Lack of evidence of sexual transmission of hepatitis C virus in a prospective cohort study of men who have sex with men

OBJECTIVES: We studied the prevalence and incidence of hepatitis C virus (HCV) infection in the ongoing Omega Cohort Study of men who have sex with men (MSM). METHODS: From January to September 2001, consenting men (n = 1085) attending a follow-up visit to the ongoing Omega Cohort Study were tested for HCV. If the test results were positive for HCV, we compared them with test results from previous serum samples collected from the time of entry into the original cohort study to determine the time of infection. RESULTS: HCV prevalence at entry was 2.9% and was strongly associated with injection drug use (32.9% vs 0.3%, P<.0001). Only 1 seroconversion was identified in 2653 person-years of follow-up (incidence rate = 0.038 per 100 person-years). The seroconverter was an active injection drug user who reported needle sharing. CONCLUSIONS: Sexual transmission of HCV among MSM appears to be rare.     

天津市男男性行为人群随访干预的效果评价

目的 评价天津市MSM人群随访干预效果,为后续研究的开展提供参考依据。方法 2013年4月至2017年9月,在天津市通过MSM活动场所和移动互联网招募MSM,建立前瞻性开放队列,并每6个月施加随访干预,评价随访干预效果。结果 基线共招募MSM 1 822人,符合纳入标准1 007人,累积随访干预时间为2 216.96人年,HIV共阳转39例,HIV阳转密度为1.76/100人年。梅毒阴性934人,累计随访观察时间为1 959.94人年,梅毒阳转100例,梅毒阳转密度为5.10/100人年。艾滋病知识知晓率随着宣传和干预活动很快发生改善;与同性性伴、同性固定性伴、同性临时性伴发生肛交的比例在干预后增加,但肛交安全套的使用率也有所增加;随访干预超过3次后安全套使用率有所下降。广义估计方程（GEE）分析结果显示,大专及以上文化程度（aOR=0.81,95% CI：0.68～0.98）,艾滋病知识知晓（aOR=0.52,95% CI：0.36～0.75）,最近6个月曾接受过安全套宣传（aOR=0.60,95% CI：0.49～0.74）,样本来源为移动互联网（aOR=0.85,95% CI：0.73～1.00）,累计干预1次（aOR=0.55,95% CI：0.45～0.66）、2次（aOR=0.38,95% CI：0.30～0.49）、3次（aOR=0.26,95% CI：0.20～0.35）、≥4次（aOR=0.24,95% CI：0.17～0.33）是无保护肛交的保护因素;最近6个月曾被诊断为性病（aOR=1.43,95% CI：1.06～1.96）,最近6个月使用过助性剂（aOR=1.22,95% CI：1.02～1.47）是无保护肛交的危险因素。结论 经过随访干预后,天津市MSM队列HIV和梅毒感染处于低水平;艾滋病知识知晓率发生改善,肛交安全套使用率有所提升;但MSM人群发生无保护肛交的影响因素很多,建议专门开展MSM人群无保护肛交的持续干预。     

Recent decline in the incidence of human immunodeficiency virus infection among California men who have sex with men

Monitoring the incidence of human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) is imperative for developing targeted prevention programs and evaluating their effectiveness. The authors used California counseling and testing data to estimate the temporal trend in HIV incidence among MSM in California. HIV incidence rates were retrospectively calculated among MSM who had received at least 1 HIV test at a public California counseling and testing site between 1997 and 2007 and had a prior HIV-negative test from any HIV testing source. All study subjects were weighted on the basis of the interval between the last HIV-negative test and the current HIV test to account for the right-truncation bias introduced by more frequent testers. The authors observed that the HIV incidence rate among MSM in California increased from 2.0/100 person-years (95% confidence interval (CI): 1.8, 2.2) in 1997 to 2.4/100 person-years (95% CI: 2.2, 2.6) in 2003 and then decreased to 1.9/100 person-years (95% CI: 1.7, 2.0) in 2006. Trend analyses showed that both the increase (P < 0.001) and the decrease (P < 0.01) were statistically significant. The study showed that HIV incidence among MSM in California had decreased since 2003.     

