Yang Zhongrong, Zhang Sichao, Dong Zhengquan, Jin Meihua, Han Jiankang
Huzhou Center for Disease Control and Prevention, Huzhou 313000, Zhejiang Province, China.
BMC Public Health. 2014 May 26;14:508. doi: 10.1186/1471-2458-14-508.
BACKGROUND: Men who have sex with men (MSM) are a high risk population for human immunodeficiency virus (HIV) infection. Our study aims to find whether MSM who were recruited online had a higher prevalence of self-reported unprotected anal intercourse (UAI) than those who were recruited offline. METHODS: A meta-analysis was conducted from the results of published studies. The analysis was stratified by the participants' geographic location, the sample size and the date of the last reported UAI. RESULTS: Based on fourteen studies, MSM who were recruited online (online-based group) reported that 33.9% (5,961/17,580) of them had UAI versus 24.9% (2,700/10,853) of MSM who were recruited offline (offline-based group). The results showed that it is more likely for an online-based MSM group to have UAI with male partners than an offline-based MSM group [odds ratio (OR) = 1.35, 95% CI = 1.13-1.62, P < 0.01]. The subgroup analysis results also showed that the prevalence of UAI was higher in the European subsample (OR = 1.38, 95% CI = 1.17-1.63, P < 0.01) and in sample sizes of more than 500 individuals (OR = 1.32, 95% CI = 1.09-1.61, P < 0.01) in the online group compared to the offline group. The prevalence of UAI was also significantly higher when the time of the last UAI was during the last 3 or more months (OR = 1.40, 95% CI = 1.13-1.74, P < 0.05) in the online group compared to the offline group. A sensitivity analysis was used to test the reliability of the results, and it reported that the results remained unchanged and had the same estimates after deleting any one of the included studies. CONCLUSIONS: A substantial percentage of MSM were recruited online, and they were more inclined to engage in UAI than MSM who were recruited offline. Targeted interventions of HIV prevention programs or services are recommended when designing preventive interventions to be delivered via the Internet.
背景:男男性行为者(MSM)是感染人类免疫缺陷病毒(HIV)的高危人群。我们的研究旨在探究通过网络招募的男男性行为者自我报告的无保护肛交(UAI)发生率是否高于线下招募的男男性行为者。 方法:根据已发表研究的结果进行荟萃分析。分析按参与者的地理位置、样本量以及最后一次报告无保护肛交的日期进行分层。 结果:基于14项研究,通过网络招募的男男性行为者(网络组)报告称,其中33.9%(5961/17580)有过无保护肛交,而线下招募的男男性行为者(线下组)这一比例为24.9%(2700/10853)。结果表明,网络组男男性行为者与男性伴侣发生无保护肛交的可能性高于线下组男男性行为者[优势比(OR)=1.35,95%置信区间(CI)=1.13 - 1.62,P < 0.01]。亚组分析结果还显示,与线下组相比,欧洲子样本(OR = 1.38,95% CI = 1.17 - 1.63,P < 0.01)以及网络组中样本量超过500人的群体(OR = 1.32,95% CI = 1.09 - 1.61,P < 0.01)的无保护肛交发生率更高。与线下组相比,当最后一次无保护肛交发生在过去3个月或更长时间时,网络组的无保护肛交发生率也显著更高(OR = 1.40,95% CI = 1.13 - 1.74,P < 0.05)。采用敏感性分析来检验结果的可靠性,结果显示在剔除任何一项纳入研究后,结果保持不变且估计值相同。 结论:相当一部分男男性行为者是通过网络招募的,他们比线下招募的男男性行为者更倾向于进行无保护肛交。在设计通过互联网提供的预防干预措施时,建议对艾滋病预防项目或服务进行有针对性的干预。
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