Introduction: Men who have sex with men (MSM) are more likely to experience Intimate partner violence (IPV) during their lifetime than heterosexual couples. HIV-status and related HIV stigma may play an important role in IPV within intimate partnerships among MSM. HIV- and MSM-related stigmas are common among Chinese MSM, yet there is sparse literature on IPV and its relationship with stigma in this vulnerable population. We evaluate the prevalence of IPV and its relationship with HIV- and MSM-related stigma among newly diagnosed HIV-infected MSM in Beijing, China. Methods: Data were collected in the baseline survey among newly HIV-diagnosed Chinese MSM in a randomized clinical trial via face-to-face interviews. Simple and multiple logistic regression analyses were performed to assess the associations between IPV and HIV- and MSM-related stigma. Results: Of 367 newly HIV-diagnosed Chinese MSM, 23.7% experienced any IPV, including 16.6% physical, 7.4% psychological and 5.2% sexual IPV. Positive associations were found between HIV- and MSM-related stigma and IPV. Men with high HIV-related stigma (score ≥27) were 1.68 times as likely to experience any IPV as those with low stigma (adjusted odds ratio [AOR]: 1.68, 95% confidence interval [CI]: 1.03-2.76). Men with high MSM-related stigma (score ≥6) were 1.98 times as likely to experience any IPV as those with low stigma (AOR: 1.98, 95% CI: 1.19-3.31). Men with high HIV- and MSM-related stigma were 2.86 times as likely to experience any IPV as those with low stigma (AOR: 2.86, 95% CI: 1.44-5.69). Conclusion: HIV- and MSM-related stigma was positively associated with IPV experiences among newly diagnosed MSM in China. The manner in which stigma may exacerbate IPV, and/or the influence of IPV on worsening stigma should be further evaluated. The high prevalence of IPV and stigma in this population suggests that interventions should be taken to reduce stigma and prevent this risky behavior among MSM.

L’histoire naturelle de l’infection anale par le virus du papillome de type 16 (VPH-16) est mal définie pour les hommes ayant des relations sexuelles avec d’autres hommes (HARSAHs) VIH-séropositifs. Le but de cette étude était d’évaluer l’association entre la charge épisomale et intégrée du VPH-16 et la progression de la néoplasie intraépithéliale anale (AIN). Les charges épisomales et intégrées du VPH-16 furent mesurées par PCR quantitatif en temps réel sur 665 spécimens anaux obtenus de 135 hommes VPH-16-positifs participant à l’étude prospective HIPVIRG (Human Immunodeficiency and Papilloma VIrus Research Group). Le grade de l’AIN fut déterminé sur des biopsies obtenues lors des anuscopies à haute résolution périodiques. L’intégration du VPH-16 fut confirmée par DIPS-PCR pour démontrer la présence de jonctions virales-cellulaires. La charge épisomale du VPH-16 [ratio de cote (OR) 1.5, intervalle de confiance (IC) à 95%=1.1–2.1], le nombre de types de VPH [OR 1.4 (IC 95%=1.1–1.8)] et le tabagisme actuel [OR 4.8 (IC 95%=1.3–18.6)], mais non la charge intégrée, furent associés aux lésions de haut-grade (AIN-2,3) après ajustement pour l’âge et le décompte des lymphocytes CD4. La charge épisomale du VPH-16 était le seul facteur prédictif de progression de l’AIN de bas-grade (AIN-1) vers l’AIN-2,3 [OR 8.0 (IC 95%=1.2–55.4)]. Les spécimens avec une charge épisomale du VPH-16 élevée étaient moins susceptibles de contenir de l’intégration [OR 0.5 (IC 95%=0.3–0.8)]. L’intégration du VPH-16 fut détectée en absence d’AIN, dans l’AIN-1 et dans l’AIN-2,3. L’analyse des jonctions virales-cellulaires ne permit pas d’identifier un site d’intégration spécifique. / The natural history of human papillomavirus type 16 (HPV-16) anal infection is undefined among HIV-seropositive men having sex with men (MSM). The aim of this study was to assess the association between HPV-16 episomal and integrated viral loads and the progression of anal intraepithelial neoplasia (AIN). HPV-16 episomal and integrated loads were measured on 665 specimens from 135 HPV-16-positive men participating in the prospective HIPVIRG (Human Immunodeficiency and Papilloma VIrus Research Group) study. AIN grade was evaluated on biopsies obtained during periodical high-resolution anoscopies. HPV-16 integration was confirmed by DIPS-PCR to demonstrate the presence of viral-cellular junctions. HPV-16 episomal loads [odds ratio (OR) 1.5, 95% confidence interval (CI)=1.1–2.1], burden of HPV infection [OR 1.4 (95% CI=1.1–1.8)] and current smoking [4.8 (95% CI=1.3–18.6)], but not integrated loads, were associated with high-grade lesions (AIN-2,3) after age and CD4 counts adjustment. A high HPV-16 episomal load was the only predictive factor of progression from low-grade AIN to high-grade AIN [OR 8.0 (95% CI=1.2–55.4)]. Specimens with higher HPV-16 episomal loads were less likely to contain integration [OR 0.5 (95% CI=0.3–0.8)]. HPV-16 integration was detected in the absence of AIN, in AIN-1 and in AIN-2,3. The analysis of the viral-cellular junctions did not allow identifying a specific site of integration.

