Truong Hong-Ha M, Fatch Robin, Grasso Michael, Robertson Tyler, Tao Luke, Chen Yea-Hung, Curotto Alberto, McFarland Willi, Grant Robert M, Reznick Olga, Raymond H Fisher, Steward Wayne T
University of California, San Francisco, California, USA Gladstone Institute of Virology and Immunology, San Francisco, California, USA.
University of California, San Francisco, California, USA.
Sex Transm Infect. 2015 May;91(3):220-5. doi: 10.1136/sextrans-2014-051660. Epub 2014 Oct 29.
International travel poses potential challenges to HIV prevention. A number of studies have observed an association between travel and behavioural disinhibition. In the present study, we assessed differences in sexual behaviour while travelling internationally and within the USA, compared with being in the home environment.
A probability-based sample of men who have sex with men (MSM) from the San Francisco Bay Area who had travelled internationally in the previous 12 months was recruited through an adapted respondent-driven sampling methodology (N=501). Participants completed interviewer-administered, computer-assisted surveys.
Detailed partner-by-partner behavioural data by destination type were collected on 2925 sexual partnerships: 1028 while travelling internationally, 665 while travelling within the USA and 1232 while staying in the San Francisco Bay Area. The proportion of partnerships during international travel that involved unprotected anal intercourse (UAI) was lower compared with during domestic travel and staying locally. International travel was associated with decreased odds of receptive UAI (AOR=0.65, p=0.02) compared with staying locally and there was a trend towards decreased odds of insertive UAI (AOR=0.70, p=0.07).
MSM engaged in proportionately fewer sexual activities which present a high HIV transmission risk when travelling internationally, namely unprotected receptive and insertive anal intercourse and particularly with HIV serodiscordant partners. The lower sexual risk-taking during international travel was robust to controlling for many factors, including self-reported HIV serostatus, age, relationship status and type of partnership. These findings suggest that when travelling internationally, MSM may experience behavioural disinhibition to a lesser extent than had been described previously.
国际旅行给艾滋病毒预防带来了潜在挑战。多项研究观察到旅行与行为抑制之间存在关联。在本研究中，我们评估了在国际旅行、在美国境内旅行以及在家中环境下性行为的差异。
通过一种改良的应答者驱动抽样方法，招募了来自旧金山湾区、在过去12个月内有过国际旅行经历的男男性行为者（MSM）的概率样本（N = 501）。参与者完成了由访谈员管理的计算机辅助调查。
按目的地类型收集了2925个性伙伴关系的详细行为数据：1028个发生在国际旅行期间，665个发生在美国境内旅行期间，1232个发生在旧金山湾区居住期间。与国内旅行和本地居住期间相比，国际旅行期间涉及无保护肛交（UAI）的性伙伴关系比例较低。与本地居住相比，国际旅行与接受性UAI的几率降低相关（调整后比值比[AOR]=0.65，p = 0.02），插入性UAI的几率有降低趋势（AOR = 0.70，p = 0.07）。
男男性行为者在国际旅行时从事的高艾滋病毒传播风险的性活动比例相对较少，即无保护的接受性和插入性肛交，尤其是与艾滋病毒血清学不一致的性伙伴。国际旅行期间较低的性冒险行为在控制了许多因素后依然稳健，这些因素包括自我报告的艾滋病毒血清学状态、年龄、恋爱状况和性伙伴类型。这些发现表明，在国际旅行时，男男性行为者可能比之前描述的经历更少的行为抑制。
