Demographic and Sexual Behavior Characteristics of Men Who Have Sex with Men (MSM) Registered in a Targeted Intervention (TI) Program in India

Background: Men who have sex with men (MSM) contribute substantially to HIV prevalence in India. The targeted intervention (TI) program is the most important link between MSM and the public health system. Hence, we studied the demographic and sexual behavior characteristics of MSM registered in TI program in India. Methods: We used information maintained at TI sites under the program catering exclusively to MSM in India. Demographic characteristics and sexual behavior of MSM over the past two decades were also studied. Risk behaviors included type of partners, alcohol use, sexual acts per week, years of sex work and age at initiation of sex work. Bivariate analysis was carried out to understand the demographic determinants of sexual behavior. Results: In total, data of 6037 MSMs from 14 TI sites were analyzed. Of these 4655 (73.8%) were young adults (<35 years) and 2565 (40.8%) had completed their matriculation. More than half (55.4%) were married. Double-decker was identified as the most common sub-typology among MSM. Average age of initiation of sex was 23.0 years and average number of sexual acts per week was 6.8 (95% CI: 6.8 - 7.0). Irregular partners and alcohol use were observed in 30.5% and 52.8% of MSM respectively. Cohort analysis revealed a statistically significant declining trend in average age of initiation of sex over the past two decades. The sexual behavior of MSM varied significantly by employment status, education, marital status, state of residence, alcohol use and type of sex partner. Conclusion: MSMs registered with the TI program in India were mostly young, educated, and employed. Many MSM also had a history of heterosexual relationships, and thus had the potential of transmitting HIV infection to the otherwise low risk general population. This analysis supports the use of TI program data for understanding the demographic and sexual behavior characteristics of hard to reach and stigmatized population in society.

The moderating impact of lifestyle factors on sex steroids, sexual activities and aging in Asian men

The present study sought to evaluate the relative associations of exercise, sleep and other lifestyle habits with aging, sex hormones, percent body fat （%BF） and sexual activities in men living in the community. A better understanding of this complex interrelationship is important in helping the formulation of modalities for a holistic approach to the management of aging men. The results showed that age is a major determinant for many physiological parameters, including sleep, hormonal and metabolic parameters, some lifestyle factors and sexual activities. Testosterone （T）, bioavailable testosterone （BloT） and dehydroepiandrosterone sulphate （DHEAS） concentrations decreased with age, while estradiol （E2）, sex hormone-binding globulin （SHBG） and %BF increased with age. In addition, there exist intricate associations among hormonal and lifestyle factors, %BF and age. High-intensity exercise and longer duration of sleep were associated with higher concentrations of T and BloT. T was shown to be associated positively with men who were engaged in masturbation. DHEAS was associated with men wanting more sex and with good morning penile rigidity. Older Singaporean men tended to sleep for shorter duration, but exercised more intensely than younger men. Coital and masturbation frequencies decreased with age, and a significantly greater number of younger men were engaged in masturbation. Relationship between the partners is a key determinant of sexuality in men. It appears that T may have a limited, while dehydroepiandrosterone （DHEA） have a greater role than previously suggest, as a motivational signal for sexual function in men. Both biological and psychosocial factors interact with each other to influence sexual functions in men. Hence, a biopsychosocial approach may be more appropriate for a more lasting resolution to sexual dysfunctions in men.

