Lorente Nicolas, Champenois Karen, Blanche Jérôme, Préau Marie, Suzan-Monti Marie, Mora Marion, Fugon Lionel, Carrieri Maria Patrizia, Sagaon-Teyssier Luis, Le Gall Jean-Marie, Spire Bruno, Yazdanpanah Yazdan
INSERM, UMR912 (SESSTIM), 13006 Marseille, France ; Aix Marseille Université, UMR_S912, IRD, 13006 Marseille, France ; ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, 13006 Marseille, France.
ATIP/AVENIR, INSERM U738, 75877 Paris, France.
J Sex Transm Dis. 2013;2013:648791. doi: 10.1155/2013/648791. Epub 2013 Jul 25.
Background. We aimed to identify factors associated with recent HIV testing in MSM who attended two experimental community-based and nonmedicalized voluntary counselling and testing programmes (CB-VCT) targeting MSM in France. Methods. This analysis was based on data collected in 2009-2011 through a self-administered pretesting questionnaire. An index measuring the level of participants' sexual orientation disclosure was built: the higher the index, the greater the disclosure. Factors associated with recent HIV testing (last test ≤ 1 year) were identified using a multivariate logistic regression model adjusted for the CB-VCT programme of enrolment. Results. 716 MSM provided data on testing history. Overall, 49% were recently tested for HIV and 51% were not. Recently tested MSM had a higher homosexuality disclosure index (adjusted OR [95% confidence interval]: aOR = 1.2 [1.1-1.4]), reported more inconsistent condom use during anal sex with men (aOR = 1.6 [1.2-2.1]), and were less likely to have sex under the influence of club drugs (aOR = 0.6 [0.4-1.0]). Conclusion. New testing strategies should focus on those who live their homosexuality relatively secretly and those who use club drugs before sex. Governments should develop policies which encourage improved social acceptance of homosexuality as concealment of sexual orientation represents a major barrier to testing.
背景。我们旨在确定参与法国两项针对男男性行为者(MSM)的基于社区的非医学化自愿咨询和检测项目(CB-VCT)的男男性行为者中与近期HIV检测相关的因素。方法。本分析基于2009年至2011年通过自我管理的检测前问卷收集的数据。构建了一个衡量参与者性取向披露水平的指数:指数越高,披露程度越高。使用针对入组的CB-VCT项目进行调整的多变量逻辑回归模型,确定与近期HIV检测(最后一次检测≤1年)相关的因素。结果。716名男男性行为者提供了检测历史数据。总体而言,49%的人最近进行了HIV检测,51%的人没有。最近进行检测的男男性行为者有更高的同性恋披露指数(调整后的比值比[95%置信区间]:aOR = 1.2 [1.1 - 1.4]),报告在与男性肛交时更多地不一致使用避孕套(aOR = 1.6 [1.2 - 2.1]),并且在俱乐部药物影响下发生性行为的可能性较小(aOR = 0.6 [0.4 - 1.0])。结论。新的检测策略应关注那些相对秘密地认同自己同性恋身份的人以及那些在性行为前使用俱乐部药物的人。政府应制定政策,鼓励提高社会对同性恋的接受度,因为性取向的隐瞒是检测方面的一个主要障碍。