Made available in DSpace on 2016-04-28T20:38:06Z (GMT). No. of bitstreams: 1 Roberto Garcia.pdf: 3656242 bytes, checksum: bf0a4acdaa32cc9c59550a43e611dd9e (MD5) Previous issue date: 2012-05-09 / Since its beginning, the Aids epidemic has established a series of social representations which hampers the daily life of men who have sex with men (MSM) living with HIV, who see themselves as doubly stigmatized due to their sexual orientation. The main objective of this study is observing the experience of stigma and discrimination in man who has sex with men living with HIV. With this ample target in mind, the specific objectives are: firstly, to observe the possible implications that HIV may cause on seropositive individuals as regards to perception of disease, self-perception as infected, social network, sexual orientation and involved contexts of vulnerability; and secondly, to observe the differences in the experiences of HIV-positive MSM through diagnosis disclosing to the social network by individuals infected before chronification and those infected after chronification. Based on the Theory of Social Representations, this work adopts the technique of the Discourse of the Collective Subject (LEFEVRE & LEFEVRE, 2010), a method of quali-quantitative nature. The corpus of the study is formed by a sample of thirty three MSM living with HIV, between 20 and 60 years of age, from a municipal clinic at the Greater São Paulo. The results reveal a high index of stigma and discrimination, manifested by sensations of fear, rejection, constant state of alert and guilt, in a social network that is fragile and unreliable. These high indexes were reflected in the increase of vulnerability of these individuals, demonstrated by the non-use of condom, by the fear of aggression, by the discrimination and the isolation, among others / A epidemia da aids, desde seu início, vem estabelecendo uma série de representações sociais que dificultam o cotidiano de homens que fazem sexo com homens (HSH) vivendo com HIV, que se veem duplamente estigmatizados devido à sua orientação sexual. O objetivo geral deste estudo é observar a experiência de estigma e discriminação em homem que faz sexo com homens vivendo com HIV. Partindo desse objetivo amplo, os objetivos específicos são: primeiro, observar as possíveis implicações que o HIV pode ocasionar nos indivíduos soropositivos, no que tange à percepção da doença, percepção de si enquanto infectado (autopercepção), à rede social, à orientação sexual e aos contextos de vulnerabilidade envolvidos; e segundo, observar as diferenças nas experiências dos HSH HIV+ por meio da revelação do diagnóstico à rede social, pelos indivíduos que se infectaram antes e os que se infectaram depois da cronificação. Fundamentada na Teoria das Representações Sociais, esta dissertação adota a técnica do Discurso do Sujeito Coletivo (LEFEVRE e LEFEVRE, 2010), que é um método de natureza qualiquantitativa. O corpus de estudo compõe-se de uma amostra de trinta e três HSH vivendo com HIV, entre 20 a 60 anos, de uma clínica municipal da Grande São Paulo. Os resultados mostraram alto índice de estigma e discriminação, manifestadas pelas sensações de medo, rejeição, constante estado de alerta e culpa, em uma rede social frágil e não confiável. Estes índices elevados refletiram-se no aumento da vulnerabilidade desses sujeitos, demonstrado pelo não uso da camisinha, pelo medo de ser agredido, pela discriminação e pelo isolamento, dentre outros

Young African American men who have sex with men (AAMSM) are at greater risk of being infected with the human immunodeficiency virus (HIV) and less likely to seek HIV testing than are members of other demographic groups. This behavior results in a significant public health threat because young AAMSM with an unrecognized HIV infection are less likely to practice safer sex and, therefore, more likely to pass the infection on to their partners. This study is an examination of the social and personality factors that influence HIV testing rates among young AAMSM, using Aday's model of the social determinants of health and the Big Five model of personality as the theoretical frameworks. A cross-sectional design was employed, and social networks