University of California, San Francisco, CA; and.
San Francisco Department of Public Health, San Francisco, CA.
J Acquir Immune Defic Syndr. 2021 Jul 1;87(3):e222-e228. doi: 10.1097/QAI.0000000000002659.
Beliefs regarding responsibility for preventing HIV transmission may differ between individuals and their sexual partners. We assessed HIV prevention responsibility beliefs among men who have sex with men (MSM) participating in the 2017 National HIV Behavioral Surveillance survey.
MSM were recruited using time-location sampling at clubs, bars, and street locations in San Francisco. HIV prevention responsibility beliefs were assessed on a four-point scale (1 = strongly disagree to 4 = strongly agree). Associations were assessed using generalizing estimating equations to adjust for behaviors within multiple partnerships.
A total of 316 HIV-negative men and 76 HIV-positive men reported on 1336 partnerships. HIV-negative compared with HIV-positive men had higher endorsement of mutual responsibility (mean 3.7 vs. 3.5; P < 0.01). Both groups had similar levels of endorsing responsibility on the HIV-negative or HIV-positive partner. HIV-positive men endorsing equal responsibility were more likely to know their partner's HIV status (P < 0.01) and less likely to have serodiscordant condomless anal intercourse (CAI) (P < 0.01) than men who did not endorse equal responsibility. HIV-negative men in partnerships with pre-exposure prophylaxis (PrEP) use were more likely to know their partner's HIV status (P = 0.02) and have serodiscordant CAI (P = 0.04) than men not in partnerships with PrEP use.
HIV-negative and HIV-positive men accept responsibility for preventing HIV. The finding that HIV-negative men in partnerships with PrEP use who engage in serodiscordant CAI is concerning because they are still at risk for other sexually transmitted infections, which are presently at elevated levels in San Francisco and other US cities.
对于预防 HIV 传播的责任，个体及其性伴侣之间的看法可能存在差异。我们评估了参加 2017 年国家 HIV 行为监测调查的男男性行为者（MSM）的 HIV 预防责任信念。
MSM 通过在旧金山的俱乐部、酒吧和街头地点采用时间定位抽样方法招募。使用四点量表（1 = 强烈不同意到 4 = 强烈同意）评估 HIV 预防责任信念。使用广义估计方程评估关联，以调整多个伴侣关系中的行为。
共有 316 名 HIV 阴性男性和 76 名 HIV 阳性男性报告了 1336 个伴侣关系。与 HIV 阳性男性相比，HIV 阴性男性更倾向于认同共同责任（平均 3.7 比 3.5；P < 0.01）。两组对 HIV 阴性或 HIV 阳性伴侣的责任认同水平相似。认同平等责任的 HIV 阳性男性更有可能了解其伴侣的 HIV 状况（P < 0.01），且更不可能发生 HIV 不一致的无保护肛交（CAI）（P < 0.01），而不认同平等责任的男性则不然。在有暴露前预防（PrEP）使用的伴侣关系中的 HIV 阴性男性更有可能了解其伴侣的 HIV 状况（P = 0.02），且更有可能发生 HIV 不一致的 CAI（P = 0.04），而不在有 PrEP 使用的伴侣关系中的男性则不然。
HIV 阴性和 HIV 阳性男性都对预防 HIV 承担责任。有 PrEP 使用的 HIV 阴性男性在发生 HIV 不一致的 CAI 的情况下仍存在感染其他性传播感染的风险，这令人担忧，因为目前旧金山和其他美国城市的这些感染的发病率都处于较高水平。
