From the College of Behavioral and Community Sciences, University of South Florida, Tampa, FL.
Sex Transm Dis. 2017 Dec;44(12):732-738. doi: 10.1097/OLQ.0000000000000680.
Reducing the risk of HIV transmission among men who have sex with men (MSM) is a national health priority. This study longitudinally examined changes in and the link between HIV-related communication, unprotected anal intercourse (UAI), and relationship status among MSM.
Data were obtained from 337 MSM living with HIV who participated in a randomized controlled study. Approximately equal percentages of men were randomized to either the disclosure intervention group or the attention control case management group. Repeated measures were collected at 5 time points for 12 months and included health-protective sexual communication (HPSC), HIV disclosure, insertive and receptive UAI, and relationship status. Data were analyzed using mixed-effects models.
Independent of the treatment condition, HPSC and HIV disclosure increased over time; insertive UAI showed a curvilinear pattern but no significant decrease over time. Relationship status was related to HIV-related communication and UAI. Greater HPSC was related to less insertive and receptive UAI; disclosure was positively related to insertive UAI.
Based on the findings, prevention programs should continue to focus on improving HIV-related communication among MSM and consider relationship status in prevention messages. Intervention studies are needed to continue to identify and test factors that help reduce risky sexual behaviors.
降低男男性行为者（MSM）中 HIV 传播的风险是国家卫生重点。本研究对 MSM 中与 HIV 相关的沟通、无保护肛交（UAI）和关系状况的变化及其关联进行了纵向研究。
本研究的数据来自于 337 名 HIV 阳性的 MSM 参与者，他们参与了一项随机对照研究。大约相等比例的男性被随机分配到披露干预组或注意控制病例管理组。在 12 个月的 5 个时间点进行了重复测量，包括健康保护性行为沟通（HPSC）、HIV 披露、插入性和接受性 UAI 以及关系状况。使用混合效应模型进行数据分析。
独立于治疗条件，HPSC 和 HIV 披露随时间增加；插入性 UAI 呈曲线模式，但随时间无显著下降。关系状况与 HIV 相关沟通和 UAI 有关。更多的 HPSC 与插入性和接受性 UAI 减少有关；披露与插入性 UAI 呈正相关。
基于这些发现，预防计划应继续关注提高 MSM 之间与 HIV 相关的沟通，并在预防信息中考虑关系状况。需要进行干预研究，以继续确定和测试有助于减少危险性行为的因素。
