Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
Department of Communicable Disease Control and Health Protection, Unit for Sexual Health and HIV Prevention, Public Health Agency of Sweden, Solna, Sweden.
BMJ Open. 2019 Jun 14;9(6):e024459. doi: 10.1136/bmjopen-2018-024459.
The purpose of this study was to explore the perceptions and experiences of sex among Swedish Men who have Sex with Men (MSM) in Berlin.
MSM are disproportionally affected by HIV.Berlin is also a key destination when looking into where Swedish MSM sero-convert, while travelling.
A qualitative study with semi-structured interviews using open-ended questions with participants recruited through network sampling. Data were analysed with content analysis.
15 Swedish cis-men (as in non-transgender) who have sex with men aged 25-44 years, who travelled to or were living in Berlin. To be included in the study, the participants had to be cis-MSM, Swedish citizens, spending time in Berlin and having sex in both settings.
For a majority of the participants, sex was the main reason for going to Berlin but cultural aspects like art and the techno scene were also important. Berlin was perceived as a sex-oriented city providing venues where respondents did not have to care about reputation and status and where social and sexual spaces co-existed side by side. This in sharp contrast to Sweden, which represented a limiting environment both in culture and what was available culturally and sexually.
The men interviewed experienced multiple partners and had a broad sexual repertoire both abroad and at home. However, the behaviour was amplified in Berlin. The men did not alter their safer sex practice depending on if they had sex in Sweden or Berlin. The high mobility and vulnerability for HIV/sexually transmitted infection (STI) among these men highlights the need of increased access to antiretroviral treatment, pre-exposure prophylaxis for HIV and low-threshold HIV/STI testing services in Europe.
本研究旨在探讨瑞典男男性行为者（MSM）在柏林的性行为观念和体验。
MSM 受到 HIV 的不成比例影响。柏林也是研究瑞典 MSM 在旅行时血清转换的关键目的地之一。
这是一项采用网络抽样招募参与者的半结构式访谈的定性研究，使用开放式问题。采用内容分析法分析数据。
15 名年龄在 25-44 岁之间、有男男性行为、曾前往或居住在柏林的瑞典顺性别男性。参与者必须是顺性别 MSM、瑞典公民、在柏林度过时间并在两个地方发生性行为，才能被纳入研究。
对于大多数参与者来说，性是去柏林的主要原因，但文化方面，如艺术和电子音乐场景也很重要。柏林被视为一个以性为导向的城市，提供了场所，让受访者不必在意声誉和地位，社会和性空间可以并存。这与瑞典形成鲜明对比，瑞典在文化和性方面都代表了一个限制环境。
接受采访的男性体验了多个性伴侣，无论是在国外还是在国内，都有广泛的性行为。然而，这种行为在柏林更为放大。这些男性在瑞典或柏林发生性行为时，并没有改变他们的安全性行为做法。这些男性的高度流动性和感染艾滋病毒/性传播感染（STI）的脆弱性突显了需要在欧洲增加获得抗逆转录病毒治疗、艾滋病毒暴露前预防和低门槛艾滋病毒/性传播感染检测服务的机会。
