南京市不同性角色MSM的行为特征及HIV和梅毒感染现状

目的了解南京市不同性角色男男性行为者(MSM)的行为特征及艾滋病病毒(HIV)、梅毒感染现状,为制定更有针对性的干预措施提供依据。方法在知情同意的前提下,采用分类滚雪球法招募MSM,开展问卷调查,收集人口学、行为学等信息,并进行HIV、梅毒抗体血清学检测。结果共调查MSM 2 377人,根据最近6个月肛交时的性角色分为三组:插入组800人(33.66%)、被插入组615人(25.87%)和双向组962人(40.47%),三组在平均年龄、文化程度、在婚比例、同性恋自我认同比例、艾滋病知识知晓率、第一次肛交年龄、最近6个月与同性肛交的频率、男性性伴总数、与同性商业性行为时安全套使用频率、与异性性行为频率方面,差异有统计学意义(P0.05)。三组梅毒感染率分别为7.63%、8.29%和6.55%,差异无统计学意义(χ~2=1.79,P=0.41);HIV感染率分别为7.00%、13.50%和13.62%,差异有统计学意义(χ~2=22.76,P0.05)。多因素Logistic回归分析结果显示,被插入组感染HIV的风险是插入组的1.98倍[95%可信区间(CI)∶1.38~2.85],双向组感染HIV的风险是插入组的2.13倍(95%CI∶1.53~2.97)。结论南京市不同性角色MSM具有不同的人口学、行为学特征,插入组、被插入组和双向组感染HIV的风险依次增高,应根据各自的特点制定更有针对性的干预措施。     

重庆市不同性角色MSM行为特征及HIV和梅毒感染现状

目的 了解重庆市不同性角色MSM行为特征及HIV、梅毒感染现状,分析MSM性角色与HIV感染的关系。方法 通过方便抽样的方法招募调查对象,在签订知情同意书后,对其进行匿名问卷调查。根据MSM近6个月肛交时性角色将其分为三组：插入组、被插入组和双向组。使用二分类Logistic回归分析不同性角色MSM的HIV感染风险。结果 共对1 151名MSM进行问卷调查。其中,插入组426人(37.0%),被插入组318人(27.6%),双向组407人(35.4%)。三组调查对象梅毒感染率分别为11.5%、13.2%和13.3%,差异无统计学意义(χ²=0.738,P=0.692);HIV感染率分别为12.7%、21.1%和17.7%,差异有统计学意义(χ²=9.574,P=0.008)。多因素Logistic回归结果显示,相较于插入组MSM,双向组(OR=1.55,95%CI:1.01～2.36)和被插入组(OR=1.92,95%CI:1.25～2.95)HIV感染风险更高。结论 不同性角色MSM社会人口学和行为特征存在差异,HIV感染风险也不同,应基于...     

深圳市场所中男男性行为者HIV感染情况及影响因素调查

目的了解深圳市场所中男男性行为者(MSM)的性行为特征,艾滋病病毒(HIV)感染状况及其影响因素。方法于2017年4-11月在深圳采用横断面调查,利用时间空间抽样法招募MSM。使用基于电脑辅助问卷调查系统收集调查对象的人口学信息,性行为特征,HIV既往检测情况,HIV、梅毒感染状况等信息,并采用SPSS 23软件进行相关统计分析。结果共招募MSM 490人,HIV检出率为11.2%(55/490),梅毒检出率为16.3%(80/490)。场所中的MSM具有多性伴、肛交性行为频繁、被动肛交比例较高等特征。与2014年深圳市场所的调查结果相比,性伴数≥2的比例显著上升(63.1%vs.56.1%,P=0.03),安全套的使用率(62.9%vs.52.3%,P=0.001)和HIV检测率(80.6%vs.64.3%,P 0.001)显著提高,HIV感染率显著降低(11.2%vs.16.8%,P=0.01),梅毒感染率略微下降(16.3%vs.17.4%,P=0.65)。多因素分析结果显示:学历较低[调整比值比(aOR)=2.73,95%可信区间(CI):1.25～5.99],梅毒阳性(a OR=3.65,95%CI:1.92～6.96)是HIV感染的危险因素。结论深圳市场所中MSM的HIV、梅毒感染率较高。尽管MSM中性伴数≥2的比例较过去显著上升,但由于安全套的使用率和HIV检测率显著提高,所以HIV和梅毒感染率较过去有所降低。因此,加强场所MSM的检测和行为干预,可降低人群HIV感染率。     

