Frankis Jamie, Goodall Lisa, Clutterbuck Dan, Abubakari Abdul-Razak, Flowers Paul
1 School of Health and Life Sciences, Glasgow Caledonian University, Glasgow.
2 Cobridge Sexual Health Centre, Church Terrace, Cobridge, Stoke on Trent.
Int J STD AIDS. 2017 May;28(6):573-583. doi: 10.1177/0956462416636780. Epub 2016 Mar 4.
Sexually transmitted infections (STIs) disproportionately affect men who have sex with men, with marked increases in most STIs in recent years. These are likely underpinned by coterminous increases in behavioural risks which have coincided with the development of Internet and geospatial sociosexual networking. Current guidelines advocate regular, annual sexually transmitted infection testing amongst sexually active men who have sex with men (MSM), as opposed to symptom-driven testing. This paper explores sexually transmitted infection testing regularity amongst MSM who use social and sociosexual media. Data were collected from 2668 men in Scotland, Wales, Northern Ireland and the Republic of Ireland, recruited via social and gay sociosexual media. Only one-third of participants report regular (yearly or more frequent) STI testing, despite relatively high levels of male sex partners, condomless anal intercourse and high-risk unprotected anal intercourse. The following variables were associated with regular STI testing; being more 'out' (adjusted odds ratio = 1.79; confidence interval = 1.20-2.68), HIV-positive (adjusted odds ratio = 14.11; confidence interval = 7.03-28.32); reporting ≥10 male sex partners (adjusted odds ratio = 2.15; confidence interval = 1.47-3.14) or regular HIV testing (adjusted odds ratio = 48.44; confidence interval = 28.27-83.01). Men reporting long-term sickness absence from work/carers (adjusted odds ratio = 0.03; confidence interval = 0.00-0.48) and men aged ≤25 years (adjusted odds ratio = 0.36; 95% confidence interval = 0.19-0.69) were less likely to test regularly for STIs. As such, we identify a complex interplay of social, health and behavioural factors that each contribute to men's STI testing behaviours. In concert, these data suggest that the syndemics placing men at elevated risk may also mitigate against access to testing and prevention services. Moreover, successful reduction of STI transmission amongst MSM will necessitate a comprehensive range of approaches which address these multiple interrelated factors that underpin MSM's STI testing.
性传播感染（STIs）对男男性行为者的影响尤为严重，近年来大多数性传播感染的发病率显著上升。这可能是由于行为风险的同步增加，而这种增加与互联网和地理空间社交性网络的发展同时出现。当前指南提倡对性活跃的男男性行为者（MSM）进行定期的年度性传播感染检测，而非症状驱动检测。本文探讨了使用社交和社交性媒体的男男性行为者中性传播感染检测的规律性。数据收集自苏格兰、威尔士、北爱尔兰和爱尔兰共和国的2668名男性，通过社交和同性恋社交性媒体招募。尽管有相对较高比例的男性性伴侣、无保护肛交和高风险无保护肛交，但只有三分之一的参与者报告进行定期（每年或更频繁）的性传播感染检测。以下变量与定期性传播感染检测相关；更加“出柜”（调整后的优势比=1.79；置信区间=1.20 - 2.68）、艾滋病毒阳性（调整后的优势比=14.11；置信区间=7.03 - 28.32）；报告有≥10名男性性伴侣（调整后的优势比=2.15；置信区间=1.47 - 3.14）或定期进行艾滋病毒检测（调整后的优势比=48.44；置信区间=28.27 - 83.01）。报告长期因病缺勤/护理者的男性（调整后的优势比=0.03；置信区间=0.00 - 0.48）和年龄≤25岁的男性（调整后的优势比=0.36；95%置信区间=0.19 - 0.69）进行性传播感染定期检测的可能性较小。因此，我们确定了社会、健康和行为因素之间的复杂相互作用，这些因素都对男性的性传播感染检测行为产生影响。总体而言，这些数据表明，使男性面临更高风险的综合征也可能阻碍他们获得检测和预防服务。此外，要成功减少男男性行为者中性传播感染的传播，需要采取一系列全面的方法来解决这些支撑男男性行为者性传播感染检测的多个相互关联的因素。
