滋病疫情主要集中在男男性行为者（MSM）中。在这种情况下，酒精使用障碍（AUDs）对与 HIV 传播相关的已知高危行为的贡献尚未得到很好的描述。
2011 年 6 月至 10 月，采用便利抽样法在五个城市招募了 5148 名活跃的男男性行为者，参与一项横断面的生物行为调查。以前在这种情况下与 HIV 感染相关的五个高危性行为标准被选为依赖结局。使用经过验证的酒精使用障碍识别测试（AUDIT）对 AUDs 进行筛查，并按严重程度对 AUDs 进行分层。计算未经调整和调整后的优势比（AOR）以确定五个依赖结局的独立相关因素。
大多数（62.8%）参与者符合 AUD 筛查标准，与以下五种高危性行为风险因素独立相关：1）性伴侣数＞5[OR=1.76；（1.54-2.02）]；2）与 HIV 感染者发生性行为[OR=1.29；（1.03-1.62）]；3）患有性传播感染[OR=1.38；（1.13-1.68）]；4）性工作者[OR=1.61；（1.40-1.87）]；5）最后一次性行为未使用保护措施[OR=1.22；（1.09-1.38）]。最近吸毒也与性伴侣数＞5[OR=1.42（1.19-1.71）]、性工作[OR=1.97（1.63-2.39）]和最后一次性行为未使用保护措施[OR=1.31（1.11-1.54）]相关。对于每个依赖变量，与 AUDs 的关联随着 AUD 严重程度的增加而显著增加。
秘鲁的 MSM 中 AUDs 的患病率很高，并且与增加的 HIV 风险行为相关，这些行为与 HIV 传播有关。针对饮酒问题的策略，如药物辅助治疗、行为咨询和结构干预，有可能减少高危行为，并最终降低秘鲁 MSM 中的 HIV 传播。
