Polydrug use is associated with new HIV infections among men who have sex with men in China: a multicenter cross-sectional survey

Abstract Background: Recreational drug use is popular among men who have sex with men (MSM), while there is limited information about polydrug use and its consequent impact on sexual health and human immunodeficiency virus (HIV) acquisition. Methods: Mixed methods were used to recruit MSM from seven cities in China between 2012 and 2013. Participants were divided into four subgroups based on the number of recreational drugs (RDs) used in the past 6 months. “Polydrug use” was defined as simultaneous use of ≥2 types of RDs. Information on demographics and HIV high-risk behaviors (HIV-HRBs) was collected, and blood samples were tested for recent HIV infection by the BED capture enzyme immunoassay. Results: A total of 4,496 Chinese MSM participated, of which 28.4% used RDs, and 5% were polydrug users. Polydrug users commonly took poppers with one or more types of other RDs (e.g. methamphetamine). Polydrug users were likely to be aged 26–30 years, have low educational attainment, be internal migrants, have a high monthly income, use versatile positions during anal intercourse, and have inadequate knowledge about prevention of HIV infection. As the number of RDs used in the past 6 months increased, the prevalence of HIV-HRBs increased ( P <0.05 for all). The odds of recent HIV infection were higher among those who used one type (aOR = 2.2, 95%CI: 1.5–3.0) or two types of RDs (2.3, 1.0–5.2) in the past 6 months compared with those who did not use RDs. Conclusion: The level and pattern of polydrug use among Chinese MSM were different from high-income countries. Polydrug use had a dose-effect relationship with HIV-HRBs. Polydrug users who have higher levels of RDs use are more likely to engage in various sexual risks, thus may be associated with new HIV infections.

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Polydrug use is associated with new HIV infections among men who have sex with men in China: a multicenter cross-sectional survey

10.21203/rs.2.10999/v1 ◽

2019 ◽

Author(s):

Xiang Mao ◽

Sequoia I. Leuba ◽

Qinghai Hu ◽

Hongjing Yan ◽

Zhe Wang ◽

...

Keyword(s):

Hiv Infection ◽

Hiv Infections ◽

Developed Countries ◽

Dose Effect ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Polydrug Use ◽

The Past ◽

Sex With Men ◽

Recent Hiv Infection

Abstract Background Recreational drug use is popular among men who have sex with men (MSM), while there is limited information about polydrug use and its consequent impact on sexual health and human immunodeficiency virus (HIV) acquisition. Methods MSM were recruited from a multicenter cross-sectional survey conducted in seven Chinese cities. Participants were divided into four subgroups based on the number of recreational drugs (RDs) used in the past 6 months. “Polydrug use” was defined as simultaneous use of ≥2 types of RDs. Information on demographics and HIV high-risk behaviors (HIV-HRBs) was collected, and blood samples were tested for recent HIV infection by the BED capture enzyme immunoassay. Results A total of 4,496 Chinese MSM participated, of which 28.4% used RDs, and 5% were polydrug users. Polydrug users commonly took poppers with one or more types of other RDs (e.g. methamphetamine). Polydrug users were likely to be aged 26–30 years, have low educational attainment, be internal migrants, have a high monthly income, use versatile positions during anal intercourse, and have inadequate knowledge about prevention of HIV infection (P<0.05 for all). As the number of RDs used in the past 6 months increased, the prevalence of HIV-HRBs increased (P<0.05 for all). The odds of recent HIV infection were higher among those who used one type (aOR = 2.2, 95%CI: 1.5–3.0) or two types of RDs (2.3, 1.0–5.2) in the past 6 months compared with those who did not use RDs. The population-attributable fractions of most HIV-HRBs for recent HIV infection were higher among polydrug users compared with those who used only one type of RD or used no RD in the past 6 months. Conclusion The level and pattern of polydrug use among Chinese MSM were different from developed countries. Polydrug use had a dose-effect relationship with HIV-HRBs. Polydrug users who have greater levels of RDs use are more likely to engage in various sexual risks, thus may associated with new HIV infections.

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Polydrug use is associated with new HIV infections among men who have sex with men in China: a multicenter cross-sectional survey

10.21203/rs.2.13247/v1 ◽

2019 ◽

Author(s):

Xiang Mao ◽

Sequoia I. Leuba ◽

Qinghai Hu ◽

Hongjing Yan ◽

Zhe Wang ◽

...