青岛市男男性行为人群新型毒品滥用者HIV新发感染队列研究

目的 了解与分析青岛市MSM新型毒品滥用者HIV新发感染情况,为该人群开展艾滋病预防工作提供参考。方法 采用开放式队列研究方法,从2017年3月开始,由社会组织通过滚雪球抽样招募HIV阴性的MSM新型毒品滥用者,建立开放队列,并每6个月进行一次随访调查,观察终点为2022年7月31日。按照队列研究样本量计算公式估计样本量为436人。调查内容包括人口学特征、性行为特征、艾滋病知识知晓情况、新型毒品滥用情况和HIV检测情况等信息。以随访中出现HIV新发感染为结局因变量,同时,以研究对象进入队列至出现HIV新发感染的时间作为时间因变量,采用Cox比例风险回归模型分析MSM新型毒品滥用者HIV新发感染的影响因素。结果 共招募MSM新型毒品滥用者987人,纳入随访队列826人。HIV新发感染者46人,队列随访累积观察时间1 960.68人年,HIV新发感染率为2.35/100人年。多因素Cox回归分析显示,<30岁（aHR=3.04,95%CI：1.62~5.71）、外省户籍（aHR=2.29,95%CI：1.20~4.39）、线下交友（aHR=4.62,95%CI：2.05~10.41）、同性性伴数>4个（aHR=3.06,95%CI：1.59~5.88）、性交时安全套破损（aHR=2.24,95%CI：1.21~4.17）和性交时出血（aHR=2.56,95%CI：1.31~5.03）的MSM新型毒品滥用者更有可能发生HIV新发感染。结论 青岛市MSM新型毒品滥用者HIV新发感染率总体较低,但该人群知行分离的现象严重,HIV感染风险较高。HIV新发感染的影响因素包括低年龄、外省户籍、线下交友、多性伴、性交时安全套发生破损和出血,应加强开展该人群行为干预的工作。     

High-risk behaviors among men who have sex with men in 6 US cities: baseline data from the EXPLORE Study

OBJECTIVES: We describe the prevalence of risk behaviors at baseline among men who have sex with men (MSM) who were enrolled in a randomized behavioral intervention trial conducted in 6 US cities. METHODS: Data analyses involved MSM who were negative for HIV antibodies and who reported having engaged in anal sex with 1 or more partners in the previous year. RESULTS: Among 4295 men, 48.0% and 54.9%, respectively, reported unprotected receptive and insertive anal sex in the previous 6 months. Unprotected sex was significantly more likely with 1 primary partner or multiple partners than with 1 nonprimary partner. Drug and alcohol use were significantly associated with unprotected anal sex. CONCLUSIONS: Our findings support the continued need for effective intervention strategies for MSM that address relationship status, serostatus of partners, and drug and alcohol use.     

