Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
PLoS One. 2019 Apr 24;14(4):e0215455. doi: 10.1371/journal.pone.0215455. eCollection 2019.
Black men who have sex with men, who account for less than 1% of the U.S. population, account for approximately 25% of new HIV infections annually. Condomless anal sex contributes to HIV infection among black men who have sex with men. The capacity to recover quickly from difficulties (resilience) may be protective against condomless anal sex, but has been understudied among black men who have sex with men. Psychosocial factors related to resilience, i.e., condom use self-efficacy and internalized homophobia, may also affect condomless anal sex. We assessed the association between resilience, condom use self-efficacy, internalized homophobia and condomless anal sex among black men who have sex with men.
Data are from a 2010-2011 study examining condomless anal sex (past 60 days) among black men who have sex with men in New York City. Validated scales assessed resilience (theoretical range = 0-100), condom use self-efficacy (theoretical range = 27-135), and internalized homophobia (theoretical range = 9-36). We described continuous variables using median and interquartile range (IQR). Univariable and multivariable Poisson regression models assuming a robust variance estimator were used to compute unadjusted and adjusted prevalence ratios, respectively, and their corresponding 95% confidence intervals (CI). Adjusted prevalence ratios (aPR) examined the association of resilience, condom use self-efficacy, and internalized homophobia with condomless anal sex, while controlling for potential confounders (e.g., having >1 sex partner).
The median resilience score within our sample (N = 228) was 75 (IQR = 66-83). Many black men who have sex with men reported condomless anal sex (55.7%) and >1 sex partner (58.8%). Decreased condomless anal sex was associated with increased levels of condom use self-efficacy (aPR: 0.94 per 10-point increase in condom use self-efficacy score; CI: 0.90-0.97; p-value: 0.001). Condomless anal sex was not associated with resilience or internalized homophobia.
Within this sample of black men who have sex with men, condomless anal sex was prevalent. Greater resilience was not protective against condomless anal sex. Interventions that support condom use are warranted for black men who have sex with men.
在美国人口中占比不足 1%的男男性行为者，每年约占新 HIV 感染人数的 25%。无保护肛交性行为导致男男性行为者中的黑人感染 HIV。从困难中快速恢复的能力（韧性）可能对无保护肛交具有保护作用，但在男男性行为者中的黑人中研究较少。与韧性相关的社会心理因素，即 condom 使用自我效能感和内化的恐同，也可能影响无保护肛交行为。我们评估了韧性、 condom 使用自我效能感、内化的恐同与黑人男男性行为者之间无保护肛交的关系。
数据来自于 2010-2011 年对纽约市男男性行为者中无保护肛交（过去 60 天）的研究。经过验证的量表评估了韧性（理论范围为 0-100）、 condom 使用自我效能感（理论范围为 27-135）和内化的恐同（理论范围为 9-36）。我们使用中位数和四分位距（IQR）描述连续变量。单变量和多变量泊松回归模型假设稳健方差估计器，分别计算未调整和调整后的患病率比及其相应的 95%置信区间（CI）。调整后的患病率比（aPR）在控制潜在混杂因素（例如，有>1 个性伴侣）的情况下，检查了韧性、 condom 使用自我效能感和内化的恐同与无保护肛交的关系。
在我们的样本中（N = 228），中位数韧性得分 75（IQR = 66-83）。许多男男性行为者报告了无保护肛交（55.7%）和>1 个性伴侣（58.8%）。 condom 使用自我效能感的增加与无保护肛交的减少相关（aPR： condom 使用自我效能感得分每增加 10 分，比值比为 0.94；置信区间为 0.90-0.97；p 值：0.001）。韧性或内化的恐同与无保护肛交无关。
在这个黑人男男性行为者样本中，无保护肛交很普遍。更大的韧性并不能预防无保护肛交。需要为男男性行为者提供支持 condom 使用的干预措施。
