Sexual risk, nitrite inhalant use, and lack of circumcision associated with HIV seroconversion in men who have sex with men in the United States

被引:178
作者
Buchbinder, SP
Vittinghoff, E
Heagerty, PJ
Celum, CL
Seage, GR
Judson, FN
McKirnan, D
Mayer, KH
Koblin, BA
机构
[1] San Francisco Dept Publ Hlth, AIDS Off, San Francisco, CA USA
[2] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA
[3] Univ Washington, Dept Biostat, Seattle, WA 98195 USA
[4] Univ Washington, Fred Hutchinson Canc Res Ctr, Seattle, WA 98195 USA
[5] Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA
[6] Dept Denver Publ Hlth, Denver, CO USA
[7] Univ Colorado, Ctr Hlth Sci, Denver, CO 80202 USA
[8] New York Blood Ctr, Epidemiol Lab, New York, NY 10021 USA
[9] Fenway Community Hlth Ctr, Dept Res, Boston, MA USA
[10] Brown Univ, Providence, RI 02912 USA
关键词
men who have sex with men; HIV infection; seroincidence; risk; circumcision; amyl nitrite; behavior;
D O I
10.1097/01.qai.0000134740.41585.f4
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Men who have sex with men (MSM) continue to account for the largest number of new HIV infections in the United States, but limited data exist on independent risk factors for infection beyond the early 1990s. The HIV Network for Prevention Trials Vaccine Preparedness Study enrolled 3257 MSM in 6 US cities from 1995 to 1997. HIV seroincidence was 1.55 per 100 person-years (95% confidence interval: 1.23-1.95) over 18 months of follow-up. On multi-variable analysis using time-dependent covariates, independent risk factors for HIV seroconversion were increased number of reported HIV-negative male sex partners (adjusted odds ratio (AOR) = 1.14 per partner, population attributable risk (PAR) = 28%), nitrite inhalant use (AOR = 2.2, PAR = 28%), unprotected receptive anal sex with an HIV unknown serostatus partner (AOR = 2.7, PAR = 15%) or HIV-positive partner (AOR = 3.4, PAR = 12%), protected receptive anal sex with an HIV-positive partner (AOR = 2.2, PAR = 11%), lack of circumcision (AOR = 2.0, PAR = 10%), and receptive oral sex to ejaculation with an HIV-positive partner (AOR = 3.8, PAR = 7%). Having a large number of male sex partners, nitrite inhalant use, and engaging in receptive anal sex explained the majority of infections in this cohort and should be targeted in prevention strategies for MSM.
引用
收藏
页码:82 / 89
页数:8
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