北京市男男性行为者HIV和梅毒螺旋体血清抗体阳转率及影响因素

目的 了解北京市男男性行为者(MSM)的HIV和梅毒螺旋体血清抗体阳转情况及其影响因素. 方法 在北京市以社区为基础招募HIV阴性的MSM共525名,以一对一的方式进行问卷调查,收集人口学和行为学情况资料,在第6、12个月进行随访,并采集血样进行HIV和梅毒螺旋体抗体检测,初筛均采用ELISA法,确证分别采用蛋白印迹(WB)和凝集法. 结果 基线共调查550名,HIV和梅毒螺旋体血清抗体阳性率分别为4.5%(25/550)和29.3%(161/550),HIV血清抗体阴性队列525名,随访12个月,队列保持率为87.0%(457/525),HIV和梅毒螺旋体血清抗体阳转率分别为3.37/100人年和9.32/100人年.近3个月同性性行为后冲洗直肠者阳转率为7.11/100人年,未冲洗者为0.76/100人年,冲洗与HIV血清抗体阳转相关(HR=9.23,95%CI=2.08～40.88).近3个月在公园、公厕或浴池寻找男性性伴者阳转率为41.77/100人年,无该行为者阳转率为7.97/100人年;近3个月同性性行为后冲洗直肠者阳转率为16.17/100人年,无该行为者阳转率为4.92/100人年;近3个月在公园、公厕或浴池寻找男性性伴(HR=4.67,95%CI=1.77～12.34)和近3个月同性性行为后冲洗直肠(HR=3.09,95%CI=1.40～6.83)与梅毒螺旋体血清抗体阳转相关. 结论 北京市MSM的HIV和梅毒螺旋体血清抗体阳转情况十分严重,主要影响因素为同性性行为后冲洗直肠、到公园等场所寻找男性性伴.

Abstract：

Objective To study the incidence and risk factors of HIV and syphilis seroconversion among men who have sex with men(MSM) in Beijing. Methods A total of 550 MSM were recruited on the basis of community and followed up after 6 and 12 months in Beijing.Each subject was investigated by only one investigator at one time to collect information on demographics and behaviors.Blood samples were collected to test HIV and syphilis seroconversion.ELISA was used for screening test,west blotting(WB) and Particle agglutination were used for confirmatory test. Results A total of 550 MSM investigated,among which 4.5% (25/550) were HIV-positive and 29.3% (161/550) were syphilis-positive.For 525 HIVnegative MSM,87.0% (457/525) retained during the 12-month investigation.Seroincidences for HIV and syphilis were 3.37/100 person-years (95% CI = 1.66-5.08) and 9.32/100 person-years (95% CI =5.87-12.77) respectively.HIV seroconversions for those who performed and did not perform rectal douching after homosexual anal intercourse in the past 3 months were 7.11/100 and 0.76/100 person-years respectively.Multivariate Cox regression analysis revealed that rectal douching after homosexual anal intercourse in the past 3 months(HR=9.23,95%CI =2.08-40.88) was significantly associated with HIV seroconversion.Syphilis seroconversions for those who met male sex partners in parks,public washrooms or bathhouses in the past 3 months were 41.77/100 and 7.97/100 person-years respectively.Syphilis seroconversions for those who performed and did not perform rectal douching after homosexual anal intercourse in the past 3 months were 16.17/100 and 4.92/100 person-years respectively.In the past 3 months,meeting male sex partners in parks,public washrooms or bathhouses (HR=4.67,95% CI = 1.77-12.34) and performing rectal douching after homosexual anal intercourse (HR = 3.09,95% CI=1.40-6.83) were significantly associated with syphilis seroconversion. Conclusion The seroconversions of HIV and syphilis during the follow-up visits in this MSM cohort study in Beijing were very serious,and that the associated factors for seroconversions were rectal douching after homosexual anal intercourse and meeting male sex partners in parks,public washrooms or bathhouses.     

沈阳市男同性恋者性病艾滋病相关KABP分析

目的 掌握沈阳市男同性恋人群性病艾滋病相关知识、态度及行为等现状，为制定有针对性的干预措施提供依据。方法 采用横断面调查和追踪调查相结合的方式，对342名出入酒吧的男同性恋者进行问卷调查及自愿检测。结果 调查对象年龄较轻，文化程度普遍较高，但艾滋病相关知识较缺乏，知识来源主要为电视、报纸及互联网，59.1％的人进行了HIV及梅毒检测，其中抗HIV阳性率为1％，梅毒(TPPA)阳性率为20.8％，11.7％认为自己很可能被感染HIV，47.1％觉得有50％的可能性。首次性行为年龄中位数为18岁，性伴数较多，平均为4.4个。且近半年36.3％的人有过女性性伴。91.5％近半年内有过肛交史，每次均使用安全套者只占11.1％。不用的原因是不喜欢或没必要。结论 本次调查的男同性恋者感染及传播艾滋病的危险行为普遍存在，相关知识知晓率低。安全套使用率低，该人群中已经具备了艾滋病流行的条件，应立即采取有效的措施加以控制，扭转其流行态势。     

