High prevalence of HIV infection and unprotected anal intercourse among older men who have sex with men in China: a systematic review and meta-analysis

Objectives. To understand the current risk of HIV infection and transmission and further elucidate the underlying risk factors among men who have sex with men and women (MSMW) in China.Methods. Following PRISMA guidelines, we conducted a systematic review and meta-analysis of searching through Chinese and English available literature databases between January 2000 and June 2014 to identify articles.Results. Thirty-six articles (including 19,730 MSMW and 53,536 MSMO) met the selection criteria and the aggregated results found that MSMW have significantly higher HIV prevalence than MSMO (6.6% versus 5.4%, OR = 1.27, 95% CI = 1.01–1.58). A higher proportion of MSMW had commercial male partners in the past 6 months (18.3% versus 12.2%, OR = 1.56, 95% CI = 1.01–2.42). Additionally, substance use in the past 6 months was significantly more frequent among MSMW than MSMO (alcohol use: 27.1% versus 13.1%, OR = 2.53, 95% CI = 2.14–2.99; illicit drug use: 5.3% versus 2.5%, OR = 2.09, 95% CI = 1.48–2.95).Conclusion. A higher proportion of commercial sex and substance use among MSMW may be a potentially indicative factor for significantly higher HIV prevalence compared to MSMO. Targeted interventions should aim at increasing the frequency of HIV/STIs screening and preventing high risk commercial sex and substance use among MSMW to decrease their HIV transmission to the general population.

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High Prevalence of Sexual Concurrency and Concurrent Unprotected Anal Intercourse Across Racial/Ethnic Groups Among a National, Web-Based Study of Men Who Have Sex With Men in the United States

Sexually Transmitted Diseases ◽

10.1097/olq.0b013e31825ec09b ◽

2012 ◽

Vol 39 (10) ◽

pp. 741-746 ◽

Cited By ~ 35

Author(s):

Eli S. Rosenberg ◽

Christine M. Khosropour ◽

Patrick S. Sullivan

Keyword(s):

United States ◽

Ethnic Groups ◽

Anal Intercourse ◽

Unprotected Anal Intercourse ◽

The United States ◽

Web Based ◽

Sexual Concurrency ◽

High Prevalence ◽

Sex With Men ◽

Racial Ethnic

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Symptomatic primary HIV infection in a 49-year-old man who has sex with men: beware of the window phase

Eurosurveillance ◽

10.2807/ese.14.48.19424-en ◽

2009 ◽

Vol 14 (48) ◽

Cited By ~ 1

Author(s):

H E van Oosten ◽

M Damen ◽

H JC de Vries

Keyword(s):

Hiv Infection ◽

Healthcare Providers ◽

Anal Intercourse ◽

Unprotected Anal Intercourse ◽

Large Contribution ◽

Hiv Diagnosis ◽

Primary Hiv Infection ◽

History Of ◽

P24 Antigen ◽

Sex With Men

A 49-year-old man with a history of receptive unprotected anal intercourse with multiple anonymous men presented with a symptomatic primary HIV infection. Upon his initial visit the rapid HIV antibody screening test was negative but a p24 antigen test suggested a highly infectious phase in the HIV infection. An immunoblot assay confirmed the HIV diagnosis only 14 days later. Recent infections are characterised by a highly infectious phase and, if gone unnoticed, can have a large contribution to the ongoing transmission of HIV. Healthcare providers should be aware of primary HIV infection and the pitfalls in its diagnosis.

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Internet-Based Methods May Reach Higher-Risk Men who have Sex with Men Not Reached Through Venue-Based Sampling§

The Open AIDS Journal ◽

10.2174/1874613601206010083 ◽

2012 ◽

Vol 6 (1) ◽

pp. 83-89 ◽

Cited By ~ 35

Author(s):

Travis Sanchez ◽

Amanda Smith ◽

Damian Denson ◽

Elizabeth DiNenno ◽

Amy Lansky

Keyword(s):

Hiv Infection ◽

Anal Intercourse ◽

Unprotected Anal Intercourse ◽

Web Based ◽

Behavioral Surveillance ◽

The Past ◽

National Hiv Behavioral Surveillance ◽

Hiv Serostatus ◽

Sex With Men ◽

College Educated

Background: Internet-based sampling methods may reach men who have sex with men (MSM) who don’t attend physical venues frequented by MSM and may be at higher risk of HIV infection. Methods: Multivariate logistic regression was used to examine characteristics of adult MSM participants in 2 studies conducted in the same 5 U.S. cities: the 2003-2005 National HIV Behavioral Surveillance System (NHBS) which used sampling from physical MSM venues (e.g., bars, clubs) and the 2007 Web-based HIV Behavioral Surveillance (WHBS) pilot which used sampling through online banner advertisements. Results: Among 5024 WHBS MSM, 95% attended a physical MSM venue in the past 12 months, and 75% attended weekly. WHBS MSM who were black, aged 18-21 years, not college educated, bisexual- or heterosexual-identifying, and reported unknown HIV serostatus were less likely to have attended a physical MSM venue in the past 12 months (all p<0.01). Compared to NHBS MSM, WHBS MSM were more likely to be white, younger, college-educated, report unknown HIV serostatus, report unprotected anal intercourse with a casual partner, and have first met that partner online (all p<0.0001). WHBS MSM were less likely to have been under the influence of drugs during most recent sex (p=0.01) or not know their sex partner’s HIV serostatus (p<0.0001). Conclusions: Many MSM recruited online also attended physical venues, but attendance varied by sub-group. Participants in WHBS and NHBS differed, and WHBS may represent a group of MSM at higher risk of HIV infection. These findings suggest that an internet-based method may be a useful supplement to NHBS.

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