Incidence and correlates of HIV and syphilis in a prospective cohort of men who have sex with men in Mianyang, China, over a 36-month period

Background Estimates for the HIV/AIDS epidemic from the China Ministry of Health show that the epidemic is spreading rapidly among men who have sex with men (MSM). Methods: Respondent-driven sampling (RDS) was adapted in 2009 and snowball sampling was adapted to supplement the number of participants in 2010 and 2011. Interviewer-administered questionnaires and blood tests were conducted to confirm enrolment eligibility of participants. Results: A total of 725 HIV-negative participants were included into the cohort study. The cohort had a HIV incidence density of 5.6 (95% CI: 3.9–7.3)/100 person-years (PY) and a syphilis incidence density of 5.6 (95% CI:3.7–7.6)/100 PY. Age ≤20 years (21–25 years, hazard ratio (HR) = 0.32, 95%CI: 0.11–0.95/ ≥ 26 years, HR = 0.17, 95%CI: 0.05–0.66), having not participated in peer education in the past year (HR = 2.96, 95%CI: 1.19–7.35), seeking male sexual partners in a public washroom/park (HR = 3.61, 95%CI: 1.03–12.47), being currently infected with syphilis (HR = 3.21, 95%CI: 1.31–7.91), having sex partners aged ≥30 years (HR = 3.40, 95%CI: 1.11–10.39) and having more than four male sexual partners within the past 6 months (HR = 3.34, 95%CI: 1.24–9.04) were found to be risk factors for HIV seroconversion (each P < 0.05). Being married (HR = 2.38, 95%CI: 1.04–5.46), having not participated in peer education in the past year (HR = 2.28, 95%CI: 1.08–4.82), having limited HIV/AIDS knowledge (HR = 4.28, 95%CI: 1.94–9.43) and having a sexually transmitted disease infection in the past 6 months (HR = 4.74, 95%CI: 1.83–12.30) were identified as factors for syphilis infection (each P < 0.05). Conclusion: The incidence rates of HIV and syphilis in Mianyang City reamained high in the cohort of MSM for 36 months. Increased attention should be given to this serious epidemic, and appropriate interventions should be implemented to address MSM-specific issues in order to prevent HIV and syphilis infection in China.

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Men who have sex with men in China have relatively low numbers of sexual partners

Infectious Disease Reports ◽

10.4081/idr.2011.e10 ◽

2011 ◽

Vol 3 (1) ◽

pp. 10 ◽

Cited By ~ 4

Author(s):

Lei Zhang ◽

Eric Pui Fung Chow ◽

David P. Wilson

Keyword(s):

Median Number ◽

Sexual Partners ◽

Hiv Prevalence ◽

Comprehensive Review ◽

The Past ◽

Male Sexual Partners ◽

Sex With Men ◽

Over Time

HIV prevalence is increasing rapidly among men who have sex with men (MSM) in China and potentially associated with the number of male sexual partners that each man has on average. This study estimates the distribution of the number of male sexual partners among Chinese MSM through a comprehensive review of English and Chinese published literature. The overall median number of male sexual partners of Chinese MSM in the past 6 months China was estimated to be 1.5 (95% CI, 1.1-1.9) and 3.8 (95% CI 1.5-6.9) sexual partners in the past 6-month and 12-month periods respectively. An estimated 31% of sexual partners of MSM in China are regular partners, 54% are casual partners, and 16% are commercial partners. The reported numbers of sexual partners has not changed over time during the past decade. The numbers of male sexual partners reported by Chinese MSM is consistently lower than other settings and may not be sufficient to explain the recent rapid increase in HIV prevalence.

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HIV Prevention Services and Testing Utilization Behaviors among Men Who Have Sex with Men at Elevated Risk for HIV in Chongqing, China

BioMed Research International ◽

10.1155/2014/174870 ◽

2014 ◽

Vol 2014 ◽

pp. 1-10 ◽

Cited By ~ 4

Author(s):

Dayong Huang ◽

Yifei Hu ◽

Guohui Wu ◽

Yujiang Jia ◽

Rongrong Lu ◽

...

