Guigayoma John, Chen Yea-Hung, Snowden Jonathan M, Santos Glenn-Milo, Hecht Jennifer, Raymond H Fisher
*School of Public Health, University of California, Berkeley, Berkeley, CA; †San Francisco Department of Public Health, San Francisco, CA; ‡Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR; §School of Public Health, Oregon Health & Science University, Portland State University, Portland, OR; ‖Community Health Systems, University of California, San Francisco, CA; and ¶San Francisco AIDS Foundation, San Francisco, CA.
J Acquir Immune Defic Syndr. 2017 Jul 1;75 Suppl 3:S309-S315. doi: 10.1097/QAI.0000000000001405.
Self-perceived viral suppression status among men who have sex with men (MSM) may impact HIV risk transmission behaviors.
We conducted a 2014 cross-sectional survey of MSM in San Francisco and assessed differences in sexual risk behavior among known HIV-positive MSM based on viral suppression of HIV. We collected demographics, self-perceived viral load status, and sexual risk behavior and tested for viral load levels through laboratory assays. Men were categorized in a hierarchical schema of sexual risk behavior categories based on responses to questions regarding recent partners' HIV status, condom use, and sexual positioning. We used Fisher exact tests to assess for differences based on self-perceived viral load status.
Out of a sample of 96 known HIV-positive men, 59 men self-reported an undetectable HIV viral load and 9 men self-reported a detectable viral load consented to confirmatory laboratory testing. The sample of self-reported undetectable men had gradually larger proportions of higher-risk sexual practices, whereas the sample of detectable men was evenly distributed across sexual practices. This association was not statistically significant (P = 0.91).
Self-perceived viral suppression may influence sexual practices of known HIV-positive MSM, but small sample size, especially within the detectable category, hinders our ability to determine statistical significance. More research is necessary to assess how HIV-positive men account for viral load in sexual decision-making practices, and this research may inform resource allocation and clinical recommendations to maintain the health of MSM populations.
男男性行为者（MSM）自我感知的病毒抑制状态可能会影响艾滋病毒风险传播行为。
我们于2014年对旧金山的男男性行为者进行了一项横断面调查，并根据艾滋病毒的病毒抑制情况评估了已知艾滋病毒呈阳性的男男性行为者在性风险行为方面的差异。我们收集了人口统计学信息、自我感知的病毒载量状态和性风险行为，并通过实验室检测来测定病毒载量水平。根据对有关近期性伴侣的艾滋病毒状态、避孕套使用情况和性行为体位问题的回答，将男性分为不同层次的性风险行为类别。我们使用Fisher精确检验来评估基于自我感知的病毒载量状态的差异。
在96名已知艾滋病毒呈阳性的男性样本中，59名男性自我报告艾滋病毒病毒载量检测不到，9名自我报告病毒载量可检测到的男性同意进行验证性实验室检测。自我报告检测不到的男性样本中，高风险性行为的比例逐渐增大，而可检测到的男性样本在性行为方面分布较为均匀。这种关联无统计学意义（P = 0.91）。
自我感知的病毒抑制可能会影响已知艾滋病毒呈阳性的男男性行为者的性行为，但样本量较小，尤其是在可检测到病毒载量的类别中，这阻碍了我们确定统计学意义的能力。需要更多研究来评估艾滋病毒呈阳性的男性在性决策行为中如何考虑病毒载量，这项研究可能为资源分配和临床建议提供参考，以维护男男性行为人群的健康。
