Shadaker Shaun, Magee Matthew, Paz-Bailey Gabriela, Hoots Brooke E
*Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA; and †Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
J Acquir Immune Defic Syndr. 2017 Jul 1;75 Suppl 3(Suppl 3):S281-S287. doi: 10.1097/QAI.0000000000001403.
Men who have sex with men (MSM) are heterogeneous with respect to sexual behavior. We examined differences in sex behaviors between men who have sex with men and women (MSMW) and men who have sex with men only (MSMO).
Data for this analysis were from MSM who participated in National HIV Behavioral Surveillance in 2011 and 2014. We used the combined years to evaluate demographic and behavioral differences between MSMW and MSMO. Using log-linked Poisson regression models, adjusted prevalence ratios (aPR) were calculated for behavioral outcomes.
Overall, 2042 (11.9%) participants were classified as MSMW. MSMW were less likely than MSMO to have condomless sex with male partners [aPR 0.77; 95% confidence interval (CI): 0.74 to 0.81] and to have been diagnosed with another sexually transmitted disease (aPR 0.83; 95% CI: 0.72 to 0.95). MSMW were more likely than MSMO to have given money or drugs for sex (aPR 2.85; 95% CI: 2.52 to 3.24) or received money or drugs for sex (aPR 2.64; 95% CI: 2.37 to 2.93) and to ever have injected drugs (aPR 2.05; 95% CI: 1.80 to 2.34). MSMW had more total sex partners (median 6, interquartile range: 4-11 vs. 3, 2-8), casual sex partners (5, 2-10 vs. 3, 1-7), and condomless sex partners (2, 1-4 vs. 1, 0-2) in the last 12 months (P < 0.01 for all comparisons).
MSMW have distinct sexual risk behaviors from MSMO and may contribute to HIV transmission among women. MSMW could benefit from tailored interventions to reduce HIV risk behaviors.
男男性行为者（MSM）在性行为方面具有异质性。我们研究了与男性和女性发生性行为的男男性行为者（MSMW）和仅与男性发生性行为的男男性行为者（MSMO）在性行为上的差异。
本分析的数据来自2011年和2014年参与全国艾滋病行为监测的男男性行为者。我们使用合并年份来评估MSMW和MSMO之间的人口统计学和行为差异。使用对数链接泊松回归模型，计算行为结果的调整患病率比值（aPR）。
总体而言，2042名（11.9%）参与者被归类为MSMW。与MSMO相比，MSMW与男性伴侣发生无保护性行为的可能性较小[aPR 0.77；95%置信区间（CI）：0.74至0.81]，且被诊断患有另一种性传播疾病的可能性较小（aPR 0.83；95%CI：0.72至0.95）。与MSMO相比，MSMW更有可能为性交易给钱或毒品（aPR 2.85；95%CI：2.52至3.24）或因性交易接受钱或毒品（aPR 2.64；95%CI：2.37至2.93），以及曾注射过毒品（aPR 2.05；95%CI：1.80至2.34）。在过去12个月中，MSMW的性伴侣总数更多（中位数6，四分位间距：4 - 11对3，2 - 8）、临时性伴侣更多（5，2 - 10对3，1 - 7）以及无保护性行为伴侣更多（2，1 - 4对1，0 - 2）（所有比较P < 0.01）。
MSMW与MSMO有不同的性风险行为，可能会导致女性中的艾滋病病毒传播。MSMW可能会从针对性的干预措施中受益，以减少艾滋病病毒风险行为。