Factors influencing HIV infection in men who have sex with men in China

To identify risk factors for HIV infection among men who have sex with men （MSM） and to provide a theoretical basis for prevention interventions. Between December 2011 and August 2012, a case-control study was conducted among MSM who underwent voluntary counselling and testing for HIV. Confirmed HIV-positive MSM were included in the case group, and HIV-negative MSM were included in the control group. Information on possible risk factors was collected by a survey questionnaire and a qualitative interview. The results of a conditional logistic regression showed that the following were influencing factors for HIV infection： average monthly income between 2001 and 3000 Yuan （odds ratio （0R）=6.341, 95% Ch 1.714-12.544）, only sometimes using condoms when having anal sex with men in the last 6 months （0R=7.601, 95% Ch 1.359-23.083）, having HIV-positive sex partners （0R=5.273, 95% Ch 1.572- 17.691）, rectal trauma with bleeding in the last 6 months （0R=2.947, 95% Ch 1.308-6.638）, not using condoms at last sexual encounter （OR-- 1.278, 95% Ch 1.012-5.595）, engaging in commercial sex （0R=5.925, 95% Ch 1.923-13.890） and having more than 16 sex partners in the last 6 months （0R=1.175, 95% Ch 1.021-1.353）. These seven factors were the risk factors of HIV infection （OR〉l）. However, having anal sex less than 10 times in the previous 1 month （OR=O.O02, 95% CI： 0.000-0.287） was a protective factor against HIV infection among MSM （OR〈l）, and insertive （0R=0.116, 95% Ch 0.000-0.236） （OR〈l） anal intercourse influenced HIV infection. Interventions should be targeted at MSM whose average monthly income is between 2001 and 3000 Yuan, and who engage in commercial sex. In addition, the importance of using condoms at every sexual encounter should be emphasised in health education, as should the treatment of rectal trauma with bleeding. Finally, MSM should decrease the number of sex partners and frequency of anal sex to decrease the rate of HIV infection.

Casual Sex, Sex Work and Unprotected Sex among Men Who Have Sex with Men in the Human Papilloma Virus (HPV) Clinical Trial —North-West Region of Tshwane, South Africa

Background: The gap in the understanding of the context of the sexually transmitted infections (STIs) and risky behaviours among men who have sex with men (MSM) could lead to the development and implementation of inappropriate interventions, which could exacerbate the rapid spread of STIs, especially HIV, among MSM. The aim of the study was to qualitatively assess the understanding of the STIs and the risky sexual behaviours of men who have sex with men in the North-West region of Tshwane. Methods: An exploratory qualitative design was employed to assess the STIs and the risky sexual behaviour of the MSM population. The study participants were enrolled in an HPV clinical trial at MECRU, which is a clinical research unit at the Sefako Makgatho Health Sciences University. Data collection occurred from September 2016 to May 2017. A convenience sampling method was used and n = 30 participants were selected. Face-to-face in-depth interviews were conducted on MSM 18 years and older, using a semi-structured interview guide. Thematic content analysis was used for data analysis, using NVivo version 10 software. Results: The mean age of the sample was 26 years, and the age range was 18 to 44 years. All were unmarried, and all of them came from townships, rural villages and informal settlements in the vicinity of the clinical research unit. The high-risk behaviours noted among the majority of the MSM in this study were having multiple sexual partners and exchanging partners, alcohol abuse, inconsistent condom-use, having unprotected anal sex, and having transactional sex. There was a high level of knowledge of STIs in the heterosexual population with poor understanding of STIs affecting MSM through anal sex. Most of the MSM played a female or bottom role, which made them vulnerable because they could not successfully negotiate condom use, and they reported that they sometimes accepted gifts or money in exchange for anal sex. Conclusion: The study concludes that the MSM in this study had casual sex, and are involved in sex work without practising safe sex. There is a need for health promotion on STIs and risky behaviours among MSM in communities as well as in health facilities for MSM in the North-West region of Tshwane.

Sexual Risk Behavior and Satisfaction Among Men Who Have Sex With Men Living With Detectable HIV Viral Loads:A Nationwide Online Survey in China

Little is known about sexual behavior and satisfaction among men who have sex with men(MSM)with detectable HIV viral loads(VL)in China.This study aims to investigate sexual risk behavior and sexual satisfaction among MSM living with HIV in China,as well as poten-tial predictors.This cross-sectional study was conducted in February 2021 using an anonymous online survey based on WeChat.Data were collected on sociodemographics,sexual behavior,HIV clinical information,sexual satisfaction and mental health.Descriptive sta-tistics,logistic regression and multivariable logistic regression were performed.MSM with detectable HIV VL(VL+)or VL not sure were more likely to report inconsistent condom use,even with HIV-negative/unknown-status regular male partners.Having an HIV-positive regular partner and recreational drug use were positively associated with inconsistent condom use during anal sex among MSM with undetectable VL(VL-).Alcohol use before or during sexual activities was positively associated with inconsistent condom use during anal sex among VL+or VL not sure MSM.A total of 58.3%of participants reported being sexually satisfied.MSM living with HIV who were currently employed,had experienced anal sex in the prior 6 months,had VL-HIV status,or had more frequent ejaculation during sex/masturbation were more likely to report sexual satisfaction.The development of targeted education and interventions to minimize sexual risk behavior among MSM living with HIV is in dire need.Treating sexual dysfunction and developing a reasonable antiretroviral therapy regimen to achieve viral suppression can help promote sexual satisfaction in MSM living with HIV.