Keyword(s):

Hiv Prevention ◽

Hiv Testing ◽

Sexual Debut ◽

Full Time ◽

Syphilis Infection ◽

Prevention Services ◽

The Past ◽

Younger Age ◽

Sex With Men ◽

Hiv Aids

Objective. To investigate barriers and correlates of the use of HIV prevention services and HIV testing behaviors among men who have sex with men in Chongqing.Methods. Three consecutive cross-sectional surveys provided demographic, sexual behavior, HIV/syphilis infection, HIV prevention service, and testing behavior data.Results. Of 1239 participants, 15.4% were infected with HIV, incidence was 12.3 per 100 persons/year (95% CI: 9.2–15.3), 38% of the participants reported ever having unprotected insertive anal sex, 40% ever received free condom/lubricants in the past year, and 27.7% ever obtained free sexually transmitted infection examination/treatment in the past year. Multivariable logistic regression revealed that lower levels of HIV/AIDS related stigmatizing/discriminatory attitudes, full-time jobs, and sex debut with men at a younger age were independently associated with use of free condom/lubricants. Large social networks, higher incomes, and sexual debut with men at a younger age were associated with use of any HIV prevention and HIV testing services. Lower levels of stigmatizing/discriminatory attitudes were also associated with HIV testing. Fearing needles and being unaware of the venues for testing were top barriers for testing service utilization.Conclusion. It is imperative to address HIV/AIDS related stigmatizing/discriminatory attitudes and other barriers while delivering intervention and testing services.

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Association between rectal douching and HIV acquisition: the mediating role of condom use and rectal bleeding in a national online sample of Chinese men who have sex with men

Sexually Transmitted Infections ◽

10.1136/sextrans-2019-054415 ◽

2020 ◽

pp. sextrans-2019-054415

Author(s):

Tianyi Lu ◽

Xiang Mao ◽

Erlei Peng ◽

Yangyang Gao ◽

Zhenxing Chu ◽

...

Keyword(s):

Rectal Bleeding ◽

Sexual Partners ◽

Mediating Role ◽

The Past ◽

Self Testing ◽

Rectal Douching ◽

Male Sexual Partners ◽

Sex With Men ◽

Hiv Acquisition ◽

Multiple Male

ObjectivesPrevious studies have demonstrated that rectal douching (RD) is associated with HIV acquisition among men who have sex with men (MSM). However, the precise mechanism underlying the association between RD and HIV remains unclear.MethodsWe recruited participants over WeChat from October 2017 to October 2018. Respondents received mailed HIV self-testing kits, uploaded images of HIV self-test results and completed an online electronic questionnaire simultaneously. The questionnaire assessed sociodemographic characteristics, RD practices and sexual risk behaviours. HIV status was measured as the result of the HIV self-testing. The Baron and Kenny statistical method was used to assess the association between RD and HIV, controlling for condomless anal intercourse (CAI) and rectal bleeding.ResultsOf 1365 participants, 39.93% (545/1365) reported RD in the past 6 months, 60.07% had multiple male sexual partners and 43.08% had CAI in the past 6 months. The prevalence of HIV, based on self-testing, was 3.37% (46/1365). Multivariable logistic analysis showed RD was significantly associated with bottom sexual role (adjusted OR (aOR) 14.0; 95% CI 9.8 to 20.2), having multiple male sexual partners (aOR 1.8; 95% CI 1.4 to 2.2), CAI (aOR 1.3; 95% CI 1.0 to 1.6), rectal bleeding (aOR 2.0; 95% CI 1.6 to 2.6) and HIV infection (aOR 1.9; 95% CI 1.0 to 3.4). Baron and Kenny analysis found both CAI (aOR 2.2; 95% CI 1.2 to 4.1) and rectal bleeding (aOR 1.9; 95% CI 1.0 to 3.4) play a mediating role in the association between RD and HIV.ConclusionsOur study results confirmed the relationship between RD and HIV, and found CAI and rectal bleeding mediated HIV infection in Chinese MSM who douched. Strategies should be encouraged to strengthen health education and reduce high-risk sexual behaviour in order to reduce the risk of HIV in MSM who use enemas. Rectal microbicides may represent an efficient means of providing HIV prophylaxis among MSM.