北京市男男性行为人群HIV和梅毒本底感染及新发感染调查研究

目的了解北京市男男性行为者（MSM）人类免疫缺陷病毒（HIV）和梅毒的感染情况与影响因素。方法2011年7月～2011年12月在北京招募MSM,进行本底调查,符合队列纳入标准者第3和6个月随访调查;使用平板电脑一对一问卷调查;快速检测试剂检测HIV和梅毒螺旋体抗体;统计分析使用SAS9．2统计软件包,影响因素分析单因素采用Х^2检验或Fisher确切概率法,P〈o．05的变量纳入多因素logistic回归模型分析。结果本底共招募500名MSM／HIV和梅毒感染率分别为5．60％（28／500）和26．40％（132／500）;多因素logistic回归分析显示：与HIV感染有统计学意义的因素有：最近一年未做过HIV抗体检测或不知晓检测结果（OR=2．57,95％CI：1．16～5．68）、第一次与男性发生性行为年龄≤18岁（OR=2．45,95％CI：1．07～5．62）、最近3个月发生过肛交的男性人数〉3人（OR=2．83,95％CI：1．25～6．42）;梅毒感染的独立影响因素为年龄〉30岁（OR=1．68,95％CI：1．13～2．52）、最近3个月发生过肛交的男性人数〉3人（OR=1．83,95％CI：1．15～2．92）。395名MSM进入队列,6个月随访队列保持率为88．10％（348／395）,HIV和梅毒螺旋体血清抗体阳转率分别为5．36／100人年（95%CI：2．19～8．53）和8．13／100人年（95％CI=3．53～12．73）。结论北京市MSM人群HIV／梅毒感染率及新发感染率均维持在较高水平,需要对MSM细分,以提供更有针对性的宣教及行为干预;MSM知晓检测结果与接受检测同样重要,可尝试在HIV检测咨询机构推广HIV快速检测试剂以提高检测结果知晓率。     

青岛市男男性行为人群新型毒品滥用发生率队列研究

目的 了解与分析青岛市MSM新型毒品滥用发生率及影响因素,为制定MSM艾滋病预防干预措施提供参考。方法 采用开放式队列研究方法,从2017年3月开始,依靠MSM社会组织采用滚雪球抽样方法招募未发生新型毒品滥用的MSM,建立开放队列,并每6个月进行一次随访调查,观察终点日期为2022年7月31日。调查内容包括社会人口学特征、性行为学特征和发生新型毒品滥用情况等信息。以随访过程中研究对象发生新型毒品滥用为结局因变量,以研究对象进入队列至发生新型毒品滥用的时间作为时间因变量,采用Cox比例风险回归模型分析MSM发生新型毒品滥用的影响因素。结果 共招募MSM 509人,纳入随访队列369人,发生新型毒品滥用62人,队列随访累积观察时间911.54人年,新型毒品滥用发生率为6.80/100人年。62人首次发生新型毒品滥用均为与他人共同滥用,16.13%（10/62）存在新型毒品混合滥用现象。多因素Cox比例风险回归分析显示,学生（aHR=2.17,95%CI：1.15~4.10）、最近6个月HIV检测次数0次和1次（aHR=4.57,95%CI：1.80~11.60;aHR=5.15,95%CI：2.83~9.36）、仅有固定性伴（aHR=4.75,95%CI：2.32~9.75）、同性性伴数>4个（aHR=1.70,95%CI：1.01~2.87）和性伴滥用新型毒品（aHR=12.78,95%CI：3.06~53.35）的MSM更有可能发生新型毒品滥用。结论 青岛市MSM新型毒品滥用发生率较高,存在较高HIV感染风险;发生新型毒品滥用的影响因素包括学生、HIV检测次数较少、仅有固定性伴、多性伴和性伴滥用新型毒品,应针对此部分人群加强干预力度,开展降低新型毒品危害的干预工作。     