郑州市467名男男性行为者HIV和性病感染状况与流行病学特征

目的分析郑州市男男性行为者(MSM)艾滋病病毒(HIV)及性病(STD)感染状况与流行病学特征,为MSM艾滋病流行控制提供科学依据。方法采用横断面调查方法,对郑州市MSM社会人口学特征、性行为特征及HIV/STD感染状况进行调查。结果共调查467名MSM,其中21~40岁占77.5%(362人),大专及以上文化程度占58.2%(272人),39.8%已婚或与女性同居。HIV抗体阳性率13.3%(62例),梅毒和2型单纯疱疹病毒(HSV-2)感染率分别为6.4%(30例)和11.3%(53例)。寻找性伴场所为浴池的MSM的HIV感染率为20.0%(27/135),显著高于其他类型MSM(χ2=7.46,P=0.006);梅毒感染者和HSV-2感染者HIV阳性率高于非梅毒感染者和非HSV-2感染者(χ2=7.79,P=0.005;χ2=6.57,P=0.01)。结论郑州市MSM的HIV感染率高,同时高危性行为普遍存在,性病患者是HIV感染的高危人群,应作为艾滋病预防控制的重点人群。     

深圳市龙岗区男男性行为者HIV感染状况及其高危行为特征分析

目的了解深圳市龙岗区男男性行为者(MSM)的艾滋病病毒(HIV)感染状况及其高危行为特征,分析HIV感染的影响因素,为在龙岗区MSM中采取针对性的干预措施提供参考依据。方法 2015年1月至2016年12月,在龙岗区MSM聚集场所,采用时间场所抽样(TLS)和"滚雪球"的抽样方式获取样本,并进行单因素和多因素Logistic回归分析,双侧P0.05为检验水准,显示差异有统计学意义。结果共调查研究801人,平均(26.5±4.3)岁,青壮年为主;高中/中专及以上占58.80%。HIV感染率为18.48%(148例),梅毒感染率为16.48%(132例),丙型肝炎病毒感染率为0.37%(3例)。梅毒感染[比值比(OR)=3.44,95%可信区间(CI):1.40~8.46)]、发生肛交(OR=1.86,95%CI:1.07~3.23)是HIV感染的危险因素;肛交时坚持使用安全套(OR=0.34,95%CI:0.17~0.69)是HIV感染的保护因素。结论龙岗区MSM中HIV感染率较高;梅毒感染、发生肛交是导致HIV感染的危险因素。提示应继续强化性病治疗转介服务,提高安全性行为比例,降低MSM艾滋病的发病率。     

深圳市男男性行为者肛交多性伴行为特征及影响因素北大核心

目的了解深圳市男男性行为者(MSM)肛交多性伴行为特征及影响因素。方法于2011-2015年应用滚雪球法和同伴推动抽样法,在深圳市招募3040名MSM为调查对象。采用一对一问卷调查方法收集其社会人口学特征、HIV检测史、近二年内献血史、药物滥用史、性取向、性角色、既往从事商业性服务工作、既往接受商业性服务史、最近半年内有无女性性伴等;采集静脉血5mL进行梅毒螺旋体抗体和抗-HIV检测。采用单因素和多因素非条件Logistic回归分析MSM肛交多性伴行为的影响因素。结果 2100名(69.08%)MSM报告最近半年内发生过多性伴肛交行为;梅毒、HIV、梅毒合并HIV感染率分别为18.29%、9.77%和5.07%。与单一性伴的MSM相比,有多性伴肛交行为的MSM梅毒感染率、HIV感染率以及梅毒合并HIV感染率较高,差异有统计学意义。多因素Logistic回归分析结果显示,婚姻状况、文化程度、HIV检测史、既往从事商业性服务工作、既往接受商业性服务、性角色,是MSM发生多性伴肛交行为的独立影响因素。结论深圳市MSM多性伴肛交行为普遍,影响因素众多,制订预防控制计划时需全方位考虑。     