Keyword(s):

Hiv Infection ◽

Hiv Infections ◽

Developed Countries ◽

Dose Effect ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Polydrug Use ◽

The Past ◽

Sex With Men ◽

Recent Hiv Infection

Abstract Background: Recreational drug use is popular among men who have sex with men (MSM), while there is limited information about polydrug use and its consequent impact on sexual health and human immunodeficiency virus (HIV) acquisition. Methods: MSM were recruited from a multicenter cross-sectional survey conducted in seven Chinese cities. Participants were divided into four subgroups based on the number of recreational drugs (RDs) used in the past 6 months. “Polydrug use” was defined as simultaneous use of ≥2 types of RDs. Information on demographics and HIV high-risk behaviors (HIV-HRBs) was collected, and blood samples were tested for recent HIV infection by the BED capture enzyme immunoassay. Results: A total of 4,496 Chinese MSM participated, of which 28.4% used RDs, and 5% were polydrug users. Polydrug users commonly took poppers with one or more types of other RDs (e.g. methamphetamine). Polydrug users were likely to be aged 26–30 years, have low educational attainment, be internal migrants, have a high monthly income, use versatile positions during anal intercourse, and have inadequate knowledge about prevention of HIV infection ( P <0.05 for all). As the number of RDs used in the past 6 months increased, the prevalence of HIV-HRBs increased ( P <0.05 for all). The odds of recent HIV infection were higher among those who used one type (aOR = 2.2, 95%CI: 1.5–3.0) or two types of RDs (2.3, 1.0–5.2) in the past 6 months compared with those who did not use RDs. The population-attributable fractions of most HIV-HRBs for recent HIV infection were higher among polydrug users compared with those who used only one type of RD or used no RD in the past 6 months. Conclusion: The level and pattern of polydrug use among Chinese MSM were different from developed countries. Polydrug use had a dose-effect relationship with HIV-HRBs. Polydrug users who have greater levels of RDs use are more likely to engage in various sexual risks, thus may associated with new HIV infections.

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Use of multiple recreational drugs is associated with new HIV infections among men who have sex with men in China: a multicenter cross-sectional survey

BMC Public Health ◽

10.1186/s12889-021-10223-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xiang Mao ◽

Sequoia I. Leuba ◽

Qinghai Hu ◽

Hongjing Yan ◽

Zhe Wang ◽

...

Keyword(s):

High Risk ◽

Hiv Infection ◽

Risk Behaviors ◽

Sexual Behaviors ◽

Hiv Infections ◽

Recreational Drugs ◽

Limited Information ◽

High Risk Behaviors ◽

Sex With Men ◽

Recent Hiv Infection

Abstract Background There is limited information about the types of recreational drugs used by men who have sex with men (MSM) in China or the consequent impact on sexual health and human immunodeficiency virus (HIV) acquisition. Methods We recruited MSM from seven cities in China between 2012 and 2013 using multiple approaches including advertisements on gay websites, collaborating with local MSM community-based organizations, peer referrals, and venues such as gay bars and bathrooms visited by MSM. We divided participants into four subgroups based on the number of recreational drugs (RDs) used in the previous 6 months. We defined use of multiple RDs as use of ≥2 types of RDs. Demographics and HIV-related high-risk behaviors were collected, and blood samples were tested for recent HIV infection by the HIV-1 subtypes B, E, and D immunoglobulin G capture enzyme immunoassay (BED-CEIA). We used multivariable logistic regression adjusted for sociodemographics to determine the adjusted odds ratios (aORs) and associated 95% confidence intervals (CIs) of the subgroups of RD use for recent or established HIV infection. Results A total of 4496 Chinese MSM participated; 28.4% used RDs, and 5% used multiple types of RDs. The prevalence of each RD use was as follows: poppers (25.9%), ecstasy (2.4%), ketamine (1.2%), amphetamine (0.6%), tramadol (0.4%), methamphetamine (3.8%), and codeine (1.9%). Users of multiple RDs commonly used poppers combined with one or more other types of RDs. Multiple RD users were likely to be aged 26–30 years (vs. 18–25 and > 30 years), live in non-local cities (vs. local cities), never married (vs. married), have a high monthly income (vs. no income and 1–599 USD), use versatile positions during anal intercourse (vs. top or bottom), and have inadequate HIV-related prevention knowledge (vs. adequate). As the number of RDs used in the previous 6 months increased, the prevalence of HIV-related high-risk behaviors increased (P < 0.05 for all). The odds of recent HIV infection were higher among those who used one type (aOR = 2.2, 95% CI: 1.5–3.0) or two types of RD (aOR=2.3, 95% CI: 1.0-5.2) in the previous 6 months compared to the odds among those who did not use RDs. Conclusion The level and pattern of multiple RD use among Chinese MSM were different from high-income countries. MSM who used more RDs are more likely to engage in high-risk sexual behaviors, and these behaviors may be associated with increases in new HIV infections.

