South American Program in HIV Prevention Research, University of California Los Angeles David Geffen School of Medicine, 10833 Le Conte Avenue, CHS 37-121, Los Angeles, CA, 90095, USA.
University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.
BMC Public Health. 2021 Jun 7;21(1):1090. doi: 10.1186/s12889-021-11091-2.
BACKGROUND: Social networks, norms, and discussions about sexual health may inform sexual practices, influencing risk of human immunodeficiency virus (HIV) or sexually transmitted infection (STI) acquisition. To better understand social networks of Peruvian men who have sex with men (MSM) and transgender women (trans women), we examined key social network members (SNMs), participant perceptions of these network members' opinions toward sexual health behaviors, and associations between network member characteristics and condomless anal intercourse (CAI). METHODS: In a 2017 cross-sectional study, a convenience sample of 565 MSM and trans women with HIV-negative or unknown serostatus was asked to identify three close SNMs; describe discussions about HIV and STI prevention with each; and report perceived opinions of condom use, HIV/STI testing, and partner notification of STIs. Generalized estimating equations evaluated relationships between SNM characteristics, opinions, and discussions and participant-reported CAI. RESULTS: Among participants who identified as MSM, 42.3% of key SNMs were perceived to identify as gay. MSM "never" discussed HIV and STI prevention concerns with 42.4% of heterosexual SNMs, but discussed them "at least once weekly" with 16.9 and 16.6% of gay- and bisexual- identifying SNMs, respectively. Among participants who identified as trans women, 28.2% of key SNMs were perceived as heterosexual; 25.9%, as bisexual; 24.7%, as transgender; and 21.2%, as gay. Trans women discussed HIV/STI prevention least with cis-gender heterosexual network members (40.2% "never") and most with transgender network members (27.1% "at least once weekly"). Participants perceived most of their close social network to be completely in favor of condom use (71.2% MSM SNMs, 61.5% trans women SNMs) and HIV/STI testing (73.1% MSM SNMs, 75.6% trans women SNMs), but described less support for partner STI notification (33.4% MSM SNMs, 37.4% trans women SNMs). Most participants reported CAI with at least one of their past three sexual partners (77.5% MSM, 62.8% trans women). SNM characteristics were not significantly associated with participant-reported frequency of CAI. CONCLUSIONS: Findings compare social support, perceived social norms, and discussion patterns of Peruvian MSM and trans women, offering insight into social contexts and sexual behaviors. TRIAL REGISTRATION: The parent study from which this analysis was derived was registered at ClinicalTrials.gov (Identifier: NCT03010020 ) on January 4, 2017.
背景：社交网络、规范和关于性健康的讨论可能会影响性行为，从而影响人类免疫缺陷病毒（HIV）或性传播感染（STI）的感染风险。为了更好地了解秘鲁男男性行为者（MSM）和跨性别女性（跨性别女性）的社交网络，我们检查了关键社交网络成员（SNM）、参与者对这些网络成员对性健康行为的看法，以及网络成员特征与无保护肛交（CAI）之间的关联。
方法：在 2017 年的一项横断面研究中，对 565 名 HIV 阴性或未知血清状况的 MSM 和跨性别女性进行了便利抽样，要求他们确定三个亲密的 SNM；描述与每个人讨论 HIV 和 STI 预防问题；并报告对 condom 使用、HIV/STI 检测和性传播感染伴侣通知的看法。广义估计方程评估了 SNM 特征、意见和讨论与参与者报告的 CAI 之间的关系。
结果：在确定为 MSM 的参与者中，42.3%的关键 SNM 被认为是同性恋者。MSM“从不”与 42.4%的异性恋 SNM 讨论 HIV 和 STI 预防问题，但分别与 16.9%和 16.6%的同性恋和双性恋 SNM 讨论 HIV 和 STI 预防问题。在确定为跨性别女性的参与者中，28.2%的关键 SNM 被认为是异性恋；25.9%，双性恋；24.7%，跨性别；和 21.2%，同性恋。跨性别女性与顺性别异性恋网络成员讨论 HIV/STI 预防问题最少（40.2%“从不”），与跨性别网络成员讨论最多（27.1%“至少每周一次”）。参与者认为他们的大部分亲密社交网络完全支持 condom 使用（71.2%的 MSM SNM，61.5%的跨性别女性 SNM）和 HIV/STI 检测（73.1%的 MSM SNM，75.6%的跨性别女性 SNM），但对伴侣 STI 通知的支持较少（33.4%的 MSM SNM，37.4%的跨性别女性 SNM）。大多数参与者报告称，他们在过去三个性伴侣中至少有一个人发生过 CAI（77.5%的 MSM，62.8%的跨性别女性）。SNM 特征与参与者报告的 CAI 频率无显著相关性。
结论：这些发现比较了秘鲁 MSM 和跨性别女性的社会支持、感知社会规范和讨论模式，为了解社会背景和性行为提供了线索。
试验注册：本分析所源自的母体研究于 2017 年 1 月 4 日在 ClinicalTrials.gov（标识符：NCT03010020）注册。
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