| Summary: | 碩士 === 國立成功大學 === 公共衛生研究所 === 102 === Introduction
Men who have sex with men (MSM) are the primary risk group for HIV infection. Gay sauna is a primary venue for MSM. In 2009, Taiwan CDC financially supported NGO established Gay Centers to build up a social venue for MSM. The purposes of the study are to compare the prevalence of HIV ,sexually transmitted infections (STIs) and risk behaviors among MSM using voluntary HIV counseling and testing services (VCT) in the venues, in order to evaluate the policy and formulate health education strategies in the future.
Methods
Using cross-sectional study samples, we compared 2416 MSM who used voluntary counseling and testing (VCT) during 2009 to 2012. After obtaining permission from venues owners, patrons were approached by trained male volunteers when they checked into the bathhouse and invited to participate in the study. Patrons who agreed to participate were asked if they have been participated in the project before. Trained male volunteers explained to participants about the items of HIV/STI screening listed on the consent form and helped them to complete a one-page self-administered questionnaire. The study protocol included providing HIV/STI information and counseling, free and anonymous HIV/STI tests: serological tests for HIV, syphilis and Amoebiasis. Logistic regression identified factors associated with unprotected anal intercourse (UAI) at their most recent venue visit. SPSS 14.0 for Windows (SPSS, Chicago, IL, USA) was used for all statistical analyses. To test for trends of HIV and STIs over time, we used χ2 tests for linear trends that considered the year of the survey as an ordered categorical variable. We used χ2 tests to evaluate the association between the positive and reactive results of each HIV and STI and various correlates: demographic characteristics, illicit drug usage, and risky sexual behaviors. Continuous variables were analyzed using t tests or analysis of variance (ANOVA). Logistic regression was used to examine the statistical relationships between the primary independent variable (HIV/STIs and consistent condom use in anal intercourse in bathhouses) and significant correlates selected from univariate analysis, while controlling for age. The proposed correlates were entered into the regression model hierarchically, with the presence of STIs entered first, prior risky behavior entered second, condom-use behavior entered third, and individual characteristics entered last. The final models achieved goodness-of-fit as assessed using the Hosmer–Lemeshow goodness-of-fit test. Statistical significance was set at P 〈 0.05.
Result
The HIV/STIs prevalence rate in gay sauna was 6.7% for HIV infection, 20.4% syphilis, 13.1% HBV, 1.7%, 8.8% Amoebiasis. In LGBT Center was 2.9% for HIV infection, 9.9% syphilis, 8.9% HBV, 1.4% Amoebiasis. The percentage of using recreational drugs among MSM enrolled in LGBT Center (24.0%) is significant higher than MSM in Gay sauna (16.1%).
Conclusions
The HIV/STI prevalence and risky behaviors of MSM enrolled in venues are different. Meth-amphetamine using is a serious health issue for young MSM. Comprehensive prevention services provided within venue may reduce undiagnosed HIV infection among MSM. These findings highlight the need for more comprehensive HIV prevention efforts for MSM in different venue.
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