Marcus U, an der Heiden M, Gassowski M, Kruspe M, Drewes J
Department of Infectious Disease Epidemiology, Robert Koch-Institut, Berlin, Germany.
Department of Public Health, Free University, Berlin, Germany.
BMJ Open. 2015 Nov 4;5(11):e009107. doi: 10.1136/bmjopen-2015-009107.
Opportunities for men having sex with men (MSM) to meet each other have very much improved by new communication technologies. Meeting venue-based characteristics can impact how many partners are met and how much sexual risk is taken. We analysed the association between physical and virtual venues and the risk for bacterial sexually transmitted infections (bSTIs) among participants in an MSM online survey.
Data were collected during 2013/2014 with a survey targeting MSM living in Germany. The impact of the meeting place with the last non-steady anal sex partner on diagnosis with a bSTI in the previous year was analysed using bivariate and multivariate regression analysis, taking into account self-reported HIV status, serostatus communication, condom use, partner number, age and city size.
The study sample consisted of 8878 respondents (7799 not diagnosed with HIV; 1079 diagnosed with HIV). Meeting partners online was most common (62% HIV-/51% HIV+), followed by sex venues (11% HIV-/25% HIV+); other venues were each reported by 2-6% of the respondents. Venue-dependent proportions reporting bSTIs in the recent year were 2-4 folds higher among men diagnosed with HIV. In multivariate analysis, HIV status was the strongest predictor for bSTIs (OR=5.0; 95% CI 2.8 to 8.7). Compared with meeting partners online, sex (OR 1.6; 95% CI 1.0 to 2.5) and social venues (OR 1.9; 95% CI 1.4 to 2.6) were associated with increased bSTI risk for men not diagnosed with HIV, but the risk when meeting partners by smartphone apps was only of borderline significance (OR 1.5; 95% CI 0.9 to 2.3). For men diagnosed with HIV, bSTI risk increased for sex venues (OR 1.5; 95% CI 1.1 to 2.1), and was lower for non-gay/other venues (OR 0.2; 95% CI 0.1 to 0.5).
Venues are connected to social-behavioural facets of corresponding sexual encounters, and may be important arenas for differential HIV and STI education, treatment and prevention.
新的通信技术极大地改善了男男性行为者（MSM）相互结识的机会。基于会面场所的特征会影响结识的性伴侣数量以及承担的性风险程度。我们分析了在一项MSM在线调查中，实体场所和虚拟场所与细菌性性传播感染（bSTIs）风险之间的关联。
2013/2014年期间，针对居住在德国的MSM进行了一项调查以收集数据。使用双变量和多变量回归分析，考虑自我报告的艾滋病毒感染状况、血清学状态告知情况、避孕套使用情况、性伴侣数量、年龄和城市规模，分析与最后一位非固定肛交性伴侣的会面场所对前一年bSTIs诊断的影响。
研究样本包括8878名受访者（7799人未被诊断出感染艾滋病毒；1079人被诊断出感染艾滋病毒）。在网上结识伴侣最为常见（未感染艾滋病毒者中占62%，感染艾滋病毒者中占51%），其次是性场所（未感染艾滋病毒者中占11%，感染艾滋病毒者中占25%）；其他场所各有2 - 6%的受访者报告。在最近一年中，报告感染bSTIs的场所相关比例在感染艾滋病毒的男性中高出2 - 4倍。在多变量分析中，艾滋病毒感染状况是bSTIs最强的预测因素（OR = 5.0；95%置信区间2.8至8.7）。与在网上结识伴侣相比，性场所（OR 1.6；95%置信区间1.0至2.5）和社交场所（OR 1.9；95%置信区间1.4至2.6）与未感染艾滋病毒男性的bSTIs风险增加相关，但通过智能手机应用程序结识伴侣时的风险仅具有临界显著性（OR 1.5；95%置信区间0.9至2.3）。对于感染艾滋病毒的男性，性场所的bSTIs风险增加（OR 1.5；95%置信区间1.1至2.1），而非同性恋/其他场所的风险较低（OR 0.2；95%置信区间0.1至0.5）。
场所与相应性接触的社会行为层面相关联，可能是进行差异化艾滋病毒和性传播感染教育、治疗及预防的重要场所。