15～24岁校内外男男性行为者艾滋病风险认识及相关行为特征

目的了解成都市15～24岁校内外男男性行为者(MSM)的艾滋病风险认识及相关行为特征状况。方法通过Blued手机交友平台和MSM活动场所对成都市15～24岁校内外MSM进行横断面调查,内容包括首次性行为年龄、艾滋病风险认识、安全套使用、毒品使用和艾滋病病毒(HIV)检测等信息。结果共纳入1 002份有效问卷,学生MSM 494人,占49.3%;非学生MSM 508人,占50.7%。发生过肛交行为的占比学生低于非学生(80.4%vs.92.7%,χ~2=32.99,P 0.001)。关于"感染其他性病会增加感染艾滋病的风险?"的知识正确率学生低于非学生(52.0%vs. 61.2%),关于"一个人是否感染了艾滋病,可以通过外表来判断?"的正确率学生高于非学生(84.8%vs. 69.3%),差异均有统计学意义(P 0.05)。做过HIV检测的比例学生低于非学生(50.6%vs.69.9%,χ~2=38.89,P 0.001)。过去6个月发生男男肛交性行为时为被插入方角色者占比学生高于非学生(52.1%vs. 40.9%,χ~2=17.28,P 0.001);使用过Rush的占比学生低于非学生(22.3%vs. 30.7%,χ~2=9.15,P=0.002)。结论成都市15～24岁校内外MSM对性病会增加感染艾滋病的风险、检测窗口期传播风险高、肛交行为中被插入方感染风险高的知晓率较低,对感染艾滋病风险认识不足,学生MSM接受过HIV检测的比例较低。     

深圳市男男性行为者肛交多性伴行为特征及影响因素

目的了解深圳市男男性行为者(MSM)肛交多性伴行为特征及影响因素。方法于2011-2015年应用滚雪球法和同伴推动抽样法,在深圳市招募3040名MSM为调查对象。采用一对一问卷调查方法收集其社会人口学特征、HIV检测史、近二年内献血史、药物滥用史、性取向、性角色、既往从事商业性服务工作、既往接受商业性服务史、最近半年内有无女性性伴等;采集静脉血5mL进行梅毒螺旋体抗体和抗-HIV检测。采用单因素和多因素非条件Logistic回归分析MSM肛交多性伴行为的影响因素。结果 2100名(69.08%)MSM报告最近半年内发生过多性伴肛交行为;梅毒、HIV、梅毒合并HIV感染率分别为18.29%、9.77%和5.07%。与单一性伴的MSM相比,有多性伴肛交行为的MSM梅毒感染率、HIV感染率以及梅毒合并HIV感染率较高,差异有统计学意义。多因素Logistic回归分析结果显示,婚姻状况、文化程度、HIV检测史、既往从事商业性服务工作、既往接受商业性服务、性角色,是MSM发生多性伴肛交行为的独立影响因素。结论深圳市MSM多性伴肛交行为普遍,影响因素众多,制订预防控制计划时需全方位考虑。     

