Logie Carmen H, Kenny Kathleen S, Lacombe-Duncan Ashley, Wang Ying, Levermore Kandasi, Jones Nicolette, Ellis Tyrone, Marshall Annecka
Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Canada. M5S 1V4.
Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, North Carolina, 27599, USA.
Sex Health. 2018 Jul;15(4):325-334. doi: 10.1071/SH17186.
Background Men who have sex with men (MSM) are at elevated risk for sexually transmissible infection (STI) acquisition globally. Yet, limited research has explored STI testing practices among MSM in contexts where same-sex practices are criminalised, such as in Jamaica.
A cross-sectional, tablet-based survey with MSM in Kingston, Ocho Rios and Montego Bay, Jamaica, was conducted. Multivariable logistic regression analyses were conducted to determine the adjusted risk ratio for lifetime STI testing and lifetime STI diagnosis. Multinomial logistic regression analyses were conducted to determine the relative odds of having had an STI test 3-5 months ago and 6-12 months ago in comparison with <3 months ago.
Three-quarters (74.8%) of the 556 participants reported receiving an STI test (44% <3 months ago; 32% 3-5 months ago; 13% 6-12 months ago; 10% >12 months ago); 12.1% reported ever receiving an STI diagnosis. In adjusted multivariable analyses, STI testing was associated with sociodemographic (education, location), individual (depression, perceived risk), social (relationship status, sexual stigma) and structural (healthcare provider access) factors. In multinomial analysis, reporting a less recent STI test (>3 months ago) versus <3 months ago was associated with increased likelihood of sexual stigma and food insecurity. Lifetime STI diagnosis was associated with sociodemographic (location), individual (HIV infection) and social (lower social support) factors.
Findings document associations between structural factors and delayed timing of STI testing. Further research is necessary to explore how to address social ecological factors in sexual health interventions with MSM in Jamaica.
背景 在全球范围内，男男性行为者（MSM）感染性传播感染（STI）的风险较高。然而，在同性行为被定罪的背景下，如牙买加，对男男性行为者的性传播感染检测行为的研究有限。
在牙买加金斯敦、奥乔里奥斯和蒙特哥贝对男男性行为者进行了一项基于平板电脑的横断面调查。进行多变量逻辑回归分析以确定终身性传播感染检测和终身性传播感染诊断的调整风险比。进行多项逻辑回归分析以确定与3个月内相比，在3 - 5个月前和6 - 12个月前进行性传播感染检测的相对几率。
556名参与者中有四分之三（74.8%）报告接受过性传播感染检测（44%在3个月内；32%在3 - 5个月前；13%在6 - 12个月前；10%在12个月前以上）；12.1%报告曾被诊断为性传播感染。在调整后的多变量分析中，性传播感染检测与社会人口统计学（教育程度、地点）、个人（抑郁、感知风险）、社会（关系状况、性耻辱）和结构（获得医疗服务提供者）因素有关。在多项分析中，报告最近（3个月以上）而非3个月内进行性传播感染检测与性耻辱和粮食不安全的可能性增加有关。终身性传播感染诊断与社会人口统计学（地点）、个人（艾滋病毒感染）和社会（社会支持较低）因素有关。
研究结果记录了结构因素与性传播感染检测延迟时间之间的关联。有必要进一步研究如何在牙买加针对男男性行为者的性健康干预中解决社会生态因素。
