Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON, M5S 2S1, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
AIDS Behav. 2018 Sep;22(9):2797-2806. doi: 10.1007/s10461-018-2117-2.
This investigation sought to identify HIV-risk and -protective factors among men-who-have-sex-with-men (MSM) who engaged in anal sex following alcohol or substance use during an international Pride Festival. MSM attending World Pride were surveyed regarding (1) alcohol, substance use, and sex during the past 24 h; and (2) HIV-risk and -protective factors. Valid data were provided by 1123 MSM. Anal sex was reported by 195 MSM, among whom the majority (n = 105) consumed alcohol or substances prior to sex. Among MSM aware of their HIV status who consumed alcohol or substances prior to sex (n = 99), those who engaged in serodiscordant condomless anal sex (n = 22) were more likely to be HIV+ (AOR = 10.14, 95% CI 1.48-69.35); report multiple sex partners (AOR = 9.05, 95% CI 1.70-48.12); and possess lower condom efficacy (AOR = 0.47, 95% CI 0.23-0.93) and social support (AOR = 0.08, 95% CI 0.01-0.46). Bolstering condom negotiation skills and social support could potentially reduce HIV acquisition/transmission-risk behavior, even when under the influence of alcohol or substances.
本研究旨在确定在国际骄傲节期间，男性与男性发生性行为（MSM）者在饮酒或使用药物后进行肛交时的艾滋病毒风险和保护因素。参加世界骄傲节的 MSM 被调查了以下两个方面：（1）过去 24 小时内的饮酒、物质使用和性行为；（2）艾滋病毒风险和保护因素。1123 名 MSM 提供了有效数据。195 名 MSM 报告了肛交行为，其中大多数（n=105）在性行为前饮酒或使用药物。在知晓自己 HIV 状况并在性行为前饮酒或使用药物的 MSM 中（n=99），那些进行血清不一致的无保护肛交的人更有可能 HIV 阳性（AOR=10.14，95%CI 1.48-69.35）；报告有多个性伴侣（AOR=9.05，95%CI 1.70-48.12）；拥有较低的 condom 有效性（AOR=0.47，95%CI 0.23-0.93）和社会支持（AOR=0.08，95%CI 0.01-0.46）。即使在饮酒或使用药物的情况下，增强 condom 谈判技巧和社会支持也可能降低 HIV 感染/传播风险行为。