苏州市MSM人群艾滋病高危行为特征、感染状况及影响因素分析

目的了解苏州市男男性行为者(MSM)艾滋病高危行为特征、感染情况及其影响因素。方法采用横断面调查,采取分类滚雪球抽样的方法于2008年5月起,对苏州市范围内的MSM人群就艾滋病(AIDS)知识态度、高危行为特征的面对面问卷调查结果 ,以及血样的艾滋病病毒(HIV)及其他性传播疾病(STD)感染的实验室检测数据进行统计分析。结果所调查280名MSM中,82.7%最近六个月发生过同性性行为,其中79.4%有多个同性性伴;48.7%曾与异性发生过性行为,其中21.2%有多个异性性伴;最近六个月与同性发生肛交性行为时坚持使用安全套的比例为52.0%,与异性发生性行为时该比例为21.2%。300名被调查者均采集血样进行了血清学检测,确证HIV阳性人数22人,阳性率为7.3%;确证梅毒抗体阳性人数为66人,阳性率为22.0%。在多因素logistic回归模型中,常通过互联网寻找性伴(OR=1.93,95%CI=1.01～3.67)、最近六个月曾与固定性伴发生性行为(OR=0.45,95%CI=0.25～0.79)与最近六个月同性性行为时安全套坚持使用率的关系有统计学意义;梅毒感染(OR=3.17,95%CI=1.25～7.99)与HIV感染的关系具有统计学意义。结论苏州市MSM人群无保护性性行为及多性伴现象较为普遍,HIV和梅毒感染率较高,需要进一步加强对该人群的行为干预以防止艾滋病在该人群中的蔓延以及传播至一般人群。

在MSM人群中开展性病知识的同伴教育效果研究

目的探讨同伴教育在男男性行为者(MSM)人群中的知识认知和行为转变的效果.方法2004年3～11月,在昆明、成都两市的MSM人群中开展有组织的同伴教育活动;在4月和11月,分别进行性病、艾滋病知识和个人性行为情况的人群抽样调查,对调查结果进行比较分析.结果基线调查184人,终期调查175人.两次调查发生首次性行为的年龄中值均为18岁,发生首次同性性行为年龄的中值均为19岁.基线和终期调查发现,调查对象对性病、艾滋病知识的认知发生了有意义的全面提高,但在近3个月内异性性行为和同性性行为的发生率和性伴数没有改变,并且平均性伴数都超过1人.各种方式性行为的发生率没有改变,安全套的使用率也没有发生有意义的提高,只是对性对象的健康状况关注增加了.结论同伴教育能够很快提高MSM群体的性病、艾滋病知识认知,但是存在'认知与行为分离'的现象,加速安全性行为的促进是面临的重要问题,同时安全套促进也需要人性化措施.

新罗区2020-2022年不同性取向男男性行为人群艾滋病监测作用

目的 观察新罗区2020-2022年不同性取向男男性行为人群(MSM)艾滋病监测作用。方法 回顾性选取2020-2022年龙岩市新罗区疾病预防控制中心艾滋病防治科122例同性MSM人群作为同性性取向组、55例双性性取向MSM人群作为双性性取向组,比较两组人口学特征、行为学特征、感染情况。结果 两组间婚姻状况差异有统计学意义(P <0.05),同性性取向组未婚比例更高,双性性取向组同居/已婚比例更高。两组间年龄、户籍、本区居住时间、学历差异均无统计学意义(P> 0.05)。两组间艾滋病知晓情况差异无统计学意义(P> 0.05)。两组间近半年异性性行为差异有统计学意义,双性性取向组近半年异性性行为更高(P <0.05)。两组间近半年同性肛交行为、近半年商业性同性行为、最近一次肛交行为使用安全套、最近一次异性性行为使用安全套、近1周肛交次数、近半年肛交用套频率、近半年异性性行为用套频率差异均无统计学意义(P> 0.05)。两组间既往检测与干预情况差异无统计学意义(P> 0.05)。新罗区2020-2022年不同性取向MSM人群丙肝、梅毒、HIV感染率分别为1.13%、15.25%、14.12%。两组间丙肝、梅毒、HIV感染率差异均无统计学意义(P> 0.05)。结论 新罗区2020-2022年同性与双性性取向MSM人群艾滋病监测能够将有效依据提供给临床干预。

