Kapadia Farzana, Bub Kristen, Barton Staci, Stults Christopher B, Halkitis Perry N
Center for Health, Identity, Behavior, and Prevention Studies, Steinhardt School of Culture, Education & Human Development, New York University, 411 Lafayette Street, 5th Floor, New York, NY, 10012, USA.
Department of Population Health, Division of General Internal Medicine, Langone School of Medicine, New York University, New York, NY, USA.
AIDS Behav. 2015 Dec;19(12):2152-61. doi: 10.1007/s10461-015-1175-y.
Given the heightened risk for HIV and other STIs among young men who have sex with men (YMSM) as well as the racial/ethnic disparities in HIV/STI risk, an understanding of longitudinal trends in sexual behaviors is warranted as YMSM emerge into adulthood. Drawing from an ongoing prospective cohort study, the present analysis employed latent growth curve modeling to examine trends in distinct types of sexual activity without condoms over time in sample of YMSM and examine differences by race/ethnicity and perceived familial socioeconomic status (SES). Overall, White and Mixed race YMSM reported more instances of oral sex without condoms as compared to other racial/ethnic groups with rates of decline over time noted in Black YMSM. White YMSM also reported more receptive and insertive anal sex acts without a condom than Black YMSM. Declines over time in both types of anal sex acts without condoms among Black men were noted when compared to White men, while increases over time were noted for mixed race YMSM for condomless insertive anal sex. The effects for race/ethnicity were attenuated with the inclusion of perceived familial SES in these models. These findings build on previous cross sectional studies showing less frequent sex without condoms among Black YMSM despite higher rates of HIV incidence in emerging adulthood, as well as the importance of considering economic conditions in such models. Efforts to understand racial/ethnic disparities in HIV/STIs among YMSM must move beyond examination of individual-level sexual behaviors and consider both race/ethnicity and socioeconomic conditions in order to evaluate how these factors shape the sexual behaviors of YMSM.
鉴于男男性行为者（YMSM）感染艾滋病毒和其他性传播感染的风险增加，以及艾滋病毒/性传播感染风险方面的种族/族裔差异，随着YMSM步入成年，了解其性行为的纵向趋势很有必要。本分析借鉴了一项正在进行的前瞻性队列研究，采用潜在增长曲线模型来研究YMSM样本中随着时间推移不使用避孕套的不同类型性行为的趋势，并按种族/族裔和感知的家庭社会经济地位（SES）进行差异分析。总体而言，与其他种族/族裔群体相比，白人和混血YMSM报告的无避孕套口交情况更多，而黑人YMSM的此类情况随时间呈下降趋势。白人YMSM报告的无避孕套接受性和插入式肛交行为也比黑人YMSM多。与白人男性相比，黑人男性中两种无避孕套肛交行为随时间均呈下降趋势，而混血YMSM的无避孕套插入式肛交行为随时间呈上升趋势。在这些模型中纳入感知的家庭SES后，种族/族裔的影响减弱。这些发现基于之前的横断面研究，该研究表明，尽管成年初期艾滋病毒发病率较高，但黑人YMSM中无避孕套性行为的频率较低，同时也表明在此类模型中考虑经济状况的重要性。了解YMSM中艾滋病毒/性传播感染方面种族/族裔差异的努力必须超越对个体层面性行为的研究，同时考虑种族/族裔和社会经济状况，以便评估这些因素如何塑造YMSM的性行为。