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Nitrite Inhalants Use and HIV Infection among Men Who Have Sex with Men in China

BioMed Research International ◽

10.1155/2014/365261 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Dongliang Li ◽

Xueying Yang ◽

Zheng Zhang ◽

Xiao Qi ◽

Yuhua Ruan ◽

...

Keyword(s):

Hiv Infection ◽

Casual Sex ◽

Structured Interviews ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Past ◽

Logistic Analysis ◽

Independent Association ◽

Blood Specimens ◽

Sex With Men

Objective. This is the first study in China to examine the use of nitrite inhalants and its correlates among men who have sex with men (MSM) in Beijing, China.Methods. A cross-sectional survey was conducted in 2012. Structured interviews collected data on demographics, sexual and drug use behaviors, and the use of HIV services. Blood specimens were collected and tested for HIV and syphilis.Results. A total of 400 MSM eligible for the study were between 19 and 63 years of age and overall HIV prevalence was 6.0% (9.0% among nitrite inhalant users and 3.3% among nonusers). Nearly half (47.3%) of them reported ever using nitrite inhalants and 42.3% admitted using nitrite inhalants in the past year. Multivariable logistic analysis revealed that ever using nitrite inhalants in the past was independently associated with being aged≤25years, having higher education attainment, seeking sex via Internet, having casual partners in the past three months, and being HIV positive.Conclusion. The use of nitrite inhalants was alarmingly prevalent among MSM in Beijing. The independent association of the nitrite inhalant use with more casual sex partners and HIV infection underscored the need for intervention and prevention of nitrite inhalant use.

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Trends in HIV prevalence and risk behaviours among men who have sex with men from 2013 to 2017 in Nanjing, China: a consecutive cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2018-021955 ◽

2019 ◽

Vol 9 (1) ◽

pp. e021955 ◽

Cited By ~ 2

Author(s):

Zhengping Zhu ◽

Hongjing Yan ◽

Sushu Wu ◽

Yuanyuan Xu ◽

Wenjiong Xu ◽

...

Keyword(s):

Hiv Infection ◽

Hiv Testing ◽

Protective Factor ◽

Hiv Prevalence ◽

Secondary Outcome ◽

Risk Behaviours ◽

Cross Sectional ◽

The Past ◽

Testing Rate ◽

Sex With Men

ObjectiveTo examine the trends of HIV prevalence, risk behaviours and HIV testing among men who have sex with men (MSM) in Nanjing.DesignFive consecutive cross-sectional surveys.SettingNanjing, China.Primary and secondary outcome measuresHIV and syphilis prevalence, HIV testing rate and factors associated with HIV infection; demographic characteristics and behaviours.Results649, 669, 577, 633, 503 MSM were recruited from 2013 to 2017. HIV prevalence was 9.9%, 12.3%, 12.5%, 9.8% and 10.1%, respectively. Syphilis prevalence decreased with a range from 10.6% to 5.6%. Risk behaviours like unprotected anal intercourse (UAI) and unprotected virginal sex in the past 6 months decreased, but multiple sex partners and ever used rush popper rose significantly. MSM tested for HIV in the previous year remained stable from 57.0% to 64.1% (P=0.633). Multivariate analysis showed that tested for HIV in the past year was protective factor against HIV infection. MSM who had UAI in the past 6 months, sex role as receptive and dual, diagnosed with sexually transmitted diseases (STDs) in the past year and currently syphilis infected were risk factors for HIV infection.ConclusionsWe observed stable high HIV prevalence, a steady HIV testing rate, decreasing syphilis prevalence and UAI among MSM in Nanjing. However, rush popper use rose dramatically. The HIV preventive strategies for MSM including condom promotion, HIV testing expansion and reduction of rush popper use, STDs screening and standardised treatment should be strengthened.