贵阳市2010～2014年MSM人群HIV感染者性行为情况

目的：了解2010-2014年贵阳市MSM人群（men who have sex with men,MSM）HIV感染者性行为特征,为预防控制MSM人群HIV感染者二代传播提供依据。方法：本研究以2010-2014年的4-7月份在贵阳市MSM人群监测哨点检测出的HIV感染者为研究对象,以一对一的方式进行问卷调查,并采集静脉血进行HIV和梅毒检测。结果：2010-2014年贵阳市MSM人群监测哨点共检测出的333名HIV感染者,年龄在18-24岁,所占的比例由2010年的55.4%下降到2014年的26.7%,在婚或同居所占的比例在5.0%-15.8%之间;文化程度大专及以上者由2010年的45.7%上升到2014年的70.0%。2010-2014年MSM人群感染者的梅毒感染检出率在6.7%-23.9%之间;最近6个月与同性发生肛交性行为所占的比例分别为79.7%-98.9%,与异性发生性行为所占的比例在7.8%-11.7%之间。73.6%-91.4%的MSM最近6个月同性肛交未坚持使用安全套;异性行为坚持使用安全套所占的比例仅为33.3%。结论：MSM人群HIV感染者年龄较小,主要处于性活跃阶段,梅毒的感染检出率较高,同性性行为及异性性行为时坚持使用安全套的比例均较低,将加速HIV和梅毒在MSM人群间及向异性人群传播。

江苏两市MSM抗病毒治疗效果及其影响因素的研究

目的:分析江苏男男性行为(men who have sex with men,MSM)人群的艾滋病抗病毒治疗效果及其影响因素,首次建立江苏省MSM抗病毒治疗评价方法。方法:通过整群抽样的方式选取江苏两市接受免费高效抗逆转病毒治疗(highly active antiretroviral therapy,HAART)的MSM作为研究对象,进行生活史和用药情况的问卷调查;从江苏省艾滋病治疗信息库中获知其CD4值,采用Epidata 3.0和SAS 9.0分别进行资料录入与统计分析。结果:157例MSM总体CD4值提高,服药依从性低。经单因素及多因素分析,确诊后安全套使用水平低、吸烟量大、确诊至治疗时间间隔长是影响治疗效果的危险因素;首次CD4值较高及服药天数较长是保护因素。结论:江苏目前男男性行为人群抗病毒治疗效果显著,建议对符合治疗条件的MSM进行早期治疗,并提高患者服药依从性。

扬州市MSM人群艾滋病高危行为特征、感染状况及影响因素分析

目的:了解江苏省扬州市男男性行为者(men who have sex with men,MSM)艾滋病高危行为特征、感染情况及其影响因素。方法:采用横断面调查设计,采取分类滚雪球抽样的方法于2008年5月起,对扬州市范围内的MSM人群就艾滋病知识态度、高危行为特征的面对面问卷调查结果,以及血样的人类免疫缺陷病毒(human immunodeficiency virus,HIV)及其他性传播疾病(sexually transmitted disease,STD)感染的实验室检测数据进行统计分析。结果:所调查300例MSM中,82.7%最近6个月发生过同性性行为,其中79.4%有多个同性性伴;48.7%曾与异性发生过性行为,其中21.2%有多个异性性伴;最近6个月与同性发生肛交性行为时坚持使用安全套的比例为52.0%,与异性发生性行为时该比例为21.2%。均采集血样进行了血清学检测,确证HIV阳性22例,阳性率为7.3%;确证梅毒抗体阳性66例,阳性率为22.0%;未发现丙型肝炎病毒抗体阳性。在多因素Logistic回归模型中,常通过互联网寻找性伴(OR=1.93,95%CI:1.01～3.67)和最近6个月曾与固定性伴发生性行为(OR=0.45,95%CI:0.25～0.79)与最近6个月同性性行为时安全套坚持使用率的关系有统计学意义;梅毒感染(OR=3.17,95%CI:1.25～7.99)与HIV感染的关系具有统计学意义。结论:扬州市MSM人群无保护性性行为及多性伴现象较为普遍,HIV和梅毒感染率较高,需要进一步加强对该人群的行为干预以防止艾滋病在该人群中的蔓延以及传播至一般人群。