采用同伴推动抽样法进行男男性接触人群 HIV/STD流行病学调查的探索

目的探索同伴推动抽样法(Respondent driven sampling,RDS)在我国男男性接触(MSM)人群调查的可行性。方法使用RDS对北京市MSM进行抽样调查及血清学检测,了解他们艾滋病病毒(HIV)、性病感染状况及行为特点;采用RDSAT软件进行统计分析,NETDRAW和EXCEL作图。结果共征募MSM 325人,其中35岁以下占90.5%,未婚占83.0%(95%CI:76.4~88.9),外地户籍为61.9%(95%CI:54.0~70.1);HIV感染率为0.4%(95%CI:0.1~0.5),梅毒抗体阳性率为13.7%(95%CI:9.1~19.0),梅毒RPR阳性率6.0%(95%CI:3.8~8.7);56.2%(95%CI:50.0~65.0)为男性性取向,88.9%首次性行为年龄≤24岁,56.3%(95%CI:49.5~64.0)半年内有≥2个性伴,近6个月无保护插入性肛交为51.8%(95%CI:44.0~59.4),无保护被插入性肛交为44.8%(95%CI:37.2~52.3)。结论RDS简便易行,无需过多调查员投入前期准备工作,实为开展隐匿人群调查的行之有效的方法之一。北京市MSM人群HIV感染率可能处于低水平,但存在HIV流行隐患。     

河北省廊坊市MSM人群艾滋病相关危险行为研究

目的了解廊坊市男男性行为人群（MSM）艾滋病相关危险行为的暴露情况,分析该人群艾滋病病毒（HIV）和梅毒感染的主要危险因素。方法通过面对面的问卷调查,收集廊坊市区MSM的人口学资料、同性性行为、异性性行为以及艾滋病相关危险行为的暴露情况,并采集血液样本检测HIV和梅毒抗体,计算HIV和梅毒阳性率以及相关危险行为OR值。结果参加调查的233名MSM中,174人（74.6%）最近6个月发生过肛交性行为,肛交时坚持和经常使用安全套的人分别占46.6%和13.8%。该人群HIV和梅毒阳性率较高,检测195份血液样本,HIV抗体阳性13人,阳性率6.7%;梅毒抗体阳性41人,阳性率为21.0%。肛交不坚持使用安全套（OR=3.53,P=0.034）和性交过程中有自己出血经历（OR=9.967,P=0.003）,是HIV感染的危险因素;而群交经历（OR=5.886,P〈0.001）是梅毒感染的危险因素。结论廊坊市MSM人群有较高的HIV和梅毒阳性率,亟需在该人群中积极开展健康教育和行为干预,推广HIV和性病检测。     

Associations of current marital status and living arrangements with HIV and syphilis risk: findings from a community-based sample of men who have sex with men in China

Chinese men who have sex with men (MSM) are disproportionally affected by HIV and sexually transmitted infections (STIs), but little is known about the role of current marital status and living arrangements in shaping their HIV/syphilis risk. A cross-sectional study was conducted among MSM in Beijing, China to assess their sociodemographic/behavioral characteristics between married and single MSM, and test the hypothesis that currently married MSM have a lower odds of being HIV- and/or syphilis-infected. Participants were recruited via short message services, peer referral, internet, and community outreach. Data collection was based on a questionnaire survey and self-report. Infection status was lab-confirmed. Multivariable logistic regression modeling was used to assess the association of marital status and living arrangement with HIV/syphilis risk. Of the 3588 MSM, infection prevalence was high (HIV?=?12.7%; syphilis?=?7.5%). Compared to single MSM living with their boyfriends or male sex partners, single/alone MSM and married MSM living with wives were less likely to practice condomless insertive (CIAI) or receptive (CRAI) anal intercourse with men; while married MSM living with boyfriends or male sex partner were more likely to practice CIAI and CRAI, and married MSM were more likely to practice condomless vaginal sex. Compared to men living with boyfriends/sexual partners, significantly reduced odds of being HIV-positive were seen among married MSM who were living alone (aOR: 0.52; 95%CI: 0.28, 0.94) or living with their wives (aOR: 0.53; 95%CI: 0.31, 0.89). Similarly, single MSM living alone (aOR: 0.67; 95%CI: 0.48, 0.95) and married MSM living with their wives were comparatively less likely to be syphilis-infected (aOR: 0.43; 95%CI: 0.23, 0.79). Future efforts should consider characteristics of marital status and living arrangements for designing subgroup-specific risk reduction strategies among Chinese MSM.     

