Consistently High Unprotected Anal Intercourse (UAI) and factors correlated with UAI among men who have sex with men: implication of a serial cross-sectional study in Guangzhou, China

Abstract Background HIV-infected men who have sex with men (MSM) who use recreational drugs (RD) or excessive alcohol (EA) may be involved in risky sexual behaviours, including unprotected anal intercourse (UAI). This study describes the prevalence RD/EA-use among HIV-infected MSM, and compares those who used RD/EA with those who did not. Methods This cross-sectional study included HIV-infected MSM who were recruited in a convenient sample from two AIDS-treatment centres and events for HIV-infected MSM in Israel in 2016. Participants completed anonymous questionnaires including RD/EA-use and their sexual behaviours. RD/EA-use was defined as consumption of any psychoactive stimulants or dissociative anaesthetics, or an uptake of alcohol until drunkenness before or during sex. Results Of all 276 HIV-infected MSM, 202 (73.2%) used RD/EA. Those who used RD/EA were younger, reported earlier sexual debut, had more sexual partners, were more likely to perform UAI with casual partners, more commonly involved in paid sex, used psychiatric medications and more likely to be unsatisfied with their health-status compared to those who did not use RD/EA. HIV-infected MSM who used RD/EA reported a lower CD4-count and higher viral-load than those who did not. In a multivariate analysis, being younger, reported earlier sexual debut and been prescribed psychiatric drugs were associated with RD/EA-use among HIV-infected MSM. Conclusions A large proportion of HIV-infected MSM used RD/EA and also engaged in risky sexual behaviours. A subset of HIV-infected MSM can benefit from mental support during their routine treatment at the AIDS treatment centres and should also receive harm reduction intervention by their providers in order to minimize potential risks pertaining to RD/EA-use.

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Are there any differences between different testing sites? A cross-sectional study of a Norwegian low-threshold HIV testing service for men who have sex with men

BMJ Open ◽

10.1136/bmjopen-2017-017598 ◽

2017 ◽

Vol 7 (10) ◽

pp. e017598 ◽

Cited By ~ 3

Author(s):

Bera Ulstein Moseng ◽

Vegar Bjørnshagen

Keyword(s):

Hiv Testing ◽

Anal Intercourse ◽

Unprotected Anal Intercourse ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Cross Sectional ◽

Testing Service ◽

Hiv Test ◽

Low Threshold ◽

Sex With Men

ObjectiveTo describe a Norwegian low-threshold HIV testing service targeting men who have sex with men (MSM).Design and settingAfter the HIV testing consultation, all users of the HIV testing service were invited to answer the study questionnaire. The study setting included the sites where testing was performed, that is, the testing service’s office in Oslo, cruising areas, bars/clubs and in hotels in other Norwegian cities.ParticipantsMSM users of the testing service.Primary and secondary outcome measuresData were collected on demographics, HIV testing and sexual behaviour as well as the participant’s motivations for choosing to take an HIV test at this low-threshold HIV testing service. The data are stratified by testing site.Results1577 HIV testing consultations were performed, the study sample consisted of 732 MSM users. 11 tested positive for HIV. 21.7% had a non-western background, 27.1% reported having a non-gay sexual orientation. 21.9% had 10 or more male sexual partners during the last year, 27.9% reported also having had a female sexual partner. 56.4% reported having practised unprotected anal intercourse during the last 6 months. 20.1% had never tested for HIV before. Most of these user characteristics varied by testing sites.ConclusionsThe Norwegian low-threshold testing service recruits target groups that are otherwise hard to reach with HIV testing. This may indicate that the testing service contributes to increase HIV testing rates among MSM in Norway.

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The use of inappropriate anal douching tool associates with increased HIV infection among men who have sex with men: a cross-sectional study in Shenyang, China

BMC Public Health ◽

10.1186/s12889-021-10276-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhen Xing Chu ◽

Guangquan Shen ◽

Qinghai Hu ◽

Hongyi Wang ◽

Jing Zhang ◽

...

Keyword(s):

