Hirshfield Sabina, Schrimshaw Eric W, Stall Ronald D, Margolis Andrew D, Downing Martin J, Chiasson Mary Ann
Sabina Hirshfield, Martin J. Downing Jr, and Mary Ann Chiasson are with Public Health Solutions, Research and Evaluation Unit, New York, NY. Eric W. Schrimshaw is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York. Ronald D. Stall is with the Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA. Andrew D. Margolis is with the Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA.
Am J Public Health. 2015 Sep;105(9):1849-58. doi: 10.2105/AJPH.2014.302346. Epub 2015 Feb 25.
We surveyed men who have sex with men (MSM) to determine whether sexual risk behaviors, recent drug use, and other psychosocial problems differed between men who engaged in one-on-one and group sexual encounters.
We conducted an Internet-based cross-sectional survey of 7158 MSM aged 18 years or older in the United States recruited from a gay-oriented sexual networking Web site in 2008. Among MSM who engaged in group sexual encounters, we compared their past-60-day sexual behaviors in one-on-one encounters and group sexual encounters. We also compared risk profiles and syndemic production between men who did and did not participate in group sex.
Men reporting a group-sex encounter had significantly higher polydrug use and sexual risk than did the men not reporting group sex in the past 60 days. The odds of engaging in group sex with 4 or more sexual partners significantly increased with the number of psychosocial problems, supporting evidence of syndemic production.
We identified a particularly high-risk subgroup in the MSM population with considerable psychosocial problems that may be reached online. Research is needed on how to engage these high-risk men in combination prevention interventions.
我们对男男性行为者（MSM）进行了调查，以确定在进行一对一和群体性行为的男性之间，性风险行为、近期吸毒情况及其他心理社会问题是否存在差异。
2008年，我们在美国一家面向同性恋的性网络网站上招募了7158名18岁及以上的MSM，进行了一项基于网络的横断面调查。在参与群体性行为的MSM中，我们比较了他们在一对一性行为和群体性行为中过去60天的性行为。我们还比较了参与和未参与群体性行为的男性的风险概况和共病情况。
在过去60天内，报告有群体性行为的男性比未报告群体性行为的男性有更高的多种药物使用和性风险。与4个或更多性伴侣进行群体性行为的几率随着心理社会问题的数量显著增加，这支持了共病情况的证据。
我们在MSM人群中确定了一个特别高危的亚组，他们存在相当多的心理社会问题，可能可以通过网络接触到。需要开展研究，探讨如何让这些高危男性参与综合预防干预措施。