Association of herpes simplex virus type 2 infection and syphilis with human immunodeficiency virus infection among men who have sex with men in Peru

BACKGROUND: We evaluated associations between human immunodeficiency virus (HIV) infection, herpes simplex virus type 2 (HSV-2) infection, and syphilis among men who have sex with men (MSM) in Peru. METHODS: A surveillance survey of 3280 MSM was conducted; sexual behavior was assessed with a structured computer-assisted self-interview, and serum antibody testing was performed for HIV, HSV-2, and Treponema pallidum. RESULTS: HIV, HSV-2, and syphilis seroprevalences of 13.9%, 46.3%, and 13.4% were detected, respectively. HSV-2 seroprevalence was twice as high in HIV-infected subjects (80.5%) than it was in HIV-uninfected subjects (40.8%) (P < .01), and HSV-2 seropositivity (adjusted odds ratio [AOR], 5.66) was found to be strongly associated with HIV infection. In addition, homosexual self-definition (AOR, 3.12), exchange of sex for money (AOR, 1.61), unprotected sex (no condom) (AOR, 2.81), history of sex work (AOR, 1.89), oral receptive sex (AOR, 1.43), and cocaine use before/during sex (AOR, 2.53) within the preceding 6 months, as well as such sexually transmitted infections (STIs) and STI syndromes as proctitis (AOR, 2.80), genital ulcer disease (GUD) (AOR, 2.06), prior syphilis (AOR, 2.64), genital warts (AOR, 1.70), and self-reported STIs within the preceding 6 months (AOR, 1.61), were also found to be significant predictors of HIV infection. CONCLUSIONS: We found a strong association between HSV-2 seropositivity and HIV infection. Intervention measures against GUD due to HSV-2 infection and syphilis, such as routine testing, early detection, HSV-2 suppressive treatment, and condom distribution, need to be enhanced as part of STI prevention strategies at a national level to effectively reduce HIV infection among MSM in Peru.     

中国大陆MSM人群HIV/梅毒感染状况性行为特征和艾滋病知识知晓情况的Meta分析

目的了解2005-2011年中国大陆男男性行为人群（MSM）的艾滋病病毒（HIV）和梅毒感染状况、性行为特征、艾滋病知识知晓的总体及随时间和地区分布的情况。方法通过相应检索策略查找2005年至2011年期间针对该人群的HIV/梅毒感染率、性行为特征和艾滋病知识知晓率的调查文献,对其进行数据提取并建立数据库后进行Meta分析。结果共有82篇文献入选。2005-2011年,中国大陆MSM人群合并HIV感染率为4.4%[95%可信区间（CI）：3.8%～5.0%],合并梅毒感染率11.1%（95%CI：9.7%～12.4%）。在各地区中,西南地区合并HIV感染率（12.1%）和合并梅毒感染率（10.6%）较高。近6个月性行为特征呈高肛交发生率（81.7%）,高多性伴发生率（59.7%）和低肛交坚持使用安全套率（37.9%）。但是,该人群有较高的艾滋病知识知晓率（87.9%）。结论就现有发表文献而言,2006-2010年中国大陆MSM人群HIV和梅毒感染率较高,特别是在西南地区。该人群虽有较高的艾滋病知识知晓率,但是高危性行为仍普遍发生,亟需针对该高危人群将艾滋病防控与梅毒防控有机结合,并采取有效的综合干预措施。     

Risk behaviour and HIV prevalence among men who have sex with men in a multiethnic society: a venue-based study in Kuala Lumpur, Malaysia