江苏省HIV阳性的MSM人群梅毒和HSV-2感染及影响因素分析

目的:了解江苏省男男性行为人群(men who have sex with men,MSM)中人类免疫缺陷病毒(human immunoddficiency virus,HIV)感染者的梅毒及单纯疱疹病毒Ⅱ型(herpes simplex virus 2,HSV-2)的感染情况及影响因素。方法:2012年3～6月在南京、镇江市整群抽取HIV阳性的MSM 264例,对其进行随访问卷调查,并回顾其病例报告时的问卷信息。静脉血采集进行梅毒和HSV-2检测。结果:264例MSM中梅毒感染率为29.55%(78/264),其中现症梅毒感染率为13.64%(36/264),HSV-2型特异性IgG抗体阳性率为28.03%(74/264)。多因素Logistic回归分析结果显示与现症梅毒感染有统计学意义的因素为感染前6个月内同性性伴数>3人、HSV-2阳性;与HSV-2感染有统计学意义的因素为年龄>35岁、本县区户籍、现症梅毒感染和接受安全套发放服务。结论:应探索新的干预模式和检测策略,以应对梅毒和HSV-2在MSM人群中的传播和流行。

HPV感染不同分类及其对MSM有关不良结局的影响

男男性行为人群(MSM)持续感染人乳头瘤病毒(HPV),尤其是高危型HPV的持续感染,将导致尖锐湿疣、肛门癌、阴茎癌、口腔癌等不良结局。MSM感染HPV后,按感染型别可分为低危型或高危型HPV感染,按感染时间可分为一过性或持续性HPV感染,按感染数量可分为单一型或多重型HPV感染;明确以上几种类别的划分依据,分析不同分类间的关系及对MSM有关不良结局的影响,探讨今后对该人群开展调查的关注点,对MSM人群HPV感染控制及预防提供参考。

杭州市不同活动场所MSM人群艾滋病病毒感染现况研究

目的了解杭州市不同活动场所男男性接触者(MSM)人群的艾滋病病毒感染率,为疫情估计和行为干预提供科学依据。方法2006-2008年期间,在酒吧、浴室、会所随机调查418名MSM人群,了解年龄、婚姻等一般特征和最近6个月与男性发生性行为时安全套的使用率,并抽取3～5mL静脉血检测艾滋病病毒抗体,计算感染率。结果418名MSM人群HIV阳性26例,感染率为6.2%。MSM人群以流动人口为主;浴室MSM人群年龄偏大,已婚占多数;酒吧MSM人群文化程度较高;每次与男性发生性行为时安全套的使用率较低;酒吧、浴室、会所的艾滋病病毒感染率分别为3.5%、12.8%、2.8%。结论MSM人群的艾滋病病毒感染率较高,属艾滋病防制的重点人群,应立即采取积极有效的防制措施。

生活化同伴教育对MSM人群艾滋病知识态度的影响

目的了解同伴教育对男男性接触(MSM)人群艾滋病性病(AIDS/STD)知识态度的转变程度。方法以活跃于武汉市同性恋活动场所的MSM为干预对象,通过社区志愿者开展以生活化同伴教育为核心的健康促进系列活动,并分别在干预前后进行AIDS相关知识和态度的基线调查和绩效调查,用SPSS11.5软件对结果进行统计分析。结果干预后目标人群的AIDS知识知晓率、STD和高危性行为知晓率、安全套防病功能正确回答率全面提高,绝大多数指标具有统计学意义。尤其是AIDS传播途径的内涵和高危性行为认知方面的核心指标均有显著改变,卡方检验均有统计学意义。干预后消除了目标人群对感染AIDS的恐惧心理和对待HIV/AIDS患者的歧视心理,“如果感染AIDS/STD不知道怎么办”的人数明显减少,对“周围的朋友或同事感染AIDS”的态度也更为宽容,P<0.001。结论生活化同伴教育是值得推广的普及MSM人群AIDS相关知识,转变MSM人群对待HIV/AIDS态度的有效干预方式。

