Strathdee S A, Hogg R S, Martindale S L, Cornelisse P G, Craib K J, Montaner J S, O'Shaughnessy M V, Schechter M T
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, University of British Columbia, Vancouver, Canada.
J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Sep 1;19(1):61-6. doi: 10.1097/00042560-199809010-00010.
Data from a cohort of young HIV-negative gay and bisexual men were analyzed to identify determinants of sexual risk-taking at baseline. Gay/bisexual men aged between 18 and 30 completed a self-administered questionnaire including demographics, depression, social support, substance use, and consensual versus nonconsensual sex. Risk-takers were defined as those who had unprotected anal sex with casual male sex partners in the previous year; non-risk-takers were defined as those who reported consistent condom use during anal sex with all male partners in the previous year. Logistic regression was used to identify independent predictors of sexual risk-taking. Of 439 men studied, risk-takers had less education, a higher depression score, less social support, and were more likely to report nonconsensual sex and recreational drug use relative to non-risk-takers. Independent predictors of sexual risk-taking were low education, nitrite use, low social support (adjusted odds ratio [AOR]=1.65; 95% CI, 1.04-2.59), and nonconsensual sex experienced as a youth or adult (AOR=1.85; 95% CI, 1.15-2.96). Young gay/bisexual men reporting nonconsensual sex, low social support, or nitrite use were significantly more likely to have recently had unprotected anal sex with casual partners. HIV prevention programs aimed at young gay/bisexual men should include sexual abuse counselling and foster community norms supporting safer sex practices.
对一组年轻的HIV阴性男同性恋者和双性恋男性的数据进行了分析，以确定基线时性冒险行为的决定因素。年龄在18至30岁之间的男同性恋者/双性恋男性完成了一份自我管理的问卷，内容包括人口统计学、抑郁、社会支持、物质使用以及自愿与非自愿性行为。冒险行为者被定义为那些在过去一年中与随意的男性性伴侣进行无保护肛交的人；非冒险行为者被定义为那些报告在过去一年中与所有男性伴侣进行肛交时始终使用避孕套的人。采用逻辑回归来确定性冒险行为的独立预测因素。在研究的439名男性中，与非冒险行为者相比，冒险行为者受教育程度较低、抑郁得分较高、社会支持较少，并且更有可能报告非自愿性行为和使用消遣性药物。性冒险行为的独立预测因素包括低教育程度、使用亚硝酸盐、低社会支持（调整后的优势比[AOR]=1.65；95%置信区间，1.04-2.59）以及青年或成年时经历的非自愿性行为（AOR=1.85；95%置信区间，1.15-2.96）。报告有非自愿性行为、低社会支持或使用亚硝酸盐的年轻男同性恋者/双性恋男性最近与随意伴侣进行无保护肛交的可能性显著更高。针对年轻男同性恋者/双性恋男性的HIV预防项目应包括性虐待咨询，并树立支持更安全性行为的社区规范。
