Scott Hyman M, Irvin Risha, Wilton Leo, Van Tieu Hong, Watson Chauncey, Magnus Manya, Chen Iris, Gaydos Charlotte, Hussen Sophia A, Mannheimer Sharon, Mayer Kenneth, Hessol Nancy A, Buchbinder Susan
Bridge HIV, San Francisco Department of Public Health, San Francisco, California, United States of America.
Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
PLoS One. 2015 Dec 31;10(12):e0146025. doi: 10.1371/journal.pone.0146025. eCollection 2015.
Black men who have sex with men (MSM) have a high prevalence of bacterial sexually transmitted infections (STIs), and individual risk behavior does not fully explain the higher prevalence when compared with other MSM. Using the social-ecological framework, we evaluated individual, social and sexual network, and structural factors and their association with prevalent STIs among Black MSM.
The HIV Prevention Trials Network 061 was a multi-site cohort study designed to determine the feasibility and acceptability of a multi-component intervention for Black MSM in six US cities. Baseline assessments included demographics, risk behavior, and social and sexual network questions collected information about the size, nature and connectedness of their sexual network. Logistic regression was used to estimate the odds of having any prevalent sexually transmitted infection (gonorrhea, chlamydia, or syphilis).
A total of 1,553 Black MSM were enrolled in this study. In multivariate analysis, older age (aOR = 0.57; 95% CI 0.49-0.66, p<0.001) was associated with a lower odds of having a prevalent STI. Compared with reporting one male sexual partner, having 2-3 partners (aOR = 1.74; 95% CI 1.08-2.81, p<0.024) or more than 4 partners (aOR = 2.29; 95% CI 1.43-3.66, p<0.001) was associated with prevalent STIs. Having both Black and non-Black sexual partners (aOR = 0.67; 95% CI 0.45-0.99, p = 0.042) was the only sexual network factor associated with prevalent STIs.
Age and the number and racial composition of sexual partners were associated with prevalent STIs among Black MSM, while other sexual network factors were not. Further studies are needed to evaluate the effects of the individual, network, and structural factors on prevalent STIs among Black MSM to inform combination interventions to reduce STIs among these men.
与男性发生性关系的黑人男性（男男性行为者）细菌性性传播感染（STIs）的患病率很高，与其他男男性行为者相比，个体风险行为并不能完全解释这种较高的患病率。我们使用社会生态框架，评估了个体、社会和性网络以及结构因素及其与黑人男男性行为者中STIs流行率的关联。
艾滋病预防试验网络061是一项多中心队列研究，旨在确定在美国六个城市对黑人男男性行为者进行多成分干预的可行性和可接受性。基线评估包括人口统计学、风险行为以及社会和性网络问题，收集了有关其性网络规模、性质和连通性的信息。采用逻辑回归来估计患有任何一种流行的性传播感染（淋病、衣原体感染或梅毒）的几率。
本研究共纳入1553名黑人男男性行为者。在多变量分析中，年龄较大（调整后的比值比[aOR]=0.57；95%可信区间[CI]为0.49-0.66，p<0.001）与STIs流行率较低相关。与报告有一名男性性伴侣相比，有2-3名伴侣（aOR=1.74；95%CI为1.08-2.81，p<0.024）或超过4名伴侣（aOR=2.29；95%CI为1.43-3.66，p<0.001）与STIs流行相关。拥有黑人和非黑人两种性伴侣（aOR=0.67；95%CI为0.45-0.99，p=0.042）是与STIs流行相关的唯一性网络因素。
年龄以及性伴侣的数量和种族构成与黑人男男性行为者中STIs的流行有关，而其他性网络因素则无关。需要进一步研究来评估个体、网络和结构因素对黑人男男性行为者中STIs流行的影响，以为减少这些男性中STIs的联合干预提供依据。