were used to recruit study respondents. Forty-three young AAMSM completed online questionnaires, and multiple regression techniques were used to examine relationships among the variables of interest. Statistical analysis indicated that neither the social risk factors derived from Aday's model nor the Big Five model predicted HIV testing. However, it is unknown whether these nonsignificant findings are attributable to a genuine lack of influence or the unique characteristics of the sample. Given the null results of this study and the mixed findings of prior research, further studies are required to draw conclusions regarding the influence of social and personality factors on HIV testing in this high-risk group. Additional research could be helpful in developing more effective strategies for encouraging HIV testing among young AAMSM. The potential for positive social change lies in slowing the spread of HIV through this vulnerable population and in engaging young AAMSM in the medical system to improve their long-term health prospects.

Trends toward increased integration and miniaturization of optical system components have created pressure to consolidate widely disparate analog and digital functions onto fewer and fewer chips with a goal of eventually built into a single mixed-signal chip. Yet, because of those performance requirements, the frontend circuit has traditionally used III-V compound semiconductor technologies, but the low-level of integration with other digital ICs limits the sustainability of such end products for short-distance applications. On the other hand, their CMOS counter parts, despite having such advantages as low power consumption, high yield that lowers the cost of fabrication, and a higher degree of integration, have not performed well enough to survive in such a noisy environment without sacrificing other important attributes. In this research, a high-speed CMOS preamplifier was designed and fabricated through TSMC 0.18/spl mu/m mixed-signal non-epi CMOS technology, and a 20/spl mu/m diameter InGaAs thin-film Inverted-MSM photodetector with a responsivity of 0.15A/W at a wavelength of 1550/spl mu/m was post-integrated onto the circuit. The circuit has a overall transimpedance gain of 60dB/spl Omega/, and bit-error-rate data and eye-diagram measurement results taken as high as 10Gbit/s are reported in this dissertation.

L’histoire naturelle de l’infection anale par le virus du papillome de type 16 (VPH-16) est mal définie pour les hommes ayant des relations sexuelles avec d’autres hommes (HARSAHs) VIH-séropositifs. Le but de cette étude était d’évaluer l’association entre la charge épisomale et intégrée du VPH-16 et la progression de la néoplasie intraépithéliale anale (AIN). Les charges épisomales et intégrées du VPH-16 furent mesurées par PCR quantitatif en temps réel sur 665 spécimens anaux obtenus de 135 hommes VPH-16-positifs participant à l’étude prospective HIPVIRG (Human Immunodeficiency and Papilloma VIrus Research Group). Le grade de l’AIN fut déterminé sur des biopsies obtenues lors des anuscopies à haute résolution périodiques. L’intégration du VPH-16 fut confirmée par DIPS-PCR pour démontrer la présence de jonctions virales-cellulaires. La charge épisomale du VPH-16 [ratio de cote (OR) 1.5, intervalle de confiance (IC) à 95%=1.1–2.1], le nombre de types de VPH [OR 1.4 (IC 95%=1.1–1.8)] et le tabagisme actuel [OR 4.8 (IC 95%=1.3–18.6)], mais non la charge intégrée, furent associés aux lésions de haut-grade (AIN-2,3) après ajustement pour l’âge et le décompte des lymphocytes CD4. La charge épisomale du VPH-16 était le seul facteur prédictif de progression de l’AIN de bas-grade (AIN-1) vers l’AIN-2,3 [OR 8.0 (IC 95%=1.2–55.4)]. Les spécimens avec une charge épisomale du VPH-16 élevée étaient moins susceptibles de contenir de l’intégration [OR 0.5 (IC 95%=0.3–0.8)]. L’intégration du VPH-16 fut détectée en absence d’AIN, dans l’AIN-1 et dans l’AIN-2,3. L’analyse des jonctions virales-cellulaires ne permit pas d’identifier un site d’intégration spécifique. / The natural history of human papillomavirus type 16 (HPV-16) anal infection is undefined among HIV-seropositive men having sex with men (MSM). The aim of this study was to assess