Risk Factors ◽

Hiv Infection ◽

Sexual Behaviors ◽

Anal Intercourse ◽

Cross Sectional Study ◽

Sectional Study ◽

Anal Sex ◽

Cross Sectional ◽

Increased Risk ◽

Sex With Men

Abstract Background Rectal douching (RD) is widely practiced by men who have sex with men (MSM), and is associated with increased risk of HIV infection. However, the mechanism of how RD increases the risk of HIV infection is not well understood, and there is limited data on RD behavior in MSM practicing anal sex in China. We examine the purpose of RD, its timing in relation to anal sex, the types of RD products used, and risky sexual behaviors among MSM reporting anal sex. Methods Between August 2017 and December 2018, a cross-sectional study was conducted among adult MSM in Shenyang, China. Data were collected on demographics, sexual behaviors, and RD for the most recent sexual intercourse by means of interviewer-administered face-to-face questionnaires. Blood samples were collected to test for antibodies to HIV and syphilis. Multivariable logistic regression models were used to assess the risk factors associated with HIV infection. Results A total of 515 eligible MSM participated in this survey (median age: 31 years). During the most recent anal intercourse, 28.3% (146/515) had condomless receptive anal intercourse (CRAI), 21.4% (110/515) practiced serosorting, and more than half (61.6%, 317/515) reported RD before or after anal sex. Of those practicing RD, 96.8% (307/317) conducted RD before sex, while 62.5% (198/317) conducted RD after sex. The douching devices used were primarily shower hoses (85.3%, 262/307), and relatively few MSM used commercial RD products (8.1%, 25/307) before sex. The prevalence of HIV-1 and syphilis was 11.7% and 13.2%, respectively. HIV infection was positively associated with RD, practicing RD before sex, the interaction between RD and CRAI using a shower hose for RD and other risk factors, practicing RD after sex, CRAI, using nitrite inhalants, main sexual role with males as bottom and syphilis infection. Conclusions RD is popular among Chinese MSM. Improper noncommercial RD tools use (such as shower hose), the interaction effect between RD and CRAI associated with HIV infection. Public health workers and the MSM community should publicize scientific knowledge and prevention approaches relating to RD and HIV transmission to MSM. We recommend that further studies should be conducted to understand the detailed mechanism between RD and increased HIV prevalence.

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Increasing Condomless Anal Intercourse and HIV Prevalence Among Men Who Have Sex with Men Who Have Never Been Tested for HIV Before: A Serial Cross-Sectional Study in Shenyang, China from 2012 to 2016

AIDS and Behavior ◽

10.1007/s10461-020-02842-0 ◽

2020 ◽

Vol 24 (10) ◽

pp. 2918-2926

Author(s):

Jing Zhang ◽

Jun-jie Xu ◽

Sequoia I. Leuba ◽

Zhen-xing Chu ◽

Qing-hai Hu ◽

...

Keyword(s):

Anal Intercourse ◽

Cross Sectional Study ◽

Hiv Prevalence ◽

Sectional Study ◽

Cross Sectional ◽

Condomless Anal Intercourse ◽

Sex With Men

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The use of inappropriate anal douching tool associates with increased HIV infection among men who have sex with men: a cross-sectional study in Shenyang, China

10.21203/rs.3.rs-17842/v2 ◽

2020 ◽

Author(s):

ZhenXing Chu ◽

Guangquan Shen ◽

Qinghai Hu ◽

Hongyi Wang ◽

Jing Zhang ◽

...

Keyword(s):

Hiv Infection ◽

Sexual Behaviors ◽

Interaction Effect ◽

Anal Intercourse ◽

Cross Sectional Study ◽

Sectional Study ◽

Anal Sex ◽

Cross Sectional ◽

Increased Risk ◽

Sex With Men

Abstract Background: Rectal douching (RD) is widely practiced by men who have sex with men (MSM), and is correlated with increased risk of HIV infection. However, the mechanism of how RD increases the risk of HIV infection is not well understood, and there is limited data on RD behavior in MSM practicing anal sex in China. We examine the purpose of RD, its timing in relation to anal sex, the types of RD products used, and risky sexual behaviors among MSM reporting anal sex.Methods: Between August 2017 and December 2018, a cross-sectional study was conducted among adult MSM in Shenyang, China. Data were collected on demographics, sexual behaviors, and RD for the most recent sexual intercourse by means of interviewer-administered face-to-face questionnaires. Blood samples were collected to test for antibodies to HIV and syphilis. Multivariable logistic regression models were used to assess the risk factors associated with HIV infection.Results: A total of 515 eligible MSM participated in this survey (median age: 31 years). During the most recent anal intercourse, 28.3% (146/515) had condomless receptive anal intercourse (CRAI), 21.4% (110/515) practiced serosorting, and more than half (61.6%, 317/515) reported RD before or after anal sex. Of those practicing RD, 96.8% (307/317) conducted RD before sex, while 62.5% (198/317) conducted RD after sex. The douching devices used were primarily shower hoses (85.3%, 262/307), and relatively few MSM used commercial RD products (8.1%, 25/307) before sex. The prevalence of HIV-1 and syphilis was 11.7% and 13.2%, respectively. HIV infection was positively associated with RD (adjusted odds ratio (AOR), 2.8; 95% confidence interval (CI), 1.4-5.5), practicing RD before sex (AOR, 2.3; 95% CI, 1.2–4.3), practicing RD after sex (AOR, 1.8; 95% CI, 1.0–3.1), using a shower hose for RD (AOR, 3.5; 95% CI, 1.1–13.0), CRAI (AOR, 2.9; 95% CI, 1.6–5.5), and an interaction effect of RD and CRAI (AOR = 4.2; 95 % CI, 2.2- 8.1) in the most recent anal intercourse.Conclusions: RD is popular among Chinese MSM. Improper noncommercial RD tools use (such as shower hose), the interaction effect between RD and CRAI associated with HIV infection. Public health workers and the MSM community should publicize scientific knowledge and prevention approaches relating to RD and HIV transmission to MSM. We recommend that cohort studies should be conducted to confirm the causal relationship between RD and acquiring HIV.

