Figueroa J P, Weir S S, Jones-Cooper C, Byfield L, Hobbs M M, McKnight I, Cummings S
Department of Community Health and Psychiatry, The University of the West Indies, Kingston 7, Jamaica.
University of North Carolina Chapel Hill, United States of America.
West Indian Med J. 2013;62(4):286-91. doi: 10.7727/wimj.2011.207.
Human immunodeficiency virus (HIV) prevalence among men who have sex with men (MSM) is thought to be high in Jamaica. The objective of this study was to estimate HIV prevalence and identify risk factors in order to improve prevention approaches.
With the help of influential MSM, an experienced research nurse approached MSM in four parishes to participate in a cross-sectional survey in 2007. Men who have sex with men were interviewed and blood taken for HIV and syphilis tests, and urine taken for gonorrhoea, chlamydia and trichomonas testing using transcription-mediated amplification assays. A structured questionnaire was administered by the nurse.
One third (65 of 201; 32%, 95% Confidence Interval (CI) 25.2, 47.9) of MSM were HIV positive. Prevalence of other sexually transmitted infections (STI) was: chlamydia 11%, syphilis 6%, gonorrhoea 3.5% and trichomonas 0%. One third (34%) of MSM identified themselves as being homosexual, 64% as bisexual and 1.5% as heterosexual. HIV positive MSM were significantly more likely to have ever been told by a doctor that they had an STI (48% vs 27%, OR 2.48 CI 1.21, 5.04, p = 0.01) and to be the receptive sexual partner at last sex (41% vs 23%, OR 2.41 CI 1.21, 4.71, p = 0.008). Men who have sex with men who were of low socio-economic status, ever homeless and victims of physical violence were twice as likely to be HIV positive. The majority (60%) of HIV positive MSM had not disclosed their status to their partner and over 50% were not comfortable disclosing their status to anyone.
The high HIV prevalence among MSM is an important factor driving the HIV epidemic in Jamaica. More effective ways need to be found to reduce the high prevalence of HIV among MSM including measures to reduce their social vulnerability, combat stigma and discrimination and empower them to practice safe sex.
在牙买加，男男性行为者（MSM）中的人类免疫缺陷病毒（HIV）流行率被认为很高。本研究的目的是估计HIV流行率并确定风险因素，以改进预防方法。
在有影响力的男男性行为者的帮助下，一名经验丰富的研究护士于2007年在四个教区接触男男性行为者，让他们参与一项横断面调查。对男男性行为者进行访谈，并采集血液进行HIV和梅毒检测，采集尿液使用转录介导扩增分析法进行淋病、衣原体和滴虫检测。护士发放一份结构化问卷。
三分之一（201人中的65人；32%，95%置信区间[CI]为25.2，47.9）的男男性行为者HIV呈阳性。其他性传播感染（STI）的流行率为：衣原体11%，梅毒6%，淋病3.5%，滴虫0%。三分之一（34%）的男男性行为者认为自己是同性恋，64%是双性恋，1.5%是异性恋。HIV呈阳性的男男性行为者更有可能曾被医生告知患有性传播感染（48%对27%，比值比[OR]为2.48，CI为1.21，5.04，p = 0.01），并且在最后一次性行为中是接受方性伴侣（41%对23%，OR为2.41，CI为1.21，4.71，p = 0.008）。社会经济地位低、曾无家可归且遭受身体暴力的男男性行为者HIV呈阳性的可能性是其他人的两倍。大多数（60%）HIV呈阳性的男男性行为者未向其伴侣透露自己的感染状况，超过50%的人不愿意向任何人透露自己的感染状况。
男男性行为者中HIV的高流行率是推动牙买加HIV疫情的一个重要因素。需要找到更有效的方法来降低男男性行为者中HIV的高流行率，包括采取措施减少他们在社会上的脆弱性、消除耻辱感和歧视，并使他们有能力进行安全性行为。