the association between HPV-16 episomal and integrated viral loads and the progression of anal intraepithelial neoplasia (AIN). HPV-16 episomal and integrated loads were measured on 665 specimens from 135 HPV-16-positive men participating in the prospective HIPVIRG (Human Immunodeficiency and Papilloma VIrus Research Group) study. AIN grade was evaluated on biopsies obtained during periodical high-resolution anoscopies. HPV-16 integration was confirmed by DIPS-PCR to demonstrate the presence of viral-cellular junctions. HPV-16 episomal loads [odds ratio (OR) 1.5, 95% confidence interval (CI)=1.1–2.1], burden of HPV infection [OR 1.4 (95% CI=1.1–1.8)] and current smoking [4.8 (95% CI=1.3–18.6)], but not integrated loads, were associated with high-grade lesions (AIN-2,3) after age and CD4 counts adjustment. A high HPV-16 episomal load was the only predictive factor of progression from low-grade AIN to high-grade AIN [OR 8.0 (95% CI=1.2–55.4)]. Specimens with higher HPV-16 episomal loads were less likely to contain integration [OR 0.5 (95% CI=0.3–0.8)]. HPV-16 integration was detected in the absence of AIN, in AIN-1 and in AIN-2,3. The analysis of the viral-cellular junctions did not allow identifying a specific site of integration.

BACKGROUND The coverage of HIV/AIDS behavioral surveillance among MSM in China falls far short of what is necessary as the current approach is expensive and time consuming. In addition MSM are difficult to reach in China. Internet-based behavioral surveys have demonstrated a number of advantages compared with the traditional paper-pen method. Chinese MSM are avid users of the Internet. Use of the internet provides an opportunity to access this hard-to-reach population and explore their use of the Internet for sexual purposes as well as to assess risk behaviors among MSM internet users. This thesis aimed to explore the trends in risk behaviors and HIV prevalence among MSM using traditional community-based surveys and Internet surveys, and to analyze the potential of web-based behavioral surveillance among MSM by comparing the differences between Internet and community-based MSM samples, and then to provide insights for the future HIV/AIDS behavioral surveillance, epidemic estimation and prediction as well as health intervention among the Chinese MSM population. METHODS This study has three components. The first focuses on trends in HIV risk behaviors and prevalence among MSM in Harbin in northeast China, based on community-based surveys. Eligible participants were approached by peer recruiters in traditional gay venues and then interviewed by health professionals with a standard questionnaire. Urine samples were collected to screen their HIV status. The second part presents two cross-sectional, Internet-based surveys among MSM in China in 2006 and 2007. The study website was advertised on three selected gay websites using a series of banners, pop-ups and text notifications. After providing consent to the survey, eligible participants were invited to complete an online questionnaire. The third component compares the demographic characteristics and risk behaviors of two samples of Chinese MSM. Participants living in Heilongjiang Province were extracted from the 2006 online survey dataset to compare with the community sample of MSM recruited in Harbin, the capital city of Heilongjiang Province in the same year. KEY FINDINGS Community-based behavioral surveillance Among MSM in Harbin, a trend was observed towards more self-identifying as homosexual (from 58% to 80%) and more living with a male partner (from 12% to 41%) over the study period 2002-06. Although there was a trend towards a reduction in the rate of never using a condom and an increase in the rate of always using condoms during anal sex in the past six months, the prevalence of unprotected anal intercourse (UAI) still remained at high level (from 90% in 2002 to 72% in 2006). Most respondents reported having multiple male sexual partners (≥ 2) in the past six months: 86.5% in 2002, 76.0% in 2004 and 91.6% in 2006. The HIV prevalence (2.2%, 15/674) among MSM in Harbin in 2006 was higher than that in previous survey years (1.3% in 2002 and 0.94% in 2004), but no statistically