上海市闵行区新发男男性行为(MSM)人群HIV感染者特征及分子流行病学研究

目的了解上海市闵行区新发男男性行为(men who have sex with men,MSM)人群人类免疫缺陷病毒(human immunodeficiency virus,HIV-1)感染者相关特征及亚型和原发性耐药现状,为该人群的HIV防治及抗病毒治疗提供依据。方法利用问卷对2014年新确诊的HIV-1男性感染者收集相关信息,对其中未进行抗病毒治疗的MSM感染者随机抽取55份冻存血浆,采用逆转录聚合酶链反应(RT-PCR)扩增和DNA测序,对序列进行亚型及原发性耐药分析。结果 2014年新发MSM感染者主要集中在25～34岁(55.7%),一般男性感染者≥35岁为主(65.4%),差异有统计学意义(χ~2=15.84,P=0.001);MSM感染者文化程度以大专及以上为主(54.6%),一般男性感染者以初、高中为主(69.2%),差异有统计学意义(χ~2=12.32,P=0.006);MSM感染者主要来源于检测咨询(60.8%),一般男性感染者主要来源于医疗机构(50.0%),差异有统计学意义(χ~2=12.03,P=0.002)。扩增出48条序列,以CRF01_AE亚型为主,占58.3%,其次为CRF07_BC亚型,占20.8%。原发耐药率4.2%,耐药位点2个,为K70R和E138G,分别引起NRTI类AZT中度耐药,D4T低度耐药,以及NNRTI类EFV、ETR、NVP、RPV的低度耐药。结论闵行区MSM感染者相比一般感染者,具有更年轻,文化程度更高,自我检测意识更强的特点,CRF01_AE及CRF07_BC为优势毒株,原发耐药为低度耐药,需加强针对该人群的防控措施及分子流行病学监测。

烟台市MSM人群性行为特征及安全套使用影响因素研究

目的了解烟台市男男性行为者(men who have sex with men,MSM)性行为特征及安全套使用影响因素,为艾滋病防治工作提供理论依据。方法采用网络和现场招募相结合的方法,招募研究对象进行问卷调查,调查内容主要包括社会人口学特征、性取向、同性交友方式、性行为及安全套使用情况等。应用Epidata 3.0软件进行数据录入,应用SPSS 13.0软件进行统计学分析,单因素分析采用χ2检验,多因素分析采用二分类logistic回归。结果共调查531人,其中网络招募431人、现场招募100人。调查对象最近1年同性肛交性伴数以1~3个为主,同性性行为坚持每次使用安全套的比例为49.9%;接受过艾滋病咨询检测、同伴教育、安全套宣传与发放的比例分别为54.4%、27.1%和28.6%。多因素分析结果显示,文化水平高(OR=0.67,95%CI:0.50-0.90)和最近一次同性肛交性行为距离调查时点较长(OR=0.84,95%CI:0.72-0.97)是同性肛交性行为安全套坚持使用的促进因素。与离异或丧偶人群相比,与同性同居为安全套坚持使用的危险因素(OR=2.87,95%CI:1.11-7.47)。结论烟台市MSM人群高危行为普遍,安全套使用率较低,接受艾滋病相关干预服务的比例相对较低,应进一步探索适合MSM人群特点的艾滋病干预措施。

基于BLUED软件的MSM人群线上交流与线下行为状况调查

目的分析浦东新区男性同性性行为(MSM)人群BLUED软件的使用情况与艾滋病病毒(HIV)感染相关健康教育状况和个人性行为的相关性,为探索MSM人群线上线下干预措施提供参考。方法于2019年2~3月通过社区艾滋病检测咨询门诊(VCT)、网络同志社区、男男同伴教育志愿者等方式招募451名MSM人群开展问卷调查,比较BLUED软件不同使用情况(频次)受试者的个人基本情况、HIV相关健康教育状况和个人性行为的差异。结果在420份有效问卷中(有效应答率为93.1%),使用BLUED软件者356人,占84.76%,未使用者64人,占15.24%;使用BLUED软件进行线上交流的MSM人群多为非上海的外地户籍(62.11%)、了解艾滋病的程度较高(98.31%)、HIV免费治疗策略知晓率较高(78.65%)、HIV感染担心程度较高(74.44%)、定期检测HIV率较高(63.20%)、感染后治疗意愿较高(96.35%)、寻找性伴频率较高(75.00%)以及安全套的使用率较高(71.35%),分别与不使用BLUED软件进行线上交流的MSM人群比较差异均具有统计学意义(P<0.05)。结论在网络沟通多样化的新形势下,应针对MSM人群采取线上线下干预措施,减少艾滋病的传播。