Differences in substance use and sexual partnering between men who have sex with men, men who have sex with men and women and transgender women

Men who have sex with men (MSM), men who have sex with men and women (MSM/W) and transgender women (TGW) remain the populations most severely and disproportionately impacted upon by HIV in Los Angeles County. Baseline data from community-based HIV-prevention programmes serving these populations were analysed to explore differences in demographic characteristics, substance use and sexual partnering between the three groups. Despite high HIV prevalence overall (MSM 34.7% versus MSM/W 16.1% versus TGW 21.9%, p < .001), there were striking differences in risk behaviours. Higher rates of homelessness were reported by MSM/W compared to MSM and TGW. Lower rates of education and less substance use were reported by TGW (62.2%), compared to MSM (79.7%) and MSM/W (92.6%). A much higher number of male sexual exchange partners were reported by TGW (MSM 1.04 [SD = 4.8] versus MSM/W 1.54 [SD = 10.3] versus TGW 12.37 [SD = 23.9], p < .001). Findings support the need for HIV-prevention interventions that specifically address the unique risk patterns among each population in order to curb HIV acquisition and transmission.     

High risk of human immunodeficiency virus in men who have sex with men with herpes simplex virus type 2 in the EXPLORE study

The relation between herpes simplex virus type 2 (HSV-2) and human immunodeficiency virus (HIV) acquisition was evaluated among 4,295 high-risk, HIV-negative men who have sex with men in an intensive behavioral intervention (colloquially referred to as "EXPLORE") study in the United States from 1999 to 2003. Sexual behavior data were obtained by computer-assisted self-interview, and sera were collected semiannually for HIV and HSV-2 serology. HSV-2 infection was classified as "recent incident" (at the first HSV-2 seropositive visit), "remote incident" (within 24 months of the first positive visit), and "prevalent" (for visits >24 months after the first HSV-2 positive visit). Baseline HSV-2 prevalence was 20.3%. HSV-2 incidence was 1.9 (95% confidence interval (CI): 1.6, 2.2) per 100 person-years; significant risk factors were African-American race, unprotected receptive anal intercourse, an HIV-positive male sex partner, and six or more male partners in the prior 6 months. The behavioral intervention did not reduce HSV-2 acquisition (adjusted hazard ratio (HR) = 1.2, 95% CI: 0.9, 1.6). Overall HIV incidence was 1.9 (95% CI: 1.7, 2.2) per 100 person-years. HIV risk was elevated among men who have sex with men with recent incident HSV-2 (adjusted HR = 3.6, 95% CI: 1.7, 7.8), remote incident HSV-2 (adjusted HR = 1.7, 95% CI: 0.8, 3.3), and prevalent HSV-2 (adjusted HR = 1.5, 95% CI: 1.1, 2.1) infection compared with HSV-2 seronegative participants. HIV intervention strategies targeting HSV-2 prevention and suppression among men who have sex with men should be evaluated.     

Public health challenges of the emerging HIV epidemic among men who have sex with men in China

A large-scale national survey was conducted in 2008 across 61 cities throughout China, covering over 18,000 men who have sex with men (MSM). The prevalence of human immunodeficiency virus (HIV) was 4.9% and incidence ranged from 2.6 to 5.4 per 100 person-years. The prevalence of sexually transmitted diseases ranged from 2.0% to 29.9% among MSM in different parts of China. Syphilis status, recruitment of sexual partners mainly from gay saunas, duration of MSM experience, and unprotected sex with regular male sex partners and multiple male sex partners predicted HIV seroconversion. The prevalence of consistent condom use was low during anal sex, ranging from 29.4% to 37.3%. Within this context, this paper considers the factors surrounding HIV prevention activity, and identifies a number of public health challenges which need to be considered if optimum outcomes are to be achieved. HIV prevention targeting MSM is a delayed response. The high risk associated with gay saunas and the need for steady condom supply at these venues needs urgent consideration. In addition, approximately one-third of MSM in China reported bisexual behavior, which may be attributed to sociocultural reasons and stigma against MSM. Female sex partners of MSM are seldom aware of their exposure to high risk of HIV transmission. Finally, the primitive nature of non-government organizations for HIV prevention and issues around their sustainability pose another serious challenge for the future of HIV prevention campaigns targeting MSM in China.     

