Card Kiffer G, Lachowsky Nathan J, Cui Zishan, Shurgold Susan, Armstrong Heather L, Rich Ashleigh J, Forrest Jamie I, Gislason Maya, Moore David M, Roth Eric A, Hogg Robert S
B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
Simon Fraser University, Burnaby, British Columbia.
AIDS Educ Prev. 2017 Apr;29(2):154-174. doi: 10.1521/aeap.2017.29.2.154.
The interpersonal determinants of condomless anal sex (CAS) within online-initiated sexual relationships remain poorly understood. Therefore, respondent-driven sampling was used to recruit a prospective cohort of sexually active gay, bisexual, and other men who have sex with men (MSM), aged ≥ 16 years in Vancouver, Canada. Follow-up occurred every 6 months, up to seven visits; at each visit participants reported their last sexual encounter with their five most recent partners. Stratified by self-reported HIV status, individual-level, interpersonal, and situational covariates of event-level CAS with partners met online were modeled using generalized estimating equations (GEE). CAS was reported during 32.4% (n = 1,015/3,133) of HIV-negative/unknown men's events, and 62.1% (n = 576/928) of HIV-positive men's events. Social (i.e., collective identity, altruism, network size social embeddedness) and situational (i.e., number of encounters, location, comparative age, seroconcordance, substance use) factors were identified as important correlates of CAS. Implications include the need for HIV prevention addressing social contexts associated with CAS.
对于通过网络建立的性关系中无保护肛交（CAS）的人际决定因素，我们仍然了解甚少。因此，采用应答驱动抽样法招募了一个前瞻性队列，该队列由加拿大温哥华年龄≥16岁、性活跃的男同性恋者、双性恋者及其他与男性发生性行为的男性（MSM）组成。每6个月进行一次随访，最多随访7次；每次随访时，参与者报告他们与最近五个性伴侣的最后一次性接触情况。根据自我报告的HIV感染状况进行分层，使用广义估计方程（GEE）对与在线结识的伴侣发生事件级CAS的个体层面、人际层面和情境层面的协变量进行建模。在HIV阴性/未知男性的性接触事件中，有32.4%（n = 1,015/3,133）报告发生了无保护肛交；在HIV阳性男性的性接触事件中，这一比例为62.1%（n = 576/928）。社会因素（即集体认同、利他主义、社交网络规模、社会嵌入性）和情境因素（即接触次数、地点、年龄差异、血清学一致性、药物使用情况）被确定为无保护肛交的重要相关因素。这意味着需要开展针对与无保护肛交相关社会背景的HIV预防工作。
