Sandfort Theo, Anyamele C, Dolezal C
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA.
J Urban Health. 2017 Jun;94(3):330-338. doi: 10.1007/s11524-017-0135-4.
We examined correlates of sexual risk among gay and bisexual men, who recently migrated from western and eastern African countries to the USA and lived in New York City and who are HIV negative or of unknown status. These men migrate from countries where same-sex sexuality is socially rejected and mostly illegal contributing to the motivation to migrate. Their background might predispose these men to engagement in sexual risk practices, while they are not specifically addressed in HIV prevention programming. Participants (N = 62) reported in face-to-face interviews on pre- and postmigration experiences, psychosocial determinants of sexual risk, and current sexual practices. Operationalization of sexual risk was based on the number of men with whom they had condomless receptive and/or insertive anal sex. Over a third of the men reported always having used condoms in the past year; among the other men, sexual risk varied. Multivariate analyses showed that sexual risk was lower among men with a stronger motivation to avoid HIV infection and higher among men who currently engaged in transactional sex. Further analyses indicated that housing instability was independently associated with reduced motivation to avoid HIV infection and with engagement in transactional sex in the USA. In recent western and eastern African gay and bisexual immigrants to the USA, structural factors, including housing instability, are strongly associated with sexual risk.
我们调查了近期从非洲西部和东部国家移民到美国并居住在纽约市的男同性恋者和双性恋男性中的性风险相关因素,这些人艾滋病毒检测呈阴性或感染状况不明。这些男性来自同性性行为在社会上遭到排斥且大多为非法行为的国家,这也是他们移民的一个动机。他们的背景可能使这些男性倾向于从事性风险行为,而艾滋病毒预防项目并未专门针对他们。参与者(N = 62)在面对面访谈中报告了移民前后的经历、性风险的心理社会决定因素以及当前的性行为。性风险的衡量基于他们与未使用避孕套进行接受性和/或插入式肛交的男性的数量。超过三分之一的男性报告在过去一年中一直使用避孕套;在其他男性中,性风险各不相同。多变量分析表明,避免感染艾滋病毒动机较强的男性性风险较低,而目前从事交易性行为的男性性风险较高。进一步分析表明,住房不稳定与在美国避免感染艾滋病毒的动机降低以及从事交易性行为独立相关。在近期从非洲西部和东部移民到美国的男同性恋者和双性恋者中,包括住房不稳定在内的结构性因素与性风险密切相关。