大连市男男性行为人群艾滋病危险行为调查

目的了解辽宁省大连市男男性行为人群(MSM)行为学特征及艾滋病病毒(HIV)、丙型肝炎(HCV)和梅毒感染率,探索HIV感染的影响因素。方法采用定向抽样方法招募MSM,进行面对面的问卷调查,并采血样进行HIV、梅毒和HCV检测。结果共招募932名MSM,HIV抗体阳性率3.43%(32/932),梅毒血清学阳性率12.12%(113/932),HCV抗体阳性率1.07%(10/932);最近6个月,88.73%(827/932)的调查对象曾经与男性发生过肛交;其中每次使用安全套的占52.18%;多因素Logistic回归模型提示,受教育程度低、外地户籍、最近6个月为男性提供商业性服务的男性、梅毒抗体阳性的MSM其HIV感染的风险高;最近1年接受过HIV抗体检测是HIV感染的保护因素。结论大连市MSM HIV感染率高,高危行为普遍存在。     

400例MSM行为特征及HIV、HAV、HCV、HEV、梅毒感染状况的横断面调查

目的 了解云南省玉溪市MSM人群的行为特征及HIV、HAV、HCV、HEV、梅毒感染状况,为开展有针对性的健康教育和行为干预提供依据。方法 2018年4 - 7月在玉溪市采用横断面调查,滚雪球抽样方法,共纳入400例MSM,开展行为学问卷调查,采集血液样本进行HIV、HAV、HCV、HEV和梅毒抗体检测。 结果 400例MSM中98.25%对艾滋病基本知识知晓。318例最近6个月与男性发生过肛交性行为,88.68%都坚持每次使用安全套,最近1次肛交时96.86%使用了安全套。84例最近6个月与异性发生性行为,94.05%都坚持每次使用安全套,最近1次与异性发生性行为时98.81%使用了安全套。HIV、HAV、HCV、HEV、梅毒感染率分别为3.00%（95%CI:1.33～4.67）、1.25%（95%CI:0.16～2.34）、0.25%（95%CI:0.00～0.74）、1.00%（95%CI:0.03～1.98）、4.75%（95%CI:2.67～6.83）。结论 MSM人群不仅是HIV、HCV、梅毒的高危人群,HAV、HEV也高发,需针对该人群推广接种HAV、HEV疫苗。     

中国18城市男男性接触者艾滋病社区干预效果评价

目的 评价针对男男性接触人群的艾滋病社区干预项目开展2年后的效果.方法 在7个省18个城市中开展男男性接触人群的综合干预,基线调查于2006年9月进行,通过滚雪球法共抽取5178名调查对象,终末调查于2008年5月进行,通过滚雪球法或同伴推动抽样(RDS)法在18个城市抽取5460名调查对象.对每个调查对象进行问卷调查,调查内容包括调查对象的一般人口学资料、艾滋病相关知识、行为状况和接受干预状况;同时抽取5 ml静脉血,检测人类免疫缺陷病毒(HIV)感染状况.评价干预效果.结果 经过2年的项目实施,2008年与2006年相比,调查对象艾滋病知晓率从76.0%(3933/5178)上升到90.5%(4943/5460)(X~2=451.786,P<0.01);与男性发生肛交性行为时最近1次安全套使用率从58.0%(2382/4105)上升到76.7%(3643/4750)(X~2=215.491,P<0.01);最近6个月安全套坚持使用率从28.2%(1163/4118)上升到44.5%(2114/4753)(X~2=264.606,P<0.01);做过HIV抗体检测的比率从18.8%(973/5170)提高到39.1%(2136/5454)(X~2=530.181,P<0.01);HIV感染率从2.3%(118/5178)上升到5.0%(271/5427)(X~2=47.613,P<0.01).结论 针对男男性接触者的社区干预项目促进了人群对艾滋病防治知识的掌握和安全性行为的采用.     

