Department of Systems, Population and Leadership, School of Nursing, University of Michigan, Ann Arbor, USA.
Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, USA.
AIDS Behav. 2021 Jul;25(7):1993-2004. doi: 10.1007/s10461-020-03129-0. Epub 2021 Jan 3.
There is strong evidence that gay, bisexual and other men who have sex with men (GBMSM) in African countries experience high prevalence of HIV. However, missing from the literature is an understanding of the HIV risk behaviors and prevention needs of partnered GBMSM in African countries. The Together Tomorrow project sampled 440 partnered GBMSM (220 couples) in South Africa and Namibia. Prevalence of HIV was high at 42%, with 33% of men in sero-discordant relationships. Despite high levels of HIV testing in the past 6 months (65%), condom use with main and outside sex partners was low. Men reported low levels of willingness to use pre-exposure prophylaxis (PrEP) (16%). HIV testing in the past 12 months and willingness to use PrEP were significantly associated with recent binge drinking and substance use. Men in sero-discordant relationships, those with sexual agreements and those who had experienced any form of IPV were all less likely to report that they had recently tested for HIV. There is a need to develop interventions that meet the unique needs of African partnered GBMSM and tackle stigma and discrimination as drivers of HIV risk in these settings.
有强有力的证据表明，非洲国家的男同性恋、双性恋和其他与男性发生性关系的男性（GBMSM）中，艾滋病毒感染率很高。然而，文献中缺少对非洲国家中已婚 GBMSM 的艾滋病毒风险行为和预防需求的了解。“携手明天”项目在南非和纳米比亚对 440 对已婚 GBMSM（220 对夫妇）进行了抽样调查。艾滋病毒感染率很高，达到 42%，33%的男性处于血清不一致的关系中。尽管过去 6 个月中有 65%的人进行了艾滋病毒检测，但与主要和外部性伴侣使用安全套的比例较低。男性报告说，他们使用暴露前预防（PrEP）的意愿较低（16%）。过去 12 个月中的 HIV 检测和使用 PrEP 的意愿与最近的狂欢饮酒和药物使用显著相关。处于血清不一致关系中的男性、有性行为协议的男性以及经历过任何形式的 IPV 的男性，都不太可能报告他们最近进行了 HIV 检测。有必要制定干预措施，满足非洲已婚 GBMSM 的独特需求，并解决这些环境中艾滋病毒风险的污名化和歧视问题。
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