男男性行为者认为与女性发生性行为感染艾滋病毒的风险最大:撒哈拉以南非洲混合方法系统评价的结果。

IF 4.6 1区 医学 Q2 IMMUNOLOGY
Marion Fiorentino, Marie Dos Santos, August Eubanks, Nathan Yanwou, Christian Laurent, Perrine Roux, Bruno Spire
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引用次数: 0

摘要

简介:在撒哈拉以南非洲(SSA),男男性行为者(MSM)通常有女性性伴侣。与男性伴侣在一起,她们感染艾滋病毒的总体风险更高。风险认知与艾滋病毒知识、性风险和预防行为有关。本综合研究旨在总结SSA男男性行为者和女男性行为者的艾滋病毒知识和感知艾滋病毒感染风险的现有数据。方法:我们对SSA的MSM与女性的关系进行了系统的文献回顾(PROSPERO-CRD42021237836)。选择并综合了与男男性行为者从与男性和女性的性行为中感知到的风险以及艾滋病毒知识相关的定量和定性数据(截至2021年出版)。结果:入选20项研究。更多的男男性接触者认为感染艾滋病毒的最大风险来自异性恋/阴道性交,而不是同性恋/肛交(53%对15%;51% vs. 39%;42%对8%;27% vs. 25%;43% vs. 11%;23% vs. 13%;35% vs. 16%,累积样本n = 4396, 6个国家)。男男性行为者获得异性恋艾滋病毒传播预防信息的比例高于同性恋艾滋病毒传播预防信息的比例(79%对22%;94% vs. 67%;54%对19%;累积样本n = 1199, 4个国家)。定性综合(8项研究)强调了基于生物学和行为的误解,导致男男性行为者认为与女性发生性行为相比,与男性发生性行为的艾滋病毒风险更低或可以忽略不计。这些误解的部分原因是艾滋病毒预防信息主要侧重于异性恋和阴道艾滋病毒传播。讨论:关于男性之间性风险的常见误解仍然没有通过异性恋的艾滋病毒预防信息得到解决。男男性行为者对其与男性伴侣感染艾滋病毒的风险的低估可能对有效的艾滋病毒预防行为造成重大障碍,并增加男男性行为者向其女性伴侣传播艾滋病毒的风险。结论:改善男男性行为者获得量身定制的艾滋病毒预防信息和工具的途径至关重要,这些信息和工具可以解决他们与男性和女性伴侣的行为。将有关肛交的信息纳入更广泛的公共卫生举措,包括针对一般人群的性健康规划,是至关重要的。有必要在SSA的不同环境中进行进一步的研究,以更好地了解MSM中艾滋病毒风险认知的驱动因素和影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Men who have sex with men perceiving that sex with women carries the greatest risk of HIV acquisition: results from a mixed-methods systematic review in sub-Saharan Africa

Men who have sex with men perceiving that sex with women carries the greatest risk of HIV acquisition: results from a mixed-methods systematic review in sub-Saharan Africa

Introduction

In sub-Saharan Africa (SSA), men who have sex with men (MSM) often have female sexual partners. Their overall risk of acquiring HIV is higher with male partners. Risk perception is associated with HIV knowledge, sexual risk and preventive behaviours. This synthesis aimed to summarize existing data about HIV knowledge and perceived HIV acquisition risk regarding sex with men and with women in MSM in SSA.

Methods

We conducted a systematic literature review of MSM's relationships with women in SSA (PROSPERO-CRD42021237836). Quantitative and qualitative data related to MSM's perceived risk from sex with men and with women and HIV knowledge (published up to 2021) were selected and synthesized.

Results

Twenty studies were selected. More MSM perceived that the greatest risk of HIV acquisition came from heterosexual/vaginal sex than from homosexual/anal sex (53% vs. 15%; 51% vs. 39%; 42% vs. 8%; 27% vs. 25%; 43% vs. 11%; 23% vs. 13%; 35% vs. 16%, cumulative sample n = 4396, six countries). A higher proportion of MSM received preventive information on heterosexual HIV transmission than on homosexual transmission (79% vs. 22%; 94% vs. 67%; 54% vs. 19%; cumulative sample n = 1199, four countries). The qualitative synthesis (eight studies) highlighted biology- and behaviour-based misconceptions leading MSM to perceive lower or negligible HIV risk from sex with men, compared to sex with women. These misconceptions were partly fuelled by the predominant focus on heterosexual and vaginal HIV transmission in HIV prevention information.

Discussion

Common misconceptions regarding sexual risk between men remain unaddressed by the heteronormative messaging of HIV prevention. Underestimation by MSM of their HIV acquisition risk with male partners can pose significant barriers to effective HIV preventive behaviours and strengthen the transmission risk from MSM to their female partners.

Conclusions

Improving access of MSM to tailored HIV prevention information and tools that address their practices with male and female partners is crucial. Integrating messages about anal sex into broader public health initiatives, including sexual health programmes targeting the general population, is essential. Further research in diverse settings in SSA is necessary to gain a greater understanding of the drivers and implications of HIV risk perception in MSM.

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来源期刊
Journal of the International AIDS Society
Journal of the International AIDS Society IMMUNOLOGY-INFECTIOUS DISEASES
CiteScore
8.60
自引率
10.00%
发文量
186
审稿时长
>12 weeks
期刊介绍: The Journal of the International AIDS Society (JIAS) is a peer-reviewed and Open Access journal for the generation and dissemination of evidence from a wide range of disciplines: basic and biomedical sciences; behavioural sciences; epidemiology; clinical sciences; health economics and health policy; operations research and implementation sciences; and social sciences and humanities. Submission of HIV research carried out in low- and middle-income countries is strongly encouraged.
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