significant change was detected. Internet-based behavioral surveys Gay website users in China are young and well educated. The majority (85%) have used the Internet to seek sex and meeting sexual partners online, which is one of the most common reasons for visiting gay websites. Traditional gay venues still play an important role in the sex seeking process, especially for MSM who are older and less educated. Gay website users are vulnerable to HIV/AIDS given their high prevalence of UAI (56.6%) and multiple male sexual partners (66.5%). The type of partners plays an important role in determining consistent condom use. An increase in condom use was observed among MSM having sex between commercial partners relative to those having sex with non-regular partners and regular partners. Among the Internet sample, participants who have regular partners are less likely to have sex with females, less likely to have multiple partners and less likely to engage in commercial sex behaviors than those who do not. Comparisons between Internet and community samples There are significant differences in terms of demographic characteristics and risk behaviors between the Internet and community samples of MSM. The Internet sample was significantly younger, more educated and more likely to be students and self identify as homosexual. Among those who had anal sex in the past six months, the Internet sample tended to use condoms less consistently than the community sample. However, using the total sample size as the denominator to calculate the prevalence of UAI, no significant difference between the two samples was observed (AOR 1.02, CI 0.73-1.43, p = 0.905). After adjusting for differences in demographic characteristics, the community sample was more likely to have had sex with females (AOR 2.01, CI 1.22-3.30, p = 0.006) and have had ≥ 6 male partners in the previous six months than the Internet sample (46.1% vs. 20.2%; AOR 4.88, CI 3.51-6.80, p < 0.001). The mean number of male partners for the community sample was 13.5 ± 16.8, whereas it was 6.0 ± 12.2 for the Internet sample. CONCLUSIONS Although there is a trend towards an increase in condom use among MSM in China, they are vulnerable to HIV/AIDS infection given their high prevalence of UAI and multiple sexual partners. Public sector officials at all levels need to recognize this risk for HIV transmission. Health promotion and behavioral interventions should be enforced and scaled up to meet the need for controlling HIV transmission among MSM in China. Since the Internet has become a risk environment for MSM and the online MSM population is significantly different from the traditional community MSM group, online MSM should be included as a risk group in national HIV sentinel and behavioral surveillance and the coverage of surveillance for this specific group should be expanded to better understand the health promotion needs of this community as part of an HIV/AIDS strategy in China. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1339648 / Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2008

Since the early 1990s with the AIDS pandemic, there has been an increasing interest on the importance of risky sexual behaviors, especially among men who have sex with men (MSM). An important antecedent for these behaviors is alcohol use. Studies consistently show an increased frequency of both alcohol use and risky sexual behaviors in MSM populations. However, to date, there has not been a precise estimate of the effect size in these diverse populations and a consistent way to measure it. More so, the importance of context is often cited as a source of variability, but is rarely measured in these studies. Contextual factors are different and specific for MSM, as they have been approached by two theories, both of which will be guiding this dissertation: Singer’s Syndemic Theory and Meyer’s Minority Stress Theory. Chapter 1, then presents a comprehensive review of both theories as they apply to alcohol use, risky sexual behaviors, and contextual factors driving them. Chapter 2 answers the first research question about effect sizes through a systematic literature review. The effect sizes or measures of association of these contextual risk and