College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA.
Sex Transm Infect. 2018 Nov;94(7):483-486. doi: 10.1136/sextrans-2017-053153. Epub 2017 Oct 24.
HIV continues to be a global and national public health challenge, and men who have sex with men (MSM) are disproportionately affected in the USA. Transmission of HIV is intentional if the person living with HIV knows about his/her serostatus, acts with the intention to and actually transmits HIV. Research on intentional transmission of HIV infections is lacking, and the relationships between perceived intentional transmission, viral suppression and psychosocial outcomes have not been assessed. The objective of this study was to investigate the association between perceived intentional transmission of HIV, sustained viral suppression and psychosocial outcomes.
Data were obtained from 338 MSM living with HIV who participated in a disclosure intervention study. Logistic and linear regression models were used to assess the associations between perceived intentional transmission and viral suppression, condomless anal intercourse in the past 30 days, being at risk for clinical depression, substance use, self-efficacies for condom use, HIV disclosure and negotiation of safer sex practices, and sexual compulsivity.
44% of the study population reported perceiving intentional HIV transmission. After adjusting for sociodemographic characteristics, men who thought that they were infected intentionally had 69% higher odds (adjusted OR: 1.69; 95% CI 1.01 to 2.83) of being at risk for clinical depression, and on average, scored approximately 3 points and 4 points higher on depressive symptoms and sexual compulsivity, respectively (adjusted β: 3.29; 95% CI 0.42 to 6.15; adjusted β: 3.74; 95% CI 1.32 to 6.17) compared with men who did not think that they were intentionally infected. After adjusting for confounders, there was no statistically significant association between perceived intentional transmission and viral suppression.
Intervention programmes for MSM living with HIV who thought they were infected intentionally are warranted and should aim to attenuate depressive symptoms and sexual compulsivity.
艾滋病毒仍然是一个全球性和全国性的公共卫生挑战，在美国，男男性行为者（MSM）受到的影响不成比例。如果艾滋病毒感染者了解其血清状况，有意为之并实际传播艾滋病毒，则艾滋病毒的传播是故意的。关于艾滋病毒感染的故意传播的研究很少，而且尚未评估感知的故意传播、病毒抑制与心理社会结果之间的关系。本研究的目的是调查感知的艾滋病毒故意传播、持续病毒抑制与心理社会结果之间的关联。
数据来自 338 名参与披露干预研究的艾滋病毒感染者的 MSM。使用逻辑和线性回归模型评估感知的故意传播与病毒抑制、过去 30 天无保护肛交、临床抑郁风险、物质使用、避孕套使用自我效能、艾滋病毒披露和协商安全性行为以及性强迫之间的关联。
研究人群中有 44%的人报告称感知到故意的艾滋病毒传播。在调整了社会人口统计学特征后，认为自己感染是故意的男性感染临床抑郁的风险增加了 69%（调整后的 OR：1.69；95%CI 1.01 至 2.83），且平均而言，抑郁症状和性强迫分别增加了约 3 分和 4 分（调整后的 β：3.29；95%CI 0.42 至 6.15；调整后的 β：3.74；95%CI 1.32 至 6.17）与不认为自己是故意感染的男性相比。在调整了混杂因素后，感知的故意传播与病毒抑制之间没有统计学上的显著关联。
需要为认为自己被故意感染的艾滋病毒感染者的 MSM 实施干预计划，以减轻抑郁症状和性强迫。
