Folch Cinta, Fernández-Dávila Percy, Ferrer Laia, Soriano Raúl, Díez Mercedes, Casabona Jordi
Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Institut Català d'Oncologia (ICO), Agència de Salut Pública de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Pública, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, España.
Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Institut Català d'Oncologia (ICO), Agència de Salut Pública de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Barcelona, España; Stop Sida, Barcelona, España.
Enferm Infecc Microbiol Clin. 2014 Jun-Jul;32(6):341-9. doi: 10.1016/j.eimc.2013.09.017. Epub 2013 Nov 15.
To identify factors associated with high risk sexual practices among men who have sex with men (MSM) in Spain.
An online survey was conducted in 2010, which included, among others, questions on HIV/STI sexual behaviours and prevention needs. Unprotected anal intercourse (UAI) with a partner of unknown or discordant HIV status in the past year was defined as a high risk sexual behaviour.
Of the 13,111 participants, 49.4% had had sex with steady partners (SP) and 73.4% with non-steady partners (NSP) in the last 12months; and the prevalence of high risk UAI was 25.4% and 29.4%, respectively. Factors associated with high risk UAI with SP were: living in a city of less than 500,000 inhabitants (OR=1.42 <100,000 inhabitants), being out to no-one or only a few people (OR=1.42), and being HIV-positive with undetectable viral load among those with a high level of HIV/STI knowledge (OR=3.18). Factors associated with high risk UAI with NSP were mainly: having a higher number of sexual partners (OR=4.31 >50 partners), having used drugs for sex (OR=1.33), and at parties (OR=1.19), having a medium (OR=1.82) or low (OR=1.33) level of HIV/STI knowledge, and being HIV-positive (OR=1.56).
Among MSM, the prevalence of high risk sexual practices is high with both SP and NSP. Factors associated with high risk UAI vary by type of sexual partner (e.g., having HIV with an undetectable viral load). These must be taken into account when planning strategies for primary and secondary prevention.
确定西班牙男男性行为者（MSM）中与高风险性行为相关的因素。
2010年开展了一项在线调查，其中包括关于艾滋病毒/性传播感染性行为及预防需求等问题。过去一年与艾滋病毒状况不明或不一致的伴侣发生无保护肛交（UAI）被定义为高风险性行为。
在13111名参与者中，49.4%的人在过去12个月内与固定伴侣（SP）发生过性行为，73.4%的人与非固定伴侣（NSP）发生过性行为；高风险UAI的患病率分别为25.4%和29.4%。与与SP发生高风险UAI相关的因素有：生活在居民人数少于50万的城市（居民人数<10万时，比值比[OR]=1.42）、未向任何人或仅向少数人公开身份（OR=1.42），以及在艾滋病毒/性传播感染知识水平较高的人群中，艾滋病毒呈阳性且病毒载量不可检测（OR=3.18）。与与NSP发生高风险UAI相关的因素主要有：性伴侣数量较多（>50个伴侣时，OR=4.31）、有过性用药行为（OR=1.33）、在派对上（OR=1.19）、艾滋病毒/性传播感染知识水平中等（OR=1.82）或较低（OR=1.33），以及艾滋病毒呈阳性（OR=1.56）。
在男男性行为者中，与固定伴侣和非固定伴侣发生高风险性行为的患病率都很高。与高风险UAI相关的因素因性伴侣类型而异（例如，艾滋病毒呈阳性且病毒载量不可检测）。在制定一级和二级预防策略时必须考虑这些因素。