HIV阳性MSM中新型毒品滥用、APP寻找性伴和高危性行为的关系研究

目的:调查人类免疫缺陷病毒(HIV)阳性男男性行为者(MSM)新型毒品滥用、使用同性交友应用程序(APP)寻找同性性伴及高危性行为的现况,并分析三者间的关系。方法:对济南市市中区1061名HIV阳性MSM进行问卷调查,收集调查对象新型毒品滥用、使用同性交友APP寻找同性性伴及高危性行为的相关信息,采用二分类非条件Logistic回归模型分析三者间的关系。结果:近6个月,18.6%(197/1061)的调查对象曾滥用新型毒品,冰毒滥用率最高,占8.5%(90/1061);87.0%(923/1061)的调查对象曾使用同性交友APP,52.2%(554/1061)曾使用同性交友APP并约见网友,36.9%(392/1061)曾使用同性交友APP约见网友并性交;74.3%(788/1061)曾有高危性行为。多因素分析结果显示,控制其他变量后,HIV阳性MSM新型毒品滥用与高危性行为呈正相关(OR=6.17,95%CI 3.28~11.64),新型毒品滥用与使用同性交友APP约见网友并性交呈正相关(OR=2.44,95%CI 1.75~3.39),使用同性交友APP约见网友并性交与高危性行为呈正相关(OR=3.03,95%CI 2.15~4.27)。结论:应将新型毒品滥用、出于性目的而过度滥用同性交友APP纳入HIV阳性MSM高危性行为的干预体系中,干预模式尤应注重线上、线下相结合。

Nitrite inhalants use, sexual behaviors and HIV/syphilis infection among men who have sex with men in Chongqing, China

Background:Emerging evidence indicates nitrite inhalants have become increasingly prevalent among men who have sex with men(MSM).The present study aimed to describe the prevalence and correlates of nitrite inhalants use and its association with risky sexual behaviors and human immunodeficiency virus(HIV)/syphilis infection among MSM in Chongqing,a city in China where MSM were burdened with the highest pooled HIV prevalence in the country.Methods:This cross-sectional study was conducted in Chongqing between March 2019 and February 2020.Information of demographics,drug use,sexual behaviors and HIV testing was collected through an anonymous survey.Blood samples were drawn from each participant for the diagnoses of HIV and syphilis.Logistic regression analysis was performed to evaluate factors correlated with nitrite inhalants use and its relationship with risky sexual behaviors and HIV/syphilis infection.Results:Of the 1151 eligible participants,18.9%(218)reported use of at least one type of recreational drugs in the past 6 months,and nitrite inhalants were the most commonly used substance(17.7,95%confidence interval[CI]:15.6-20.2%).The proportions of participants reported engaging in group sex and practicing condomless internal ejaculation during anal sex in the past six months were 5.8%(95%CI:4.4-7.2%)and 41.7%(95%CI:38.7-44.7%),respectively.The general prevalence of HIV and syphilis infection among the enrolled MSM were 16.8%(95%CI:14.7-19.0%)and 12.6%(95%CI:10.7-14.4%),respectively.Factors positively associated with nitrite inhalants use included:age<25(adjusted odds ratio[aOR]=2.08,95%CI:1.10-3.94),monthly individual income≥CNY 3000(Chinese Yuan)(aOR=1.95,95%CI:1.18-3.22),preferring receptive anal intercourse(aOR=2.27,95%CI:1.34-3.84)and versatile anal intercourse(aOR=2.60,95%CI:1.64-4.13),age at first anal intercourse<18(aOR=1.79,95%CI:1.21-2.67),engaging in group sex in the past six months(aOR=9.34,95%CI:4.95-17.63),having multiple male sex partners in the past 6 months(aOR=2.32,95%CI:1.50-3.58),practicing CIE during anal sex in the past six months(aOR=1.71,95%CI:1.19-2.46),HIV infection(aOR=1.72,95%CI:1.11-2.66)and syphilis infection(aOR=1.98,95%CI:1.23-3.17).Conclusions:This study found that nitrite inhalants were the most commonly used recreational substance among MSM and nitrite inhalants use were associated with higher probability of HIV and syphilis infection.Therefore,increased attention and counselling should be given to nitrite inhalants-using MSM.