哈尔滨市男男性行为人群HIV新发感染及失访影响因素分析

目的 了解黑龙江省哈尔滨市MSM人群中HIV新发感染率及失访影响因素。方法 2013年4－6月在哈尔滨市MSM人群中招募661人进行前瞻性调查,分别于6、12、18个月进行随访,入组及随访时均对调查对象进行面对面问卷调查,并采集静脉血进行HIV抗体检测,计算发病密度。利用logistic回归模型探讨MSM人群队列研究中失访的影响因素。结果 随访至18个月,调查对象HIV发病密度为4.23/100人年(95%CI:2.91/100人年～5.93/100人年),队列失访率为15.4%。未接受过干预、高年龄组、低学历者及非男男同志社区组织的研究对象易失访。结论 MSM人群HIV新发感染率较高,积极依托社区组织能提高该人群随访率。     

Prevalence of HIV and sexually transmitted and blood-borne infections,and related preventive and risk behaviours,among gay,bisexual and other men who have sex with men in Montreal,Toronto and Vancouver: results from the Engage Study

ObjectivesThe last Canadian biobehavioural surveillance study of HIV and other sexually transmitted and blood-borne infections (STBBI) among gay, bisexual and other men who have sex with men (GBM) was conducted in 2010. We designed a study to measure STBBI prevalence among GBM in metropolitan Montreal, Toronto and Vancouver and to document related preventive and risk behaviours.MethodsThe Engage Cohort Study used respondent-driven sampling (RDS) to recruit GBM who reported sex with another man in the past 6 months. At baseline, we examined recruitment characteristics of the samples, and the RDS-II-adjusted distributions of socio-demographics, laboratory-confirmed HIV and other STBBI prevalence, and related behaviours, with a focus on univariate differences among cities.ResultsA total of 2449 GBM were recruited from February 2017 to August 2019. HIV prevalence was lower in Montreal (14.2%) than in Toronto (22.2%) or Vancouver (20.4%). History of syphilis infection was similar across cities (14–16%). Vancouver had more HIV-negative/unknown participants who reported never being HIV tested (18.6%) than Toronto (12.9%) or Montreal (11.5%). Both Montreal (74.9%) and Vancouver (78.8%) had higher proportions of men who tested for another STBBI in the past 6 months than Toronto (67.4%). Vancouver had a higher proportion of men who used pre-exposure prophylaxis (PrEP) in the past 6 months (18.9%) than Toronto (11.1%) or Montreal (9.6%).ConclusionThe three largest cities of Canada differed in HIV prevalence, STBBI testing and PrEP use among GBM. Our findings also suggest the need for scale-up of both PrEP and STI testing among GBM in Canada.     

淮南市男男性行为者艾滋病相关高危行为及影响因素分析

目的了解男男性行为者(MSM)高危行为特征及其影响因素,为制定艾滋病防治措施提供参考依据。方法采用"滚雪球"方法在淮南市招募279名MSM为研究对象,通过问卷收集人口学、艾滋病知识、高危行为及干预服务接受情况等,对数据进行单因素及多因素logistic回归分析。结果 279名调查对象绝大部分为青壮年,平均年龄28岁,未婚居多、文化程度以高中及以上为主,AIDS知识知晓率为89.90%。最近6个月,应答者中100%的调查对象发生过同性肛交,7.72%发生过同性商业性行为,31.05%MSM曾经和异性发生性接触;过去6个月同性非商业性无保护肛交的发生率为62.36%,同性无保护商业性性行为发生率为38.10%,与异性发生无保护性行为发生率为83.53%。多因素logistic回归分析发现,来自县城的招募对象、最近一周同性肛交多于1次、最近六个月有异性性行为、最近一年患过性病、高艾滋病知识得分、最近一年检测过HIV与MSM最近6个月同性肛交安全套坚持使用率的关系有统计学意义。结论淮南市MSM人群艾滋病相关的高危行为普遍存在,亟需采取针对性的干预措施。     

