Wang J, Rodés A, Blanch C, Casabona J
AIDS Prevention and Control Program, Department de Sanitat i Seguretat Social, Generalitat de Catalunya, Barcelona, Spain.
Soc Sci Med. 1997 Feb;44(4):469-77. doi: 10.1016/s0277-9536(96)00176-1.
As part of the first quantitative study of men who have sex with men (MSM) and HIV/ AIDS in Spain, anonymous, self-administered questionnaires were distributed via gay/lesbian organization mailings, bathhouses, and sex shops in Barcelona. We analyzed 547 gay/bisexual men along self-reported HIV testing history-i.e. untested, previously tested HIV-, and previously tested HIV +. Eleven variables discriminated significantly between the three groups in multivariable analysis. HIV- men were over-represented in the mailing subsample. While untested men exhibited potentially protective behaviors (e.g. least likely to have had stable and casual sex partners with HIV/AIDS and to practice anal intercourse), they were also least likely to be out with their homosexuality and most likely to never use condoms when they practiced anal intercourse. HIV + men were most likely to report insertive and receptive anal intercourse with a condom and least likely to practice insertive anal intercourse without a condom in the past month, yet they were also most likely to report the highest interpersonal barriers to safer sex, recent cocaine use with sex, meeting sex partners in public restrooms, and recent episodes of STD. A potentially volatile combination of higher sexual activity (e.g. more sex partners and casual sex activity) coupled with the presence of safer sex barriers (e.g. poor scores on indices measuring safer sex disposition, elevated drug use accompanying sex) was evidenced among HIV + men. There were no statistically significant differences between the three groups for anal intercourse without a condom, but with 37.5% of this collective reporting one such episode in the past month, all groups can be considered equally risky. Against the backdrop of a 20.5% self-reported HIV prevalence, there is considerable need for enhanced prevention efforts among gay/bisexual men in general and targeted strategies among HIV + men in particular.
作为西班牙针对男男性行为者（MSM）与艾滋病毒/艾滋病的首次定量研究的一部分，通过同性恋组织邮件、巴塞罗那的澡堂和性用品商店分发了匿名的自填式问卷。我们根据自我报告的艾滋病毒检测史，分析了547名男同性恋者/双性恋男性，即未检测过、以前检测过艾滋病毒阴性和以前检测过艾滋病毒阳性的人。在多变量分析中，11个变量在三组之间有显著差异。艾滋病毒阴性的男性在邮件子样本中占比过高。虽然未检测过的男性表现出潜在的保护行为（例如，最不可能有感染艾滋病毒/艾滋病的固定和临时性伴侣以及进行肛交），但他们公开自己同性恋身份的可能性最小，并且在进行肛交时最不可能使用避孕套。艾滋病毒阳性的男性最有可能报告使用避孕套进行插入式和接受式肛交，并且在过去一个月中最不可能在不使用避孕套的情况下进行插入式肛交，然而他们也最有可能报告在安全性行为方面存在最高的人际障碍、最近在性行为时使用可卡因、在公共卫生间结识性伴侣以及最近感染性传播疾病的情况。在艾滋病毒阳性的男性中，有证据表明存在一种潜在不稳定的组合，即较高的性活动（例如，更多的性伴侣和随意性行为）加上存在安全性行为障碍（例如，在衡量安全性行为倾向的指标上得分较低、性行为时吸毒增加）。在不使用避孕套进行肛交方面，三组之间没有统计学上的显著差异，但在这个总体群体中有37.5%的人报告在过去一个月中有过一次这样的行为，所有组都可被视为同样有风险。在自我报告的艾滋病毒感染率为20.5%的背景下，总体上非常有必要加强对男同性恋者/双性恋男性的预防工作，特别是针对艾滋病毒阳性男性的有针对性策略。
