HIV 和性传播感染检测在物质使用的性少数和性别少数青少年和年轻人中：一项随机对照试验的基线调查。
HIV and Sexually Transmitted Infection Testing Among Substance-Using Sexual and Gender Minority Adolescents and Young Adults: Baseline Survey of a Randomized Controlled Trial.
机构信息
Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States.
Program for Sexuality, Technology, and Action Research, University of Pennsylvania, Philadelphia, PA, United States.
出版信息
JMIR Public Health Surveill. 2022 Jul 1;8(7):e30944. doi: 10.2196/30944.
BACKGROUND
Gay, bisexual, and other men who have sex with men and transgender individuals are more heavily affected by HIV and other sexually transmitted infections (STIs) than their cisgender, heterosexual peers. In addition, sexual and gender minorities who use substances are often at a further increased risk of HIV and other STIs. Increasing testing for HIV and other STIs allows this hardly reached population to receive early intervention, prevention, and education.
OBJECTIVE
We explored HIV and STI testing patterns among 414 sexual and gender minority adolescents and young adults aged 15 to 29 years who self-reported substance use and lived in southeastern Michigan.
METHODS
We analyzed data from the baseline survey of a 4-arm randomized controlled trial that aimed to examine the efficacy of a brief substance use intervention for creating gains in engagement in HIV prevention. We fit multinomial logistic regression models to 2 categorical HIV and STI testing variables (lifetime and previous 12 months) based on self-reports of testing (never, STIs only, HIV only, or both). In addition, we compared HIV and STI testing behaviors across demographic characteristics, structural factors, psychosocial barriers, substance use, and sexual behaviors.
RESULTS
Our findings showed that 35.5% (147/414) of adolescents and young adults reported not being tested for either HIV or STIs in the previous year, and less than half (168/414, 40.6%) of the sample achieved the Centers for Disease Control and Prevention recommendation of HIV and STI testing once per year. We observed HIV and STI testing disparities across sociodemographic (eg, sexual identity, education, and income) and health (eg, substance use) correlates. Specifically, cisgender gay men who have sex with men were more likely to report being tested for HIV compared with bisexual men and transgender individuals, who were more likely to be tested for STIs.
CONCLUSIONS
This study illustrates the results of an HIV prevention intervention in southeastern Michigan showing the need for HIV prevention interventions that leverage structural factors, psychosocial barriers, and substance use as key drivers to achieve HIV and STI testing rates to meet the Centers for Disease Control and Prevention guidelines.
TRIAL REGISTRATION
ClinicalTrials.gov NCT02945436; http://clinicaltrials.gov/ct2/show/NCT02945436.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/resprot.9414.
背景
男同性恋、双性恋和其他与男性发生性关系的男性以及跨性别者比顺性别、异性恋者受到 HIV 和其他性传播感染（STI）的影响更为严重。此外，使用物质的性和性别少数群体感染 HIV 和其他 STI 的风险通常进一步增加。增加对 HIV 和其他 STI 的检测可以使这些难以接触到的人群获得早期干预、预防和教育。
目的
我们调查了自我报告物质使用且居住在密歇根州东南部的 414 名年龄在 15 至 29 岁之间的性和性别少数青少年和年轻人的 HIV 和性传播感染检测模式。
方法
我们分析了一项 4 臂随机对照试验基线调查的数据，该试验旨在检验简短的物质使用干预措施在增加 HIV 预防参与方面的效果。我们根据检测自我报告（从未、仅 STI、仅 HIV 或两者都有），对 2 个基于类别 HIV 和 STI 检测变量（终生和过去 12 个月）拟合多项逻辑回归模型。此外，我们比较了人口统计学特征、结构因素、心理社会障碍、物质使用和性行为之间的 HIV 和 STI 检测行为。
结果
我们的研究结果表明，35.5%（147/414）的青少年和年轻人报告在过去一年中未接受过 HIV 或 STI 检测，不到一半（168/414，40.6%）的样本达到了疾病预防控制中心建议的每年进行一次 HIV 和 STI 检测。我们观察到社会人口统计学（例如，性身份、教育和收入）和健康（例如，物质使用）相关性方面的 HIV 和 STI 检测差异。具体而言，与双性恋男性和跨性别者相比，顺性别男同性恋男性更有可能接受 HIV 检测，而后者更有可能接受 STI 检测。
结论
本研究说明了密歇根州东南部一项 HIV 预防干预的结果，表明需要实施 HIV 预防干预措施，利用结构因素、心理社会障碍和物质使用作为实现 HIV 和 STI 检测率以达到疾病预防控制中心指南的关键驱动因素。
试验注册
ClinicalTrials.gov NCT02945436；http://clinicaltrials.gov/ct2/show/NCT02945436。
国际注册报告标识符（IRRID）：RR2-10.2196/resprot.9414。
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