Differences in substance use and sexual partnering between men who have sex with men,men who have sex with men and women and transgender women

Men who have sex with men (MSM), men who have sex with men and women (MSM/W) and transgender women (TGW) remain the populations most severely and disproportionately impacted upon by HIV in Los Angeles County. Baseline data from community-based HIV-prevention programmes serving these populations were analysed to explore differences in demographic characteristics, substance use and sexual partnering between the three groups. Despite high HIV prevalence overall (MSM 34.7% versus MSM/W 16.1% versus TGW 21.9%, p < .001), there were striking differences in risk behaviours. Higher rates of homelessness were reported by MSM/W compared to MSM and TGW. Lower rates of education and less substance use were reported by TGW (62.2%), compared to MSM (79.7%) and MSM/W (92.6%). A much higher number of male sexual exchange partners were reported by TGW (MSM 1.04 [SD = 4.8] versus MSM/W 1.54 [SD = 10.3] versus TGW 12.37 [SD = 23.9], p < .001). Findings support the need for HIV-prevention interventions that specifically address the unique risk patterns among each population in order to curb HIV acquisition and transmission.     

Distributions and trends in sexual behaviors and HIV incidence among men who have sex with men in China

ABSTRACT: BACKGROUND: HIV prevalence is increasing at a concerning rate among men who have sex with men (MSM) in China. Numerous studies have reported on levels of behaviors of Chinese MSM for different types of sexual partnerships, such as regular, non-commercial casual and commercial. This study aims to investigate the trends HIV incidence rates in relation to their risk sexual behaviors and partnership types among Chinese MSM. METHOD: Through a comprehensive literature research from available English and Chinese literature databases, we collated relevant information of sexual behaviors of Chinese MSM. Further, with the utilization of a mathematical optimization approach, this study reconciles the distributions of sexual behavioral data over the last decade and infers the heterogeneous distributions of behavioral patterns among Chinese MSM. Distributions of high-risk behavioural indicators, including the number of sexual partners, number of sexual acts and condom usage in the past 6 months, are calibrated to available empirical data. Based on the resultant temporal trends in these distributions, the trends in HIV incidence rates associated with each type of partnership among MSM in China are also estimated. RESULTS: A total of 55 qualified articles have been identified. An average MSM has approximately 0.96 (95 % CI, 0.59-1.18) regular, 3.75 (1.72-6.25) casual and 1.61 (0.97-2.78) commercial partners over a 6 month period and 4.33 (2.81-6.46), 1.42 (0.62-3.08), 1.48 (0.79-3.30) sexual acts per partnership respectively, corresponding to a total of 11.87 (8.87-15.25) acts. Condom usage has increased significantly during 2002-2010, at annual increases of 3.58 % (2.98-4.12 %), 5.55 % (4.55-6.54 %), and 5.03 % (4.19-5.74 %) for regular, casual and commercial partners respectively. These behavioral data implies an increase in HIV incidence of approximately 3.3-fold, from 2.04 (1.96-2.12) to 7.02 (6.71-7.35) per 1000 person-years during the same period. The proportion of new infections attributed to regular partnerships increased from 34 % to 40 %, whereas infections attributed to commercial partnerships reduced from 29 % to 23 % during 2002-2010. CONCLUSION: Regular partnerships are the main contributor of new HIV cases among MSM in China, public health intervention strategies are required to increase condom usage and HIV testing rates among regular partners to curb the growing trend HIV incidence.