protective factors were summarized using meta-analytic techniques. Using five electronic databases, we identified 26 studies in 26 years (1990–2015), all diverse in terms of sampling techniques, assessment of sexual orientation, operationalization of alcohol use and risky sexual behaviors, contextual factors included, and measurement of effect sizes. Despite this diversity, studies reporting an effect size were pooled and summarized using both descriptive and meta-analytic techniques, as appropriate. Meta-analyses were conducted using Cochrane’s guidelines for generic inverse variance outcomes with random effects. The pooled effects of alcohol use on condomless anal intercourse (CAI; OR 1.73 [95% CI 1.43, 2.10], I2 0%), heavy episodic drinking on CAI (OR 1.88 [95% CI 1.25, 2.81], I2 32%), and heavy episodic drinking on condomless oral sex (OR: 8.00; 95% CI 2.48, 25.81), as well as the effects of substance use, mental health status, violence and victimization, and self-reported HIV status as contextual factors in the pathway between alcohol use and risky sexual behaviors were calculated, reported, and discussed along with study limitations and implications for public health. Chapter 3 answers the second research question regarding a standardized measurement model for effect sizes and the multiple mediation of contextual factors. We used the male subset of Wave IV of the AddHealth dataset to test our hypotheses through structural equation modeling approaches, including measurement analysis with invariance testing, path analysis for direct effects, and multiple mediation analysis through bootstrapping for indirect effects. The AUD scale was invariant between MSM and MSW, but the risky sexual behavior scale was not. For MSM, the standardized direct effect of AUD onto risky sexual behaviors was –1.25 and the standardized total indirect effect of the multiple mediation model was 1.58, 95% CI [1.42, 1.73]. Among the mediators, the strongest indirect effect for any measured or latent mediator was the mental health construct (2.09). We conclude that even though AUD has the same measurement structure for MSM and MSW, its effect on risky sexual behaviors does not operate the same way for these two populations, supporting both causal and contextual behavioral theories. Conclusions are individually discussed, respectively, in Chapters 2 and 3. However, Chapter 4 puts both manuscript conclusions in context and further discusses future implications for public health research, practice, and policy.

In 2010, men who have sex with men (MSM) represented 4% of the population in the United States (US) and accounted for 78% of all new Human Immunodeficiency Virus (HIV) infections among Hispanic men. Hispanic men who have sex with men (HMSM) accounted for the third largest number of new HIV infections (6,700 cases). This dissertation explored the effects of age, loneliness, substance use, depression, and social support on high risk sexual behaviors that predispose middle aged HMSM to sexually transmitted infections (STIs) and HIV infection risk. A sample of 150 urban HMSM aged 40 to 65 were surveyed in this study. Singer’s Syndemics Theory (1996) provided this study’s theoretical framework. Data was analyzed using a variety of parametric and non-parametric statistics. Loneliness, social support, depressive symptoms, alcohol/drug use, and sexual risk behaviors were found to have an influence on HIV infection status in this study. Partner status, religious affiliation and age did have an influence on alcohol use in this study’s participants. Also, participants with increased age had increased depressive symptoms in this study. Lastly, depressive symptoms, substance use, social support, and loneliness did have an influence on sexual risk behaviors in this study’s participants, specifically alcohol use and illicit drug use. The findings from this study should be used to assess, diagnose, plan, implement and evaluate prevention strategies geared to reduce STI and HIV infection in this population. Future research should build on these findings and develop tailored risk reduction interventions addressing HMSM, with particular attention to the understudied age group of the middle aged HMSM.