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Correlates of recent HIV infection among men who have sex with men recruited through the internet in Huzhou City, Eastern China

Journal of International Medical Research ◽

10.1177/0300060518789813 ◽

2018 ◽

Vol 46 (12) ◽

pp. 5052-5061

Author(s):

Zhongrong Yang ◽

Jing Li ◽

Zhengquan Dong ◽

Nanping Wu ◽

Meihua Jin

Keyword(s):

Hiv Infection ◽

Instant Messaging ◽

Eastern China ◽

Sexual Partners ◽

Stepwise Multiple Regression ◽

The Internet ◽

Syphilis Infection ◽

Male Sexual Partners ◽

Sex With Men ◽

Recent Hiv Infection

Objective To identify factors associated with recent HIV infection among men who have sex with men (MSM) in Huzhou City, Eastern China, who seek sexual partners via the internet. Methods Adult members of Tencent QQ instant messaging software, who completed a face-to-face interview questionnaire and serological HIV testing at baseline, were enrolled into this prospective cohort study. Questionnaires and serological testing were also completed at 6 and 12 months. Cox proportional hazards was used for initial bivariate analyses of differences between participants with or without recent HIV infection, and for subsequent forward stepwise multiple regression of statistically significant variables. Results Out of 415 baseline participants, 283 completed the 12-month follow-up (25 with recent HIV infection and 258 without; recent HIV infection rate, 8.20 per 100 person-years). Recent HIV infection was shown to be significantly associated with ≤ high school education (versus college/university), registered residence outside Huzhou City (versus within Huzhou City), having ≥ two male sexual partners, and syphilis infection. Conclusions Improving education levels, treating syphilis promptly, and reducing the number of male sexual partners may reduce HIV transmission among MSM in Eastern China.

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Factors related to HIV testing frequency in MSM based on the 2011–2018 survey in Tianjin, China: a hint for risk reduction strategy

BMC Public Health ◽

10.1186/s12889-021-11948-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhongquan Liu ◽

Yang Chen ◽

Tingting Yao ◽

Tiantian Zhang ◽

Desheng Song ◽

...

Keyword(s):

Hiv Testing ◽

Cost Effective ◽

Snowball Sampling ◽

Logistic Analysis ◽

Testing Frequency ◽

Ordinal Logistic Regression Analysis ◽

Young Msm ◽

Sex With Men ◽

Low Educated ◽

Hiv Aids

Abstracts Background In recent years, HIV testing has become one of the effective strategies to reduce the risk of the infection. Frequent quarterly HIV testing can be cost effective. Therefore, an in-depth study of factors related to the testing behavior of men who have sex with men (MSM) were analyzed to optimize intervention strategies. Methods From March 2011 to October 2018, the project was implemented in a Tianjin (China) bathhouse, and 5165 MSM were surveyed using snowball sampling. Factors related to HIV testing behavior were analyzed by ordinal logistic regression analysis after grouping according to testing frequency, and comprehensive analysis was performed. Results The multivariate logistic analysis showed that 6 variables including young MSM (OR = 0.67, 95% CI: 0.49–0.92, p = 0.01), low-educated MSM (OR = 0.60, 95% CI: 0.48–0.77, p < 0.0001), low HIV/AIDS knowledge (95% CI: 0.57–0.83, p < 0.0001), marital status (OR = 1.30, 95% CI: 1.07–1.57, p = 0.007), acceptance of condom promotion and distribution (OR = 14.52, 95% CI: 12.04–17.51, p < 0.0001), and frequency of condom use (p < 0.05) could link to HIV testing behaviors. Conclusions In order to achieve the 95–95-95 goal, target publicity, HIV/AIDS education and promotion of HIV self-testing kits should be carried out to encourage frequent HIV testing among MSM who are young (especially students), married to women, poorly educated and who are reluctant to always use condoms.

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Sexual network characteristics of men who have sex with men with syphilis and/or gonorrhoea/chlamydia in Lima, Peru: network patterns as roadmaps for STI prevention interventions

Sexually Transmitted Infections ◽

10.1136/sextrans-2018-053865 ◽

2019 ◽

Vol 95 (5) ◽

pp. 336-341

Author(s):

Cherie Blair ◽

Ryan Colby Passaro ◽

Eddy R Segura ◽

Jordan E Lake ◽

Amaya G Perez-Brumer ◽

...