This research aimed to determine HIV prevalence, risk behaviour and knowledge of transmission methods among men who have sex with men (MSM) in Kuala Lumpur, Malaysia. Venue-day-time sampling (VDTS) was applied to identify venues where men congregate to solicit sex from other men. Participants recruited from clubs, massage parlours, saunas and one park self-completed a computerized behavioural questionnaire, were administered an oral rapid HIV test and given the opportunity to return later to receive full counselling and learn their HIV status. A total of 517 men were enrolled into the study. The majority were Malays (47.0%) and Chinese (43.7%). Twenty tested HIV positive (3.9%). Significant predictors of HIV infection included having unprotected anal sex with a casual partner (44.9% of participants, odds ratio [OR] = 2.99; 95% confidence interval [CI] 1.13-7.90; P = 0.027), having unprotected receptive anal sex (27.9%, OR = 2.71; 95% CI 1.10-6.54; P = 0.030) and having group sex (33.3%, OR = 3.95; 95% CI 1.55-10.09; P = 0.004). One in five participants (20.1% and 19.5%) did not believe that HIV could be transmitted through insertive or receptive anal sex, respectively. Risk behaviour is high and knowledge of HIV transmission methods was low among MSM in Kuala Lumpur. Future prevention efforts should focus on providing risk reduction education to this community.     

HIV testing and sexual risks among migrant men who have sex with men: findings from a large cross-sectional study in Beijing,China

Despite the exacerbating HIV transmission among migrant men who have sex with men (MSM) in China, few epidemiological studies explore their HIV testing/risk profiles. We sought to explore sociodemographic/behavioral correlates of HIV/syphilis and HIV testing among migrant MSM. A study was conducted among 3,588 HIV-uninfected MSM. Participants were recruited via short message services, peer referral, web-advertisement and community outreach. HIV/syphilis infections were lab-confirmed. Migrant MSM were more likely to be HIV-infected compared to local MSM. Among 2,699 migrant MSM, HIV testing was associated with older age, living longer in Beijing, having ≥10 lifetime male sexual partners (LMSPs), having insertive anal sex; while being unemployed/retired and having condomless receptive anal sex (CRAS) were associated with a lower odds of HIV testing. Being married, living longer in Beijing, ever testing for HIV and having sex with women were associated with lower HIV odds; while being unemployed/retired, having higher HIV perception, having ≥ 10 LMSPs and having CRAS were associated a higher HIV odds. Increased likelihood of syphilis was associated with older age, being employed, higher HIV perception, having ≥10 LMSPs and having CRAS. Our study provides implications for targeted interventions to tackle HIV/STI risks and improve HIV testing among migrant Chinese MSM.     

HIV,syphilis and heterosexual bridging among Peruvian men who have sex with men

OBJECTIVES: To determine prevalence of and risk factors associated with HIV and syphilis seropositivity and estimate incidence of HIV infection among Peruvian men who have sex with men (MSM) and characterize behaviors of men who report sex with both men and women ('bridgers'). DESIGN: Cross-sectional study of MSM in Lima, Peru. METHODS: Four-hundred and fifty-one MSM (of whom 442 responded to the question regarding sexual orientation) recruited through street outreach. Each was interviewed and underwent serologic testing for syphilis and HIV, including the less sensitive enzyme immunoassay test to estimate HIV incidence. RESULTS: Overall, HIV and syphilis prevalence were 18.5% and 16.0%, respectively, with highest prevalence among cross-dressers (33.3% and 51.1%, respectively). The estimated overall HIV seroincidence was 11.2% per year (95% confidence interval, 4.8-23.6). Overall, 47.1% of men reported ever having sex with a woman: 78.6% of men self-identifying as heterosexuals, 85.1% of bisexuals, 35.5% of homosexuals, and 12.5% of cross-dressers. Of these, 26.5% were 'bridgers', of whom 55% reported two or more female partners during the last year. 'Bridgers' were less likely to have always used condoms during the past year for vaginal sex (17%) than for insertive anal sex with men (25.5%). CONCLUSIONS: Among MSM in Peru, HIV and syphilis prevalence and HIV incidence were high, especially among cross-dressers. The high prevalence of bisexuality and low rates of consistent condom use, especially with female sexual partners indicates potential HIV transmission into the heterosexual population.     

重庆市男男性行为者商业性性活动及影响因素分析

目的 了解重庆市男男性行为者(MSM)发生商业性性活动的基本情况及影响因素.方法 于2019-2020年应用方便抽样的方法在重庆市招募1 151名MSM,采用自填式问卷方法收集社会人口学特征、性行为特征、毒品使用史等;采集调查对象静脉血5 mL进行抗艾滋病病毒(HIV)检测和梅毒螺旋体抗体检测.采用二分类多因素Logi...     