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Internet-Based Sex-Seeking Behavior Promotes HIV Infection Risk: A 6-Year Serial Cross-Sectional Survey to MSM in Shenyang, China

BioMed Research International ◽

10.1155/2016/2860346 ◽

2016 ◽

Vol 2016 ◽

pp. 1-11 ◽

Cited By ~ 14

Author(s):

Shi Pan ◽

Jun-Jie Xu ◽

Xiao-Xu Han ◽

Jing Zhang ◽

Qing-Hai Hu ◽

...

Keyword(s):

Hiv Infection ◽

Multivariable Analysis ◽

Cross Sectional Study ◽

Hiv Prevalence ◽

The Internet ◽

Transmitted Drug Resistance ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Seeking Behavior ◽

Sex With Men

HIV prevalence is still rapidly increasing among Chinese men who have sex with men (MSM). The Internet also makes it easier for MSM to have casual partners. This study aims to evaluate the trend of Internet-based sex-seeking behavior of MSM and its impact on HIV prevalence, the distribution of HIV subtype strains, and transmitted drug resistance rates. A serial cross-sectional study was conducted from 2009 to 2014. Of the 1,981 MSM, 50.5% (1,000/1,981) mainly sought homosexual partners through the Internet (Internet-based MSM, IBM). The proportion of IBM among total MSM subjects increased from 43.3% to 61.5% (p<0.001). HIV prevalence of IBM increased from 5.7% to 20.7%, while that of non-Internet-based MSM (NIBM) increased from 7.0% to 14.7%. A relative higher proportion of NIBM were infected with HIV CRF01_AE subtype than IBM (79.5% versus 72.2%, p=0.52). Multivariable analysis found IBM had a significantly higher HIV prevalence than NIBM (13.2% versus 10.5%, aOR = 1.4, 95% CI [1.0–1.9]). Being a migrant non-Shenyang resident MSM (aOR = 1.9, 95% CI [1.3–2.9]) and occasionally/never using condoms with casual homosexual partners (aOR = 1.7, 95% CI [1.1–2.6]) were two distinct risk factors for HIV infection in IBM. More efforts should be targeted towards developing interventions aimed at IBM, particularly migrant MSM and who engage in UAI with casual homosexual partners.

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HIV prevalence among men who have sex with men following the implementation of the HIV preventive guideline in Tanzania: respondent-driven sampling survey

BMJ Open ◽

10.1136/bmjopen-2019-036460 ◽

2020 ◽

Vol 10 (10) ◽

pp. e036460

Author(s):

Mwijage Alexander Ishungisa ◽

Kare Moen ◽

Germana Leyna ◽

Neema Makyao ◽

Angela Ramadhan ◽

...

Keyword(s):

Risk Factors ◽

Hiv Infection ◽

Primary Outcome ◽

Behavioural Change ◽

Dar Es Salaam ◽

Hiv Prevalence ◽

Respondent Driven Sampling ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Sex With Men

ObjectivesTo estimate HIV prevalence and associated risk factors among men who have sex with men (MSM) in Dar es Salaam, Tanzania following the implementation of the national comprehensive package of HIV interventions for key population (CHIP).DesignA cross-sectional survey using respondent-driven sampling.SettingDar es Salaam, Tanzania’s largest city.ParticipantsMen who occasionally or regularly have sex with another man, aged 18 years and above and living in Dar es Salaam city at least 6 months preceding the study.Primary outcome measureHIV prevalence was the primary outcome. Independent risk factors for HIV infection were examined using weighted logistics regression modelling.ResultsA total of 777 MSM with a mean age of 26 years took part in the study. The weighted HIV prevalence was 8.3% (95% CI: 6.3%–10.9%) as compared with 22.3% (95% CI: 18.7%–26.4%) observed in a similar survey in 2014. Half of the participants had had sex with more than two partners in the month preceding the survey. Among those who had engaged in transactional sex, 80% had used a condom during last anal sex with a paying partner. Participants aged 25 and above had four times higher odds of being infected than those aged 15–19 years. HIV infection was associated with multiple sexual partnerships (adjusted OR/AOR, 3.0; 95% CI: 1.8–12.0), not having used condom during last sex with non-paying partner (AOR, 4.1; 95% CI: 1.4–7.8) and ever having engaged in group sex (AOR, 3.4; 95% CI: 1.7–3.6).ConclusionHIV prevalence among MSM in Dar es Salaam has decreased by more than a half over the past 5 years, coinciding with implementation of the CHIP. It is nonetheless two times as high as that of men in the general population. To achieve the 2030 goal, behavioural change interventions and roll out of new intervention measures such as pre-exposure prophylaxis are urgently needed.