Keyword(s):

Network Size ◽

Sexual Partners ◽

Sexual Network ◽

Syphilis Infection ◽

Screening Process ◽

Cross Sectional ◽

Sti Prevention ◽

Network Characteristics ◽

Condomless Anal Intercourse ◽

Sex With Men

ObjectiveWhile men who have sex with men (MSM) are disproportionately affected by Peru’s overlapping HIV and STI epidemics, there are few data on how partnership-level and network-level factors affect STI transmission in Peru. We explored partnership-level and network-level factors associated with gonorrhoea/chlamydia (Neisseria gonorrhoeae and/or Chlamydia trachomatis (NG/CT)) and/or syphilis infection among MSM in Peru.MethodsWe present the results of a cross-sectional secondary analysis of MSM (n=898) tested for syphilis and NG/CT infection as part of the screening process for two STI control trials in Lima, Peru. Participants completed questionnaires on demographics, sexual identity and role, characteristics of their three most recent sexual partners (partner sexual orientation, gender, role, partnership type, partner-specific sexual acts) and 30-day sexual network characteristics (number of sexual partners, partnership types, frequency of anal/vaginal intercourse). Participants were tested for syphilis and urethral, rectal and oropharyngeal NG/CT. Differences in network characteristics were analysed with χ2 and Kruskal-Wallis tests.ResultsApproximately 38.9% of participants had a new STI diagnosis (syphilis (rapid plasma reagin ≥16): 10.6%; NG/CT: 22.9%; syphilis-NG/CT coinfection: 5.4%). Condomless anal intercourse (CAI) was not significantly associated with an STI diagnosis. Gay-identified participants with exclusively homosexual networks had a higher prevalence of STIs (47.4%) than gay-identified MSM with only heterosexual/bisexual partners (34.6%, p=0.04), despite reporting fewer sexual partners (any partners: 2, 1–4 vs 3, 2–6; p=0.001; casual partners: 1, 0–3 vs 2, 1–4; p=0.001) and more stable partnerships (1, 0–1 vs 0, 0–1; p=0.003) in the last month.ConclusionsNetwork size and the number of casual sexual partners were associated with NG/CT infection among MSM in Peru. Despite reporting fewer sexual risk behaviours (smaller network size, more stable partnerships, less CAI), MSM with homosexual-only sexual networks had a higher prevalence of NG/CT and syphilis. These findings suggest network composition among MSM in Peru plays an important role in the risk for STI acquisition.

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Only recent sexual partners contribute to oropharyngeal gonorrhoea positivity: the number of sexual partners over different time periods as an indicator of gonorrhoea and chlamydia infection duration among men who have sex with men

Sexual Health ◽

10.1071/sh17196 ◽

2018 ◽

Vol 15 (4) ◽

pp. 342 ◽

Cited By ~ 6

Author(s):

David Priest ◽

Tim R. H. Read ◽

Marcus Y. Chen ◽

Catriona S. Bradshaw ◽

Christopher K. Fairley ◽

...

Keyword(s):

Health Centre ◽

Sexual Partners ◽

Chlamydia Infection ◽

Gonococcal Infection ◽

The Past ◽

Retrospective Data Analysis ◽

Number Of Sexual Partners ◽

Time Periods ◽

Sex With Men ◽

Generalised Estimating Equations

Background Mathematical models have demonstrated that the majority of gonococcal transmission is from oropharynx to oropharynx (i.e. kissing) among men who have sex with men (MSM). The aim of this study is to investigate the association between the number of partners within specific time periods and gonorrhoea and chlamydia positivity. Methods: This was a retrospective data analysis of MSM attending the Melbourne Sexual Health Centre between 2007 and 2016. Univariable and multivariable logistic regression analyses, with generalised estimating equations (GEE), were performed to determine if the number of partners within specified time periods was associated with site-specific gonorrhoea and chlamydia positivity. Results: There were 45933 consultations which included 15197 MSM. Oropharyngeal gonorrhoea positivity was associated with the number of partners in the past 3 months, but not the number of partners 4–12 months ago; men who had ≥6 partners in the past 3 months had significantly higher odds of acquiring oropharyngeal gonorrhoea (aOR 1.93; 95% CI 1.61–2.31), but this was not the case for men who had ≥6 partners 4–12 months ago. Anorectal gonorrhoea and chlamydia and urethral chlamydia were associated with the number of partners in both time periods after adjusting for age and condom use. Conclusions: The association of oropharyngeal gonorrhoea with the number of recent partners, but not partners from an earlier period, unlike anorectal gonorrhoea and anorectal and urethral chlamydia, could be explained by a shorter duration of oropharyngeal gonococcal infection. Annual screening for gonorrhoea may be insufficient to materially reduce oropharyngeal prevalence.

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Clinical factors associated with syphilis concordance in men in sexual partnerships: a cross-sectional couples study

Sexually Transmitted Infections ◽

10.1136/sextrans-2017-053297 ◽

2017 ◽

Vol 94 (8) ◽

pp. 571-573 ◽

Cited By ~ 1

Author(s):

Janet M Towns ◽

Sarah Huffam ◽

Eric P F Chow ◽

Ian Denham ◽

Lei Zhang ◽

...

Keyword(s):

Health Centre ◽

Secondary Syphilis ◽

Sexual Partners ◽

Concordance Rate ◽

Hiv Positive ◽

Clinical Factors ◽

Syphilis Infection ◽

Factors Associated ◽

Early Syphilis ◽

Male Sexual Partners

BackgroundSyphilis infections continue to increase among men who have sex with men (MSM) in many countries, with rates often higher among HIV-positive MSM. There is limited understanding of the risk and determinants of syphilis transmission between men. We aimed to examine the concordance of early syphilis infection between male sexual partners and clinical factors associated with transmission.MethodsMen attending Melbourne Sexual Health Centre with their male partners, where at least one was diagnosed with early syphilis, were identified from linkage of partner records between March 2011 and April 2016. Early latent syphilis was defined as a new asymptomatic syphilis presentation of less than 2 years’ duration. Associations between concordance and potential risk factors were examined using Fisher’s exact test.ResultsAmong 43 couples (86 men) identified, there were 13 couples (26 men) where both were diagnosed with early syphilis, representing a concordance rate of 30.2% (95% CI 17.2% to 46.1%). Among the 13 concordant couples, 5 men had primary syphilis (4 penile, 1 anal), 11 secondary syphilis (8 generalised rash, 3 penile, 2 anal, 1 oral lesion) and 10 early latent infections. Concordance was higher among couples where at least one partner had secondary syphilis compared with couples where neither partner had secondary syphilis (53% (9/17) vs 15% (4/26), P=0.016). Furthermore, concordance was higher among couples where one was HIV positive compared with couples where both were HIV negative (62% (5/8) vs 23% (8/35), P=0.042).ConclusionsThere was an overall concordance rate of 30%. Higher concordance rates for early syphilis infection between male sexual partners were associated with HIV and secondary syphilis.

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Alcohol Use, Stigmatizing/Discriminatory Attitudes, and HIV High-Risk Sexual Behaviors among Men Who Have Sex with Men in China

BioMed Research International ◽

10.1155/2014/143738 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 15

Author(s):

Meizhen Liao ◽

Dianmin Kang ◽

Xiaorun Tao ◽

Jennifer Huang Bouey ◽

Muktar H. Aliyu ◽

...

Keyword(s):

Alcohol Use ◽

Drug Use ◽

Sexual Behaviors ◽

Unprotected Sex ◽

Sex Partners ◽

Anal Sex ◽

The Past ◽

Male Sex ◽

Sex With Men ◽

Hiv Aids

Objective. This research was conducted to assess the correlates of alcohol consumption and HIV/AIDS-related stigmatizing and discriminatory attitudes among men who have sex with men (MSM) in Shandong province, China.Methods. A cross-sectional survey provided demographics, sexual behaviors, illicit drug use, alcohol consumptions, and service utilization.Results. Of 1,230 participants, 82.8% were single, 85.7% aged <35 years, 47.2% had college or higher education, and 11.7% drank alcohol >3 times per week in the past six months. The average total score of stigmatizing and discriminatory attitude was 37.4 ± 4.4. More frequent episodes of alcohol use were independently associated with higher levels of HIV/AIDS-related stigma and discrimination, unprotected anal sex, bisexual identity, multiple male sex partners, drug use, and lower levels of education. Expressing higher levels of HIV/AIDS-related stigmatizing and discriminatory attitudes was independently associated with alcohol use, unprotected male anal sex, bisexuals, more male sex partners, commercial sex with men, and non-receipt of peer education in the past year.Conclusion. HIV/AIDS-related stigmatizing and discriminatory attitudes are common and associated with alcohol use and unprotected sex among MSM. The finding highlights the needs to develop programs that would reduce HIV/AIDS-related stigmatizing and discriminatory attitudes and strengthen alcohol use prevention and risk reduction initiatives among MSM.

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