深圳市MSM人群的HIV感染状况及相关危险因素

目的了解深圳市男男性行为人群（MSM）艾滋病病毒（HIV）感染状况及其行为特征,分析其影响因素,为制定针对性干预策略提供建议。方法应用同伴推动抽样法招募MSM,采用电脑辅助自填问卷形式进行调查,采血检测HIV和梅毒抗体。使用RDSAT软件进行统计分析。结果调查的492名MSM,HIV阳性率为4．6％[95％可信区间（CI）：2．59％～6．7％],梅毒患病率为16．4％（95％CI：11．9％～21．0％）。平均年龄为（27．2±6．3）岁,初中以上文化占98．4％,该市户籍占8．5％,60％以上通过互联网寻找性伴,最近半年内平均男男性伴数为2．37个,32．2％的调查对象最近6个月男男性行为时未能使用安全套。艾滋病基本知识知晓率仅为61．1％,安全套使用知识知晓情况也较差,仅为55．7％。Logistic回归分析结果显示,在深圳居住小于3个月、已婚、来自HIV高流行地区、有超过一个非商业男性性伴,是MSM感染HIV的危险因素;最近6个月内获得过艾滋病相关服务,是感染HIV的保护因素。结论需进一步加强MSM中HIV监测和干预工作,有效阻断HIV传播和蔓延。     

Pre-exposure Prophylaxis Awareness Among Gay and Other Men who have Sex with Men in Vancouver,British Columbia,Canada

Men who have sex with men (MSM) account for approximately half of Canada’s new HIV infections. Pre-exposure prophylaxis (PrEP), a recently established and effective HIV prevention tool for MSM is currently not approved nor publicly funded. We recruited MSM via respondent-driven sampling to complete a self-administered computer-based interview. Stratified by HIV status, multivariable logistic regression identified factors associated with PrEP awareness. Of 673 participants, 102/500 (20.9 %) HIV-negative and 63/173 (26.5 %) HIV-positive men were aware of PrEP, but none had used it. One third of PrEP-aware MSM spoke about it with friends or sex partners. Self-declared knowledge was limited. Factors associated with PrEP awareness varied by HIV status, but included greater HAART optimism for HIV-negative MSM. Among HIV-negative MSM, being PrEP unaware was associated with younger age, not always having condoms, and preferring receptive versus insertive anal sex. Future longitudinal research should identify early adopters of PrEP and its associated impacts.     

HIV trends and related risk factors among men having sex with men in mainland China: findings from a systematic literature review

The purpose of this study was to assess trends in the HIV epidemic and risk factors for HIV infection among men having sex with men (MSM) in mainland China. A literature review was conducted. Data from studies regarding HIV prevalence, syphilis infection and risk behavior, were pooled into three chronological stages. The independent correlates of HIV infection were gathered in order to guide the development of future interventions. HIV prevalences were 2.5% (95%CI 1.8-3.7), 1.8% (95%CI 1.1-2.9) and 3.3% (95%CI 2.0-5.3) before 2004, during 2004 to 2005 and 2006 to 2007, respectively. About two-thirds of MSM had multiple male sex partners during the previous six months (P6M), and more than one third of MSM engaged in unprotected anal intercourse (UAI) during last sex. Only UAI among commercial sex workers declined significantly. More than one quarter of MSM had female partners in P6M and the proportion having multiple female partners declined. The rates of unprotected vaginal sex had a downward trend. The prevalence of injecting drug use was low and remained the same. The number of lifetime male sexual partners and the frequency of anal sex in P6M were independently associated with HIV infection; UAI was correlated to the number of male partners, buying sex from males, being part of a mobile population, prior HIV testing and having a prior sexually transmitted disease (STD). We conclude intervention programs targeting UAI and multiple partners are urgently needed to control the HIV epidemic among MSM in mainland China.