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HIV infection among young men who have sex with men in China: comparison of risks among students and non-students

10.21203/rs.2.12321/v1 ◽

2019 ◽

Author(s):

Jing Wu ◽

Zihuang Chen ◽

Fei Yu ◽

Youran Xu ◽

Yue Ma ◽

...

Keyword(s):

Logistic Regression ◽

Hiv Infection ◽

Infection Rate ◽

Multivariate Logistic Regression Analysis ◽

Young Men ◽

Multivariate Logistic Regression ◽

Cross Sectional ◽

Factors Associated ◽

The Past ◽

Sex With Men

Abstract Background The human immunodeficiency virus (HIV) epidemic has been drastically increasing among men who have sex with men (MSM) in China over the past decade. More so, the number of HIV infections among young adults in the country has also been on the rise, highlighting a unique sub-population, which may lead to increased incidence and transmission of the disease. This study aimed to determine the HIV infection rate amongst student and non-student young men who have sex with men (YMSM) in three regions in China and factors associated with their HIV infection. Methods A cross-sectional study was conducted from 1 September to 6 September 2017 in Beijing, Sichuan, and Guangzhou). Participants were recruited through a popular Chinese gay social networking application, as well as several college-based youth associations. Univariate and multivariate logistic regression analyses were conducted to assess factors associated with HIV infection. Results The HIV infection rate among non-student YMSM was significantly higher than that of student YMSM (10.3% versus 5.3%, χ2trend=17.34, P<0.001). The multivariate logistic regression analysis showed that YMSM self-identifying as homosexual (AOR=2.81, 95%CI=1.40-5.66, P=0.004) and perceived themselves at risk for HIV (AOR=3.08, 95:CI:1.33-7.15, P=0.009) had a 3 times increased odds of being HIV positive. Additionally, participants whom reported not always using condoms with sex partners in the past six months (AOR=1.69, 95%CI=1.17-2.44, P=0.006) were at increased odds of HIV infection. Conclusions Young men who have sex with men, particularly those identifying as homosexual and not always using condoms during intercourse, are at increased odds of HIV infection in China. Promoting comprehensive sexual education to youth and other measures aimed at improving HIV knowledge could help control HIV transmission among this key sub-population.

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Synthetic drug use and HIV infection among men who have sex with men in China: A sixteen-city, cross-sectional survey

PLoS ONE ◽

10.1371/journal.pone.0200816 ◽

2018 ◽

Vol 13 (7) ◽

pp. e0200816 ◽

Cited By ~ 6

Author(s):

Wei Luo ◽

Hang Hong ◽

Xiaofang Wang ◽

Jennifer M. McGoogan ◽

Keming Rou ◽

...

Keyword(s):

Drug Use ◽

Hiv Infection ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Synthetic Drug ◽

Sex With Men

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Understanding Beliefs, Intention, and Behavior on Daily PrEP Uptake Among MSM in California and New York

AIDS Education and Prevention ◽

10.1521/aeap.2021.33.2.129 ◽

2021 ◽

Vol 33 (2) ◽

pp. 129-142

Author(s):

Minhao Dai ◽

Nancy Grant Harrington

Keyword(s):

New York ◽

Hiv Infections ◽

The United States ◽

Integrative Model ◽

Path Modeling ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Sex With Men ◽

Exposure Prophylaxis ◽

And Behavior

Pre-exposure prophylaxis (PrEP) is an effective daily prevention medicine to reduce the risks of HIV infections. Even though the number of PrEP users has been rapidly growing in the United States since 2012, only approximately 5% of the men who have sex with men (MSM) population is currently taking PrEP. This study examined PrEP uptake among MSM using the integrative model of behavioral prediction (IMBP) as the theoretical framework. The authors conducted formative elicitation interviews and a cross-sectional survey with MSM. Among the survey respondents, half of them were PrEP takers and half were not. The path modeling results showed that attitudes and norms predicted behavioral intention, and intention predicted PrEP uptake among MSM. The results also identified the strongest attitudinal predictors and normative referents of PrEP uptake. The study offers practical implications in helping professionals and scholars to understand PrEP uptake among MSM in a theoretically grounded way.

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