“勉强度日”：一项横断面研究，探讨秘鲁男男性行为者中的男男性行为者中 HIV/性传播感染的男性性工作者这一关键人群
'Just getting by': a cross-sectional study of male sex workers as a key population for HIV/STIs among men who have sex with men in Peru.
机构信息
Program in Global Health, Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, , Los Angeles, California, USA.
出版信息
Sex Transm Infect. 2014 May;90(3):223-9. doi: 10.1136/sextrans-2013-051265. Epub 2014 Jan 3.
OBJECTIVES
To describe the sociodemographic and sex work characteristics, recent sexual practices, HIV risk perception and testing history, and HIV and syphilis prevalence of Cercado (downtown) and non-Cercado (close urban) male sex workers (MSWs) in Lima, Peru.
METHODS
Eighty-nine MSWs completed a self-administered survey and participated in HIV and syphilis testing.
RESULTS
Cercado MSWs had significantly lower median weekly earnings than non-Cercado MSWs (US$43 vs US$72, p=0.04). Most non-Cercado MSWs (81%) reported only insertive anal intercourse with male/transgender partners, while Cercado MSWs primarily reported only insertive (52%) or insertive and receptive (45%) anal intercourse (p=0.03). Consistent condom use was low with insertive and receptive anal intercourse in both subgroups. Among MSWs with recent female partners, condom use with the last partner was lower among Cercado versus non-Cercado MSWs for vaginal sex (37% vs 65%, p=0.04) and anal sex (27% vs 80%, p=0.01). More Cercado than non-Cercado MSWs (57% vs 42%) perceived high HIV risk (p=0.05) and Cercado MSWs had a much higher prevalence than non-Cercado MSWs of HIV (23% vs 4%, p=0.04) and syphilis (22% vs 0%, p=0.02) infections.
CONCLUSIONS
MSWs in Lima are diverse and Cercado MSWs are 'just getting by,' engaging in more risk behaviours, and more likely to have HIV/STIs. Future research should identify, describe and carry out HIV/STI testing with broader groups of MSWs and their client and non-client partners. Prevention efforts should provide HIV/STI risk reduction education for MSWs and related subgroups who are currently not targeted such as female partners.
目的
描述秘鲁利马市中心（Cercado）和非市中心（非 Cercado）男性性工作者（MSW）的社会人口学和性工作特征、最近的性行为、HIV 风险认知和检测史，以及 HIV 和梅毒的流行情况。
方法
89 名 MSW 完成了一份自我管理的调查，并接受了 HIV 和梅毒检测。
结果
Cercado MSW 的周收入中位数明显低于非 Cercado MSW（43 美元对 72 美元，p=0.04）。大多数非 Cercado MSW（81%）报告仅与男性/变性伴侣进行插入性肛交，而 Cercado MSW 主要报告仅进行插入性（52%）或插入性和接受性（45%）肛交（p=0.03）。两组的插入性和接受性肛交时， condom 的使用都很低。在最近有女性伴侣的 MSW 中，Cercado 组与非 Cercado 组相比，与最后一位伴侣进行阴道交和肛交时 condom 的使用较低，分别为 37%对 65%（p=0.04）和 27%对 80%（p=0.01）。与非 Cercado MSW 相比，更多的 Cercado MSW（57%对 42%）认为 HIV 风险高（p=0.05），并且 Cercado MSW 的 HIV（23%对 4%，p=0.04）和梅毒（22%对 0%，p=0.02）感染率明显更高。
结论
利马的 MSW 是多样化的，Cercado MSW 只是“勉强维持生计”，他们从事更多的风险行为，并且更有可能感染 HIV/性传播感染。未来的研究应该确定、描述并对更广泛的 MSW 及其客户和非客户伴侣进行 HIV/性传播感染检测。预防工作应该为目前未被针对的 MSW 和相关亚群提供 HIV/性传播感染风险降低教育，如女性伴侣。
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