期刊论文详细信息
BMC Public Health
Distributions and trends in sexual behaviors and HIV incidence among men who have sex with men in China
David P Wilson1  Eric P F Chow1  Lei Zhang1 
[1] The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
关键词: Sexual behaviors;    Incidence;    HIV;    China;    MSM;    Men who have sex with men;   
Others  :  1163429
DOI  :  10.1186/1471-2458-12-546
 received in 2012-02-16, accepted in 2012-07-10,  发布年份 2012
PDF
【 摘 要 】

Background

HIV prevalence is increasing at a concerning rate among men who have sex with men (MSM) in China. Numerous studies have reported on levels of behaviors of Chinese MSM for different types of sexual partnerships, such as regular, non-commercial casual and commercial. This study aims to investigate the trends HIV incidence rates in relation to their risk sexual behaviors and partnership types among Chinese MSM.

Method

Through a comprehensive literature research from available English and Chinese literature databases, we collated relevant information of sexual behaviors of Chinese MSM. Further, with the utilization of a mathematical optimization approach, this study reconciles the distributions of sexual behavioral data over the last decade and infers the heterogeneous distributions of behavioral patterns among Chinese MSM. Distributions of high-risk behavioural indicators, including the number of sexual partners, number of sexual acts and condom usage in the past 6 months, are calibrated to available empirical data. Based on the resultant temporal trends in these distributions, the trends in HIV incidence rates associated with each type of partnership among MSM in China are also estimated.

Results

A total of 55 qualified articles have been identified. An average MSM has approximately 0.96 (95% CI, 0.59-1.18) regular, 3.75 (1.72-6.25) casual and 1.61 (0.97-2.78) commercial partners over a 6 month period and 4.33 (2.81-6.46), 1.42 (0.62-3.08), 1.48 (0.79-3.30) sexual acts per partnership respectively, corresponding to a total of 11.87 (8.87-15.25) acts. Condom usage has increased significantly during 2002–2010, at annual increases of 3.58% (2.98-4.12%), 5.55% (4.55-6.54%), and 5.03% (4.19-5.74%) for regular, casual and commercial partners respectively. These behavioral data implies an increase in HIV incidence of approximately 3.3-fold, from 2.04 (1.96-2.12) to 7.02 (6.71-7.35) per 1000 person-years during the same period. The proportion of new infections attributed to regular partnerships increased from 34% to 40%, whereas infections attributed to commercial partnerships reduced from 29% to 23% during 2002–2010.

Conclusion

Regular partnerships are the main contributor of new HIV cases among MSM in China, public health intervention strategies are required to increase condom usage and HIV testing rates among regular partners to curb the growing trend HIV incidence.

【 授权许可】

   
2012 Zhang et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150413101201946.pdf 987KB PDF download
Figure 5. 70KB Image download
Figure 4. 69KB Image download
Figure 3. 62KB Image download
Figure 2. 49KB Image download
Figure 1. 54KB Image download
【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

【 参考文献 】
  • [1]Ministry of Health of the People's Republic of China: China 2010 UNGASS Country Progress Report (2008–2009). Beijing, China: Ministry of Health; 2010.
  • [2]Sheng L, Cao WK: HIV/AIDS epidemiology and prevention in China. Chin Med J (Engl) 2008, 121(13):1230-1236.
  • [3]Ministry of Health of the People's Republic of China: UNGASS Country Progress Report P. R. China (2006–2007). Beijing, China: Ministry of Health; 2008.
  • [4]Chow EPF, Wilson DP, Zhang J, Jing J, Zhang L: Human immunodeficiency virus prevalence is increasing among men who have sex with men in China: findings from a review and meta-analysis. Sex Transm Dis 2011, 38(9):845-857.
  • [5]van Griensven F, de Lind van Wijngaarden JW, Baral S, Grulich A: The global epidemic of HIV infection among men who have sex with men. Curr Opin HIV AIDS 2009, 4(4):300-307.
  • [6]Wong FY, Huang ZJ, Wang W, He N, Marzzurco J, Frangos S, Buchholz ME, Young D, Smith BD: STIs and HIV among men having sex with men in China: a ticking time bomb? AIDS Educ Prev 2009, 21(5):430-446.
  • [7]Zhang B, Li X, Chu Q, Wang N, Wang Z, Zhou S, Tong C, Zhang J, Guan W, Cui Z, et al.: A survey of HIV/AIDS related behaviors among 2250 MSM in nine major cities of China. Chinese Journal of AIDS & STD 2008, 14(6):541-547.
  • [8]Jin F, Jansson J, Law M, Prestage GP, Zablotska I, Imrie JCG, Kippax SC, Kaldor JM, Kaldor JM, Grulich AE, Wilson DP: Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART. AIDS 2010, 24:907-913.
  • [9]Sullivan PS, Salazar L, Buchbinder S, Sanchez TH: Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS 2009, 23(9):1153-1162.
  • [10]Chow EPF, Wilson DP, Zhang L: Patterns of Condom Use Among Men Who Have Sex with Men in China: A Systematic Review and Meta-Analysis. AIDS Behav 2012, 16(3):653-663.
  • [11]Chow EPF, Wilson DP, Zhang L: Estimating HIV incidence among female partners of bisexual men in China. International Journal of Infectious Diseases. Int J Infect Dis 2012, 16(5):e312-e320.
  • [12]Kault D: The shape of the distribution of the number of sexual partners. Stat Med 1996, 15(2):221-230.
  • [13]Chow EPF, Wilson DP, Zhang L: HIV and syphilis co-infection increasing among men who have sex with men in China: a systematic review and meta-analysis. PLoS One 2011, 6(8):e22768.
  • [14]Weller SC: A meta-analysis of condom effectiveness in reducing sexually transmitted HIV. Soc Sci Med 1993, 36(12):1635-1644.
  • [15]Weller SC, Davis KR: Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database Syst Rev 2002, 1:CD003255.
  • [16]Pinkerton SD, Abramson PR: Effectiveness of condoms in preventing HIV transmission. Soc Sci Med 1997, 44(9):1303-1312.
  • [17]Fitch JT, Stine C, Hager WD, Mann J, Adam MB, McIlhaney J: Condom effectiveness: factors that influence risk reduction. Sex Transm Dis 2002, 29(12):811-817.
  • [18]Davis KR, Weller SC: The effectiveness of condoms in reducing heterosexual transmission of HIV. Fam Plann Perspect 1999, 31(6):272-279.
  • [19]Zhang L, Chow EPF, Wilson DP: Men who have sex with men in China have relatively low numbers of sexual partners. Infectious Disease Reports 2011, 3(1):46-51.
  • [20]Zeng G, Xiao Y, Xu P, Feng N, Jin CR, Lu F: Evaluation of effect of community-based HIV/AIDS interventions among men who have sex with men in eighteen cities, China. Zhonghua Yu Fang Yi Xue Za Zhi 2009, 43(11):977-980.
  • [21]Liu H, Wang N, Zhang Q, Shao Y, Wu T, Liu Y, Jiang HB, Song Y, Zhang L, Yin WY, et al.: Study of HIV and syphilis infection situation and sexual behavioral characteristics among 416 MSM. Chinese Journal of AIDS & STD 2007, 13(3):230-232. 234
  • [22]Lau JT, Wang M, Wong HN, Tsui HY, Jia M, Cheng F, Zhang Y, Su X, Wang N: Prevalence of bisexual behaviors among men who have sex with men (MSM) in China and associations between condom use in MSM and heterosexual behaviors. Sex Transm Dis 2008, 35(4):406-413.
  • [23]Rosenberg ES, Sullivan PