Phillips Gregory, Grov Christian, Mustanski Brian
Northwestern University, Feinberg School of Medicine, Department of Medical Social Sciences, 625N. Michigan Avenue, Chicago, IL 60611, USA.
Department of Health and Nutrition Sciences, Brooklyn College, City University of New York (CUNY), 2900 Bedford Avenue, New York, NY 11210, USA.
Sex Health. 2015 Nov;12(6):495-500. doi: 10.1071/SH15108.
Men who have sex with men (MSM) remain the group most affected by the HIV epidemic in the United States. At least one-quarter of MSM report engagement in group sex events (GSEs), which can pose a risk for HIV transmission and acquisition. In this study, identification of event-level correlates of sexual and drug use behaviours at GSEs was sought to better inform prevention activities.
For this study, participants were recruited via banner and pop-up advertisements placed on a geosocial networking mobile phone application that MSM use to meet men.
Of the 1997 individuals who completed the study screener, 36.0% reported participating in at least one GSE in the prior year. In multivariable logistic regression analysis, attendance at a GSE in the past year was significantly associated with older age, full/part time employment and being HIV positive. Of the men who attended a GSE, more than half reported condomless anal sex (CAS) with at least one of their partners (insertive: 57.7%; receptive: 56.3%). MSM who indicated drug use had significantly higher odds of having insertive CAS [odds ratio (OR)=2.45; 95% confidence interval (CI): 1.37-4.39] and receptive CAS (OR=3.60; 95% CI: 1.96-6.63) at their last GSE.
The high prevalence of HIV-positive MSM engaging in group sex, coupled with their greater odds of CAS, poses a significant risk for HIV/STI transmission within the group sex setting. More research is needed to determine patterns of condom use at these events and whether seroadaptive behaviours are driving CAS.
男男性行为者(MSM)仍是美国受艾滋病毒疫情影响最严重的群体。至少四分之一的男男性行为者报告参与过群体性性行为活动(GSEs),这可能带来艾滋病毒传播和感染风险。在本研究中,旨在确定群体性性行为活动中性行为和药物使用行为的事件层面相关因素,以便更好地为预防活动提供信息。
在一款男男性行为者用于结识男性的地理社交网络手机应用程序上投放横幅和弹出式广告,招募本研究的参与者。
在完成研究筛选的1997名个体中,36.0%报告在前一年至少参与过一次群体性性行为活动。在多变量逻辑回归分析中,过去一年参加过群体性性行为活动与年龄较大、全职/兼职工作以及艾滋病毒呈阳性显著相关。在参加过群体性性行为活动的男性中,超过一半报告与至少一名性伴侣有无保护肛交(插入方:57.7%;接受方:56.3%)。表示有药物使用行为的男男性行为者在最近一次群体性性行为活动中进行插入式无保护肛交[比值比(OR)=2.45;95%置信区间(CI):1.37 - 4.39]和接受式无保护肛交(OR = 3.60;95% CI:1.96 - 6.63)的几率显著更高。
艾滋病毒呈阳性的男男性行为者参与群体性性行为的比例较高,再加上他们进行无保护肛交的几率更大,这在群体性性行为环境中构成了艾滋病毒/性传播感染传播的重大风险。需要更多研究来确定这些活动中的避孕套使用模式,以及血清适应性行为是否在推动无保护肛交行为。