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HIV/STIs risks between migrant MSM and local MSM: a cross-sectional comparison study in China

PeerJ ◽

10.7717/peerj.2169 ◽

2016 ◽

Vol 4 ◽

pp. e2169 ◽

Cited By ~ 7

Author(s):

Jie Wu ◽

Hong Wu ◽

Pengsheng Li ◽

Ciyong Lu

Keyword(s):

Anal Intercourse ◽

Unprotected Anal Intercourse ◽

Cross Sectional Study ◽

Comparison Study ◽

Hiv Knowledge ◽

Cross Sectional ◽

Sexually Transmitted ◽

Hiv Epidemic ◽

Migratory Status ◽

Sex With Men

Background.Internal migration plays a significant role in China’s HIV epidemic. However, few studies have directly compared migrant men who have sex with men (MSM) with local MSM with regard to HIV/sexually transmitted infections (STIs) risks.Methods.We conducted a study in Guangzhou, China, with the aim of understanding the differences in HIV/STIs risks between migrant MSM and local MSM. A cross-sectional study was conducted among 273 migrant MSM and 249 local MSM in Guangzhou, China. Their behavioral and serologic data on HIV/syphilis were collected and compared between the two groups. A multivariate logistic regression was used to estimate the associations between HIV/STIs risks and migratory status.Results.Migrant MSM, compared to local MSM, have higher odds of reporting unprotected anal intercourse (UAI) (OR= 1.4; 95% CI [0.9–2.0]) and having multiple homosexual partners (OR= 1.2; 95% CI [0.8–1.8]). A lower rate of condom use at homosexual debut was reported in migrant MSM than in local MSM (OR= 0.7; 95% CI [0.5–0.9]). Migrant MSM have less odds of reporting HIV/STIs testing in the previous 6 months relative to local MSM (OR= 0.5; 95% CI [0.4–0.8]). In addition, migrant MSM demonstrated a lower level of HIV knowledge than local MSM (OR= 0.4; 95% CI [0.2–0.8]).Conclusion.Migrant MSM are more likely to engage in sexual risk behaviors, report a lower level of HIV knowledge and have less access to HIV/STIs testing. Further comprehensive interventions targeting migrant MSM are urged.

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The use of inappropriate anal douching tool associates with increased HIV infection among men who have sex with men: a cross-sectional study in Shenyang, China

10.21203/rs.3.rs-17842/v4 ◽

2021 ◽

Author(s):

ZhenXing Chu ◽

Guangquan Shen ◽

Qinghai Hu ◽

Hongyi Wang ◽

Jing Zhang ◽

...

Keyword(s):

Risk Factors ◽

Hiv Infection ◽

Sexual Behaviors ◽

Anal Intercourse ◽

Cross Sectional Study ◽

Sectional Study ◽

Anal Sex ◽

Cross Sectional ◽

Increased Risk ◽

Sex With Men

Abstract Background: Rectal douching (RD) is widely practiced by men who have sex with men (MSM), and is associated with increased risk of HIV infection. However, the mechanism of how RD increases the risk of HIV infection is not well understood, and there is limited data on RD behavior in MSM practicing anal sex in China. We examine the purpose of RD, its timing in relation to anal sex, the types of RD products used, and risky sexual behaviors among MSM reporting anal sex.Methods: Between August 2017 and December 2018, a cross-sectional study was conducted among adult MSM in Shenyang, China. Data were collected on demographics, sexual behaviors, and RD for the most recent sexual intercourse by means of interviewer-administered face-to-face questionnaires. Blood samples were collected to test for antibodies to HIV and syphilis. Multivariable logistic regression models were used to assess the risk factors associated with HIV infection.Results: A total of 515 eligible MSM participated in this survey (median age: 31 years). During the most recent anal intercourse, 28.3% (146/515) had condomless receptive anal intercourse (CRAI), 21.4% (110/515) practiced serosorting, and more than half (61.6%, 317/515) reported RD before or after anal sex. Of those practicing RD, 96.8% (307/317) conducted RD before sex, while 62.5% (198/317) conducted RD after sex. The douching devices used were primarily shower hoses (85.3%, 262/307), and relatively few MSM used commercial RD products (8.1%, 25/307) before sex. The prevalence of HIV-1 and syphilis was 11.7% and 13.2%, respectively. HIV infection was positively associated with RD, practicing RD before sex, the interaction between RD and CRAI using a shower hose for RD and other risk factors, practicing RD after sex, CRAI, using nitrite inhalants, main sexual role with males as bottom and syphilis infection.Conclusions: RD is popular among Chinese MSM. Improper noncommercial RD tools use (such as shower hose), the interaction effect between RD and CRAI associated with HIV infection. Public health workers and the MSM community should publicize scientific knowledge and prevention approaches relating to RD and HIV transmission to MSM. We recommend that further studies should be conducted to understand the detailed mechanism between RD and increased HIV prevalence.

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