scholarly journals 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

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.

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

2011 ◽  
Vol 3 (1) ◽  
pp. 10 ◽  
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.

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

Sexual Health ◽  
2015 ◽  
Vol 12 (6) ◽  
pp. 546 ◽  
Author(s):  
Yi Wang ◽  
Yuling Huang ◽  
Huailiang Chen ◽  
Liulin Li ◽  
Jie Xu ◽  
...  
Keyword(s):  
Transmitted Disease ◽  
Peer Education ◽  
Sexual Partners ◽  
Incidence Density ◽  
Snowball Sampling ◽  
Syphilis Infection ◽  
The Past ◽  
Male Sexual Partners ◽  
Sex With Men ◽  
Hiv Aids

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.

Feasibility of Indirect Secondary Distribution of HIV Self-Test Kits via WeChat Among Men Who Have Sex with Men: A National Cross-Sectional Study in China (Preprint)

2021 ◽  
Author(s):  
Li Shangcao ◽  
Jing Zhang ◽  
Xiang Mao ◽  
Tianyi Lu ◽  
Yangyang Gao ◽  
...  
Keyword(s):  
Social Media ◽  
Online Survey ◽  
Sexual Partners ◽  
Cross Sectional ◽  
Self Testing ◽  
Hiv Test ◽  
Condomless Anal Intercourse ◽  
Secondary Distribution ◽  
Self Test ◽  
Sex With Men

BACKGROUND The use of HIV self-test (HST) kits is commonplace in key sexually active populations. The direct secondary distribution of HST kits (DSDHK) is effective in improving the uptake of HIV self-testing. However, there are concerns about various limitations of DSDHK, including limited geographic location, payment problems, and face-to-face interaction. OBJECTIVE We evaluated the feasibility and characteristics of the indirect secondary distribution of HST kits (ISDHK) via WeChat (distributing HST application links and follow-up HST kits to partners) among men who have sex with men (MSM). METHODS From October 2017 to September 2019, an HIV self-testing (HIVST) recruitment advertisement was disseminated on the WeChat social media platform to invite MSM to apply for HST kits (referred to as “index participants” [Ips]). All of the MSM participants were encouraged to distribute the HST application link to their friends and sexual partners (referred to as “Alters”) through their social networks. All Alters were further encouraged to continue to distribute the HST application link. All participants paid a deposit (USD 7), refundable upon completion of the questionnaire and uploading of the test result via an online survey system. RESULTS 2,263 MSM met the criteria and successfully applied for HST. Of these, 1,816 participants returned their HST test results, including 1,422 (88.3%) IPs and 394 (21.7%) Alters. Compared with the IPs, the Alters practiced more condomless anal intercourse (CAI), a higher proportion of them never previously had an HIV test, and they had a greater willingness to distribute HST kits to sexual partners (all p < 0.05). After controlling for age, education, and income, the Alters had a greater proportion of MSM who had never tested for HIV before (aOR = 1.29, 95% CI 1.00–1.68), were more willing to distribute the HST application link (aOR = 1.71, 95% CI 1.21–2.40), had a lower number of sexual partners (aOR = 0.71, 95% CI 0.57–0.90), and were less likely to search for sexual partners via online means (aOR = 0.78, 95% CI 0.60–1.02). In comparison, the rates of reactive HST results, conducting HIV confirmatory tests, HIV seropositivity, and initiation of HIV antiretroviral therapy (ART) were similar for IPs and Alters. CONCLUSIONS The ISDHK mode of distributing HST application links via social media is feasible among the MSM population. The ISDHK mode should be used to supplement the DSDHK mode in order to enable a greater proportion of the MSM population to know their HIV infection status.

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 ◽  
2018 ◽  
Vol 15 (4) ◽  
pp. 342 ◽  
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.

scholarly journals HIV and other STIs self-testing to reduce risk compensation among men who have sex with men who use oral pre-exposure prophylaxis in China: protocol for a randomised waitlist-controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e036231
Author(s):  
Jing Zhang ◽  
Xiaojie Huang ◽  
Yaokai Chen ◽  
Hui Wang ◽  
Yonghui Zhang ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Sexual Partners ◽  
Risk Compensation ◽  
Standard Facility ◽  
Self Testing ◽  
Condomless Anal Intercourse ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
The Impact

IntroductionPre-exposure prophylaxis (PrEP) reduces the risk of HIV infection among men who have sex with men by up to 99%. However, in real-world settings, PrEP users may exhibit risk compensation after uptake of PrEP, including more condomless anal intercourse (CAI) and increased sexually transmitted infection (STI) acquisition. HIV self-testing (HIVST) decreases CAI among men who have sex with men (MSM) by providing awareness of the HIV status of oneself and one’s sexual partners. Here, we describe the rationale and design of a randomised waitlist-controlled trial to examine the impact of HIVST on risk compensation among PrEP users.Methods and analysisThe study is a two-arm randomised waitlist-controlled trial with 1000 HIV-negative MSM in four major cities in China who will be taking oral PrEP (involving tenofovir disoproxil fumarate/emtricitabine) either daily (n=500) or in an event-driven regimen (n=500). The participants will be randomised (1:1) to either the immediate HIVST intervention arm (HIVST plus standard facility-based counselling and testing from 0 to 12 months) or the waitlist arm (standard facility-based counselling and testing from 0 to 6 months, then crossover to receive the HIVST intervention in months 7–12). Participants will provide blood samples to assess the incidence of syphilis and herpes simplex virus type 2 (HSV-2) during a follow-up. The primary outcomes will be the occurrence of CAI, number of sexual partners and incidence of syphilis and HSV-2 during a follow-up. The secondary outcomes will be the HIV and STI testing frequency and STI treatment adherence during a follow-up. The planned start and end dates for the study is 26 December 2018 and 31 December 2020.Ethics and disseminationThe Medical Science Research Ethics Committee of The First Affiliated Hospital of China Medical University has approved the study (IRB(2018)273).Trial registration numberChiCTR1800020374

scholarly journals Prevalence and Factors Associated With HIV Self-testing Uptake Among Men Who Have Sex With Men in Ningbo, China: A Cross-sectional Study

2020 ◽  
Author(s):  
Hang Hong ◽  
Hong-bo Shi ◽  
Hai-bo Jiang ◽  
Hong-jun Dong ◽  
Yun-liang Shen
Keyword(s):  
Hiv Testing ◽  
Cross Sectional Study ◽  
Sexual Contact ◽  
Categorical Variables ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
The Past ◽  
Self Testing ◽  
Sex With Men

Abstract BackgroundHIV testing and early linkage to care are critical for reducing the risk of HIV transmission. HIV self-testing (HIVST) is an useful tool for increasing HIV testing frequency.This study aimed to investigate HIVST rates among men who have sex with men (MSM), the characteristics of MSM who had HIVST, and factors associated with HIVST uptake among MSM in Ningbo, China. MethodsA cross-sectional study was conducted from April to October 2019 in Ningbo,China. Participants were aged at least 18 years and having had sexual contact with men in the past year. Proportions were used for categorical variables. Adjusted Odds Ratio (AOR) and 95% Confidence Interval (CI) for characteristics associated with HIVST uptake was processed by multiple logistic regression models.ResultsAmong a sample of 699 MSM recruited, 38.2% had reported previous use of an HIV self-test kit. A greater proportion of HIVST Users had a higher frequency of HIV testing(≥2 times: 70.0% versus 41.2%, p<0.001) in the past one year. Factor associated with HIVST uptake was gay apps use(AOR=1.86,CI=1.13-3.05), multiple male sex partners (AOR=1.90,CI=1.29-2.80), frequency of male-male sexual contact ≥1 times per week(AOR=1.86, CI=1.30-2.66), syphilis infection(AOR=5.48, CI=2.53-11.88).ConclusionsFurther HIVST education should be strengthened for school-aged children and teenagers, and free HIVST kits may be provided to low-income high-risk MSM through gay apps and NGOs to achieve the increased HIV testing frequency.

scholarly journals Syphilis Self-testing: A Nationwide Pragmatic Study Among Men Who Have Sex With Men in China

2019 ◽  
Vol 70 (10) ◽  
pp. 2178-2186 ◽  
Author(s):  
Cheng Wang ◽  
Weibin Cheng ◽  
Changchang Li ◽  
Weiming Tang ◽  
Jason J Ong ◽  
...  
Keyword(s):  
Sexual Behaviors ◽  
Online Survey ◽  
Scaling Up ◽  
Cross Sectional ◽  
Self Testing ◽  
Immunodeficiency Virus ◽  
Self Test ◽  
Male Sexual Partners ◽  
Sex With Men ◽  
First Time

AbstractBackgroundSyphilis self-testing may help expand syphilis testing among men who have sex with men (MSM). China has rapidly scaled up human immunodeficiency virus (HIV) self-testing, creating an opportunity for integrated syphilis self-testing. However, there is a limited literature on implementing syphilis self-testing.MethodsA cross-sectional online survey was conducted among Chinese MSM in 2018. Participants completed a survey instrument including sociodemographic characteristics, sexual behaviors, syphilis self-testing, and HIV self-testing history. Multivariable logistic regression was conducted to identify correlates of syphilis self-testing. We also recorded potential harms associated with syphilis self-testing.ResultsSix hundred ninety-nine MSM from 89 cities in 21 provinces in China completed the study. A total of 361/699 (51.7%) men tested for syphilis, of whom 174/699 (24.9%) men used syphilis self-testing. Among 174 who had self-tested, 90 (51.7%) reported that the self-test was their first syphilis test and 161 (92.5%) reported that they undertook syphilis self-testing together with HIV self-testing. After adjusting for covariates, syphilis self-testing was correlated with disclosure of sexual orientation to family or friends (adjusted odds ratio [aOR], 1.90; 95% confidence interval [CI], 1.32–2.73), reporting 2–5 male sexual partners (aOR, 1.81; 95% CI, 1.04–3.16), HIV self-testing (aOR, 39.90; 95% CI, 17.00–93.61), and never tested for syphilis in the hospital (aOR, 2.96; 95% CI, 1.86–4.72). Self-reported harms associated with syphilis self-testing were minimal.ConclusionsScaling up syphilis self-testing could complement facility-based testing in China among MSM. Self-testing may increase first-time testing and has limited harms. Our findings suggest that syphilis self-testing could be integrated into HIV self-testing services.

scholarly journals Barriers to HIV Testing and Opportunities for Expansion Using Home-Based HIV Self-Testing: Results of a National Study of Higher HIV Risk Young Men Who Have Sex With Men

SAGE Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 215824402110168
Author(s):  
Sarah J. Marks ◽  
Roland C. Merchant ◽  
Melissa A. Clark ◽  
Tao Liu ◽  
Joshua G. Rosenberger ◽  
...  
Keyword(s):  
Hiv Testing ◽  
The United States ◽  
National Study ◽  
National Guidelines ◽  
The Past ◽  
Home Based ◽  
Self Testing ◽  
Hiv Test ◽  
Condomless Anal Intercourse ◽  
Sex With Men

HIV incidence among young adult men-who-have-sex-with-men (YMSM) is among the highest in the United States (US), yet YMSM have lower rates of HIV testing than most other MSM. Among 1,835 U.S. Black, Hispanic, and White YMSM who reported condomless anal intercourse (CAI) in the prior year, 30% (95% confidence interval [CI]: [28%, 32%]) had not been tested for HIV in the past year as recommended by national guidelines, and 19% (95% CI: [17%, 21%]) had never been tested. Factors associated with not being tested in the past year included not having a primary care provider (PCP)) (odds ratio [OR]: 2.00, 95% CI: [1.53, 2.60]), discomfort with asking a PCP for an HIV test (OR: 2.66, 95% CI: [2.05, 3.44]), living in a smaller community (OR: 1.71, 95% CI: [1.35, 2.18]), younger age (OR: 2.00, 95% CI: [1.53, 2.60]), and greater self-perception of having an undiagnosed HIV infection (OR: 1.46, 95% CI: [1.07, 1.99]). YMSM who had not been tested in the prior year were less likely to know where to get tested, yet were interested in trying home-based HIV self-testing. This study shows that knowledge, clinician-relationship, geographic, and perceptional barriers must be overcome to improve HIV testing among YMSM. Home-based HIV self-testing may address some of these barriers, particularly for YMSM living in smaller communities.

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