2014 年，在纽约市接受伙伴服务的新诊断 HIV 阳性男男性行为者中，与已知 HIV 阳性伴侣发生不一致使用 condom 的情况。

Inconsistent condom use with known HIV-positive partners among newly diagnosed HIV-positive men who have sex with men interviewed for partner services in New York City, 2014.

机构信息

Field Services Unit, New York City Department of Health and Mental Hygiene, Long Island City, New York, USA

Field Services Unit, New York City Department of Health and Mental Hygiene, Long Island City, New York, USA.

出版信息

Sex Transm Infect. 2019 Mar;95(2):108-114. doi: 10.1136/sextrans-2017-053479. Epub 2018 Nov 8.

DOI:10.1136/sextrans-2017-053479

PMID:30409918

Abstract

OBJECTIVES

Condomless anal intercourse contributes significantly to the spread of HIV among men who have sex with men (MSM). Factors related to condomless anal intercourse with known HIV-positive partners among MSM are not well understood. The authors describe factors associated with inconsistent condom use with known HIV-positive partners prior to participants' diagnosis with HIV.

METHODS

New York City health department disease intervention specialists interviewed newly HIV-diagnosed MSM ages ≥13 years reporting knowingly having anal sex with HIV-positive partners between June 2013 and October 2014. Univariate and bivariate statistics were calculated, in addition to logistic regression analysis.

RESULTS

Among 95 MSM interviewed, 56% were >30 years and 74% had higher than a high school education. Respondents reported a median of 2 known HIV-positive sex partners. Drug or alcohol use during last sex with their last known HIV-positive partner was reported by 53% of participants. Sixty-five per cent of participants reported inconsistent condom use with last known HIV-positive partner. Inconsistent condom use with all HIV-positive partners was higher among individuals reporting two or more known HIV-positive partners since sexual debut than among those with one (90% vs 59%, p<0.01) and among those reporting feelings of love/emotional attachment as a reason for having sex (85% vs 63%, p=0.02). In the bivariate logistic regression models for inconsistent condom use, feelings of love or emotional attachment were the only significant predictor of inconsistent condom use (OR 3.43, 95% CI 1.23 to 9.58). After adjusting for confounding, the relationship feelings of love or emotional attachment continued to be the only significant predictor of inconsistent condom use (OR 3.69, 95% CI 1.06 to 12.82).

CONCLUSIONS

Surveyed MSM engaged in high-risk behaviours, including condomless anal sex and drug or alcohol use during sex with persons known to be HIV-positive. These findings can inform interventions with MSM in serodiscordant partnerships.

摘要

目的

无保护肛交在男男性行为者（MSM）中 HIV 的传播中起着重要作用。与 MSM 与已知 HIV 阳性伴侣发生无保护肛交相关的因素尚未得到很好的理解。作者描述了参与者 HIV 诊断前与已知 HIV 阳性伴侣发生不一致 condom 性行为的相关因素。

方法

纽约市卫生部门疾病干预专家对 2013 年 6 月至 2014 年 10 月期间报告与 HIV 阳性伴侣有过知情肛交的新诊断 HIV 的 MSM 进行了采访。除了逻辑回归分析外，还计算了单变量和双变量统计数据。

结果

在接受采访的 95 名 MSM 中，56%年龄大于 30 岁，74%受过高等教育。受访者报告了中位数为 2 名已知的 HIV 阳性性伴侣。53%的参与者报告称，在上一次与最后一名已知 HIV 阳性伴侣发生性关系时，他们使用了药物或酒精。65%的参与者报告称，在上一次与最后一名已知 HIV 阳性伴侣发生性关系时，没有使用 condom。与性开始以来报告有两个或更多已知 HIV 阳性伴侣的个体相比，与仅有一个伴侣的个体相比，报告与 HIV 阳性伴侣发生性行为的原因是感觉爱/情感依恋的个体（90%与 59%，p<0.01）以及报告与 HIV 阳性伴侣发生性行为的原因是感觉爱/情感依恋的个体（85%与 63%，p=0.02）不一致 condom 使用率更高。在不一致 condom 使用的双变量逻辑回归模型中，感觉爱或情感依恋是不一致 condom 使用的唯一显著预测因素（OR 3.43，95%CI 1.23 至 9.58）。在调整混杂因素后，感觉爱或情感依恋的关系仍然是不一致 condom 使用的唯一显著预测因素（OR 3.69，95%CI 1.06 至 12.82）。