Hakim Avi, Patnaik Padmaja, Telly Nouhoum, Ballo Tako, Traore Bouyagui, Doumbia Seydou, Lahuerta Maria
From the *Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention (CDC), Atlanta, GA; †ICAP at Columbia University, Mailman School of Public Health, New York, NY; ‡International Center of Excellence in Research (ICER-Mali), Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako (USTTB); §Cellule Sectorielle de Lutte contre le Sida, Ministère de la Santé, Bamako, Mali; and ∥Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
Sex Transm Dis. 2017 Sep;44(9):565-570. doi: 10.1097/OLQ.0000000000000655.
Concurrent male-male sexual partnerships have been understudied in sub-Saharan Africa and are especially important because human immunodeficiency virus (HIV) prevalence and acquisition probability are higher among men who have sex with men (MSM) than among heterosexual men and women.
We conducted a respondent-driven sampling survey of 552 men who have sex with men in Bamako, Mali from October 2014 to February 2015. Eligibility criteria included 18 years or older, history of oral or anal sex with another man in the last 6 months, residence in or around Bamako in the last 6 months, ability to communicate in French.
HIV prevalence was 13.7%, with 86.7% of MSM with HIV unaware of their infection. Concurrent male-male sexual partnerships were common, with 60.6% of MSM having a concurrent male sexual partnerships or believing their sex partner did in the last 6 months, and 27.3% having a concurrent male sexual partnerships and believing their sex partner did in the last 6 months. Over half (52.5%) of MSM had sex with women, and 30.8% had concurrent male partnerships and sex with a woman in the last 6 months. Concurrency was more likely among MSM with limited education, telling only MSM of same-sex behaviors, high social cohesion, and not knowing anyone with HIV.
The high proportion of HIV-infected MSM in Bamako who are unaware of their HIV infection and the high prevalence of concurrent partnerships could further the spread of HIV in Bamako. Increasing testing through peer educators conducting mobile testing could improve awareness of HIV status and limit the spread of HIV in concurrent partnerships.
在撒哈拉以南非洲地区，男男性行为伴侣关系一直未得到充分研究，而这一关系尤为重要，因为男男性行为者（MSM）感染人类免疫缺陷病毒（HIV）的患病率和感染概率高于异性恋男性和女性。
2014年10月至2015年2月，我们在马里巴马科对552名男男性行为者进行了一项应答驱动抽样调查。入选标准包括年龄在18岁及以上、在过去6个月内有与另一名男性进行口交或肛交的经历、在过去6个月内居住在巴马科或其周边地区、能够用法语交流。
HIV患病率为13.7%，86.7%感染HIV的男男性行为者不知道自己已感染。同时存在的男男性行为伴侣关系很常见，60.6%的男男性行为者在过去6个月内有同时存在的男性性伴侣或认为其性伴侣有，27.3%的人在过去6个月内有同时存在的男性性伴侣且认为其性伴侣有。超过一半（52.5%）的男男性行为者与女性发生过性行为，30.8%的人在过去6个月内有同时存在的男性伴侣且与女性发生过性行为。并发情况在受教育程度有限、只向男男性行为者透露同性性行为、社会凝聚力高且不认识任何HIV感染者的男男性行为者中更为常见。
巴马科大量感染HIV却不知自己感染状况的男男性行为者以及同时存在的伴侣关系的高患病率可能会促使HIV在巴马科进一步传播。通过同伴教育者进行移动检测来增加检测次数，可能会提高对HIV感染状况的知晓率，并限制HIV在同时存在的伴侣关系中的传播。
