Gordon Kirsha S, Edelman E Jennifer, Justice Amy C, Fiellin David A, Akgün Kathleen, Crystal Stephen, Duggal Mona, Goulet Joseph L, Rimland David, Bryant Kendall J
VA Connecticut Healthcare System, 950 Campbell Ave. Blg. 35A 2nd FL, 11-ACSLG, West Haven, CT, 06516, USA.
General Internal Medicine, Yale University School of Medicine, New Haven, CT, 06520-8088, USA.
AIDS Behav. 2017 May;21(5):1497-1510. doi: 10.1007/s10461-016-1590-8.
Black and Hispanic (minority) MSM have a higher incidence of HIV than white MSM. Multiple sexual partners, being under the influence of drugs and/or alcohol during sex, having a detectable HIV-1 RNA, and non-condom use are factors associated with HIV transmission. Using data from the Veterans Aging Cohort Study, we consider minority status and sexual orientation jointly to characterize and compare these factors. White non-MSM had the lowest prevalence of these factors (p < 0.001) and were used as the comparator group in calculating odds ratios (OR). Both MSM groups were more likely to report multiple sex partners (white MSM OR 7.50; 95 % CI 5.26, 10.71; minority MSM OR 10.24; 95 % CI 7.44, 14.08), and more likely to be under the influence during sex (white MSM OR 2.15; 95 % CI 1.49, 3.11; minority MSM OR 2.94; 95 % CI 2.16, 4.01). Only minority MSM were more likely to have detectable HIV-1 RNA (OR 1.87; 95 % CI 1.12, 3.11). Both MSM groups were more likely to use condoms than white non-MSM. These analyses suggest that tailored interventions to prevent HIV transmission among minority MSM are needed, with awareness of the potential co-occurrence of risk factors.
黑人与西班牙裔(少数族裔)男男性行为者感染艾滋病毒的发生率高于白人男男性行为者。多个性伴侣、性行为期间受药物和/或酒精影响、可检测到HIV-1 RNA以及不使用避孕套是与艾滋病毒传播相关的因素。利用退伍军人老龄化队列研究的数据,我们联合考虑少数族裔身份和性取向,以描述和比较这些因素。白人非男男性行为者这些因素的患病率最低(p<0.001),并在计算比值比(OR)时用作比较组。两个男男性行为者组报告有多个性伴侣的可能性更高(白人男男性行为者OR 7.50;95%CI 5.26,10.71;少数族裔男男性行为者OR 10.24;95%CI 7.44,14.08),性行为期间受影响的可能性也更高(白人男男性行为者OR 2.15;95%CI 1.49,3.11;少数族裔男男性行为者OR 2.94;95%CI 2.16,4.01)。只有少数族裔男男性行为者更有可能检测到HIV-1 RNA(OR 1.87;95%CI 1.12,3.11)。两个男男性行为者组使用避孕套的可能性均高于白人非男男性行为者。这些分析表明,需要针对少数族裔男男性行为者制定预防艾滋病毒传播的针对性干预措施,并认识到风险因素可能同时存在。