Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA.
College of Medicine, Charles Drew University, Los Angeles, CA, USA.
Arch Sex Behav. 2018 Jan;47(1):183-194. doi: 10.1007/s10508-017-1052-z. Epub 2017 Nov 9.
Black men who have sex with men and women (BMSMW) are at increased HIV risk, but few efficacious interventions meet their unique needs. Three HIV prevention interventions were evaluated with a common protocol. Baseline data were pooled to describe sexual behavior involving transmission risk with male, female, and male-to-female transgender partners and identify factors associated with transmission risk. BMSMW from Los Angeles, Philadelphia, and Chicago who reported sexual risk and bisexual behavior in the past year were recruited via modified chain referral sampling and community recruitment. Baseline assessments were conducted via audio computer-assisted interview and sexual behaviors assessed over the past 3 months. From December 2010 to November 2012, 584 BMSMW were enrolled across the three cities. More than half (55%) were recruited by other participants. Overall, the mean age was 43 years. Seventy-five percent reported an annual income <$10,000 and selling sex was prevalent (31%). Three-quarters identified as bisexual. Thirty-nine percent were HIV-positive. Among HIV-positive participants, 46% reported sex without condoms with HIV-negative or unknown male partners and 45% with HIV-negative or unknown female partners. Overall, factors associated with sex without condoms included network size, education, income, sexual orientation identification, HIV status, exchange sex, homonegativity, and social support. Findings support the need for enhanced HIV prevention efforts for this population. Future studies should examine contextual factors in addition to individual risk behaviors to inform the development and implementation of promising strategies to prevent HIV and promote the overall health and wellness of BMSMW and their sexual partners.
与男性和女性发生性关系的男男性行为者(BMSMW)感染 HIV 的风险增加,但很少有有效的干预措施能满足他们的特殊需求。本研究采用相同的方案评估了三种 HIV 预防干预措施。通过汇集基线数据来描述涉及男性、女性和跨性别女性性伴侣的具有传播风险的性行为,并确定与传播风险相关的因素。通过改良的连锁转诊抽样和社区招募,从洛杉矶、费城和芝加哥招募了过去一年报告有性风险和双性恋行为的男男性行为者。通过音频计算机辅助访谈进行基线评估,并评估过去 3 个月的性行为。2010 年 12 月至 2012 年 11 月,三个城市共招募了 584 名 BMSMW。超过一半(55%)是由其他参与者招募的。总体而言,参与者的平均年龄为 43 岁。75%报告年收入<10000 美元,性交易普遍存在(31%)。三分之二的人认为自己是双性恋。39%的人 HIV 呈阳性。在 HIV 阳性参与者中,46%报告与 HIV 阴性或未知男性伴侣无保护措施发生性行为,45%与 HIV 阴性或未知女性伴侣无保护措施发生性行为。总体而言,与无保护措施性行为相关的因素包括网络规模、教育、收入、性取向认同、HIV 状况、性交易、对同性恋的反感和社会支持。研究结果支持为该人群加强 HIV 预防工作。未来的研究应该除了个体风险行为外,还应该研究情境因素,为制定和实施预防 HIV 以及促进 BMSMW 及其性伴侣的整体健康和幸福的有前途的策略提供信息。