Heimer Robert, Barbour Russell, Khouri Danielle, Crawford Forrest W, Shebl Fatma, Aaraj Elie, Khoshnood Kaveh
1 Department of Epidemiology of Microbial Diseases, Yale University School of Public Health , New Haven, Connecticut.
2 Department of Biostatistics, Yale University School of Public Health , New Haven, Connecticut.
AIDS Res Hum Retroviruses. 2017 Nov;33(11):1149-1154. doi: 10.1089/AID.2016.0326. Epub 2017 Jun 29.
Little is known about HIV prevalence and risk among men who have sex with men (MSM) in much of the Middle East, including Lebanon. Recent national-level surveillance has suggested an increase in HIV prevalence concentrated among men in Lebanon. We undertook a biobehavioral study to provide direct evidence for the spread of HIV. MSM were recruited by respondent-driven sampling, interviewed, and offered HIV testing anonymously at sites located in Beirut, Lebanon, from October 2014 through February 2015. The interview questionnaire was designed to obtain information on participants' sociodemographic situation, sexual behaviors, alcohol and drug use, health, HIV testing and care, and experiences of stigma and discrimination. Individuals not reporting an HIV diagnosis were offered optional, anonymous HIV testing. Among the 292 MSM recruited, we identified 36 cases of HIV (12.3%). A quarter of the MSM were born in Syria and recently arrived in Lebanon. Condom use was uncommon; 65% reported condomless sex with other men. Group sex encounters were reported by 22% of participants. Among the 32 individuals already aware of their infection, 30 were in treatment and receiving antiretroviral therapy. HIV prevalence was substantially increased over past estimates. Efforts to control future increases will have to focus on reducing specific risk behaviors and experience of stigma and abuse, especially among Syrian refugees.
在中东大部分地区，包括黎巴嫩，男男性行为者（MSM）中艾滋病毒的流行情况和风险鲜为人知。最近的国家级监测表明，黎巴嫩的艾滋病毒流行率有所上升，且集中在男性群体中。我们开展了一项生物行为研究，以提供艾滋病毒传播的直接证据。2014年10月至2015年2月期间，通过应答者驱动抽样法招募了男男性行为者，在黎巴嫩贝鲁特的一些地点对他们进行了访谈，并为其提供匿名艾滋病毒检测。访谈问卷旨在获取有关参与者的社会人口状况、性行为、酒精和药物使用情况、健康状况、艾滋病毒检测与治疗，以及耻辱和歧视经历等信息。未报告艾滋病毒诊断的个体可选择进行匿名艾滋病毒检测。在招募的292名男男性行为者中，我们发现了36例艾滋病毒感染者（12.3%）。四分之一的男男性行为者出生在叙利亚，最近才抵达黎巴嫩。避孕套的使用并不常见；65%的人报告与其他男性有无保护性行为。22%的参与者报告有群交行为。在已了解自身感染情况的32人中，有30人正在接受抗逆转录病毒治疗。艾滋病毒流行率比过去的估计值大幅上升。控制未来增长的努力将不得不侧重于减少特定的风险行为以及耻辱和虐待经历，尤其是在叙利亚难民当中。