Mots clés : Groupe à Haut risque - Typologie - TS - HSH –VIH -IST- Afrique CentraleProblématique : Les femmes travailleuses du sexe (TS) et les hommes qui ont des rapports sexuels avec des hommes (HSH) constituent les populations les plus à risque d’infection au VIH dans différents pays d’Afrique subsaharienne. A ce jour, très peu d’interventions sont menées pour réduire le risque d’infection en influant sur les facteurs de risque dans ces deux populations en Afrique Centrale et particulièrement en République Centrafricaine. Les objectifs de cette thèse étaient d’établir une typologie documentée des transactions sexuelles féminines à Bangui et de mesurer la prévalence du VIH et des comorbidités associées dans ces deux populations.Méthodologie : D’abord de 1384 femmes volontaires sensibilisées ont été recrutées sur les lieux de leurs activités et orientées au niveau du site de l’enquête. Parmi lesquelles 345 ont été identifiées comme travailleuses du sexe. Et, par effet « boule de neige », 131 Hommes ayant des rapports sexuels avec des Hommes (HSH) ont été recrutés pour constitués la deuxième population de l’étude. Des analyses biologiques ont été effectuées. Un volet d’entretien est réalisé auprès de 20 TS.Résultats : Les résultats en ce qui concerne les TS montrent que cette pratique est très hétérogène et que la prévalence du VIH varie selon les catégories. Ainsi, la prévalence du VIH était de 6 fois plus élevé chez les "katas" que chez les "pupulenge" (39,1% contre 6,3%). Parmi les TS non professionnel, les «élèves/étudiants», «fonctionnaires ou salariées » et «femmes au foyer» étaient moins infectées par le VIH (6,1%, 9,8%, 13,0%, respectivement), tandis que les «vendeuses ambulantes», constituait la catégorie la plus touchées par le VIH (31,9%). Et, l'infection à VIH était fortement associée à la pratique du sexe anal avec les clients (OR ajusté, 4.3), à l'utilisation ou non du préservatif avec les clients (OR ajusté, 24.9), à la consommation d'alcool avant le travail du sexe (OR ajusté, 2.8) et à la notion d’antécédents d'IST (OR ajusté, 4.2).La population de HSH à Bangui est identifiée pour la première fois comme un groupe à haut risque pour l’infection à VIH, étant 5 fois plus infectées par le VIH que la population générale d'adultes hétérosexuels. Parmi eux 20 % étaient infectés par le virus de l'hépatite B (VHB) (Ag HBs), dont 6 cas étaient co- infectés par le VIH et le VHB et dans 3,8 % cas la sérologie positive pour la syphilis. Les HSH à Bangui ont donc besoin d'interventions d'urgence spécifiques de prévention et de soins de santé.Conclusion : Les résultats de ce travail permis de mieux caractérisés et documentés les populations des femmes TS et les HSH à Bangui. Deux groupes de populations « originales » pour la République Centrafricaine, vulnérables et à haut risque d’infection à VIH. / Keywords : high risk group- typology - FSW - MSM –HIV -STD- Central AfricanBackground: The population of female sex workers (FSW) and the group of men who have sex with men (MSM) constitutes a priori an important core group of HIV transmission. In the context of the Central African Republic the situation of FSW and MSM is yet unknown. The objectives of this thesis were to establish a documented typology of female sexual transactions in Bangui and to measure the prevalence of HIV and associated comorbidities in these two populations.Materials and Methods: First 1384 sensitized female volunteers were recruited to the site of their activities and oriented at the survey site. Finally, 345 FSW questionnaires were selected for study analysis. MSM were recruited on a voluntary basis by the way of local network of nonprofit organizations working in the field of HIV infection. Included MSM were referred to the National STD center of Bangui for social, behavioral and medical evaluation. After collection of social and behavioral characteristics, each participant received a physical examination and a blood sample was taken for HIV and STD testing.Main results: Female prostitution in the CAR is remarkably heterogeneous. Risk-taking regarding HIV infection is very different between each category of female prostitution. HIV varied according to FSW categories, Thus, HIV prevalence was 6-fold higher among « kata » than « pupulenge » (39.1% versus 6.3%).Among non professionnal FSW, « students », « civil servants » and « housewifes » were the less infected (6.1%, 9.8%, 13.0%, respectively), whereas « sellers » constituted the category of highest HIV prevalence (31.9%).HIV infection in the whole study FSW population was strongly associated with anal sex practice with last clients (adjusted OR, 4.3), condom use in last 3 months (adjusted OR, 24.9), alcohol consumption before sex (adjusted OR, 2.8) and past history of STIs (adjusted OR, 4.2). The population of MSM in Bangui is identified for the first time as a yet unexpected high-risk group for HIV, being 5-fold higher HIV-infected than the general adult heterosexual population. The 131 (100%) MSM accepted blood sampling: 24 % were HIV-1-infected; 20% were infected by hepatitis B virus (HBV) (Ag HBs), including 6 cases of co-infection by HIV and HBV; 3,8 % showed positive syphilis serology. The MSM in Bangui, needing urgently specific interventions for prevention and heath care.Conclusion: The results of this work led to better characterized and documented populations of women and TS MSM in Bangui. Two groups population "original" for the Central African Republic, vulnerable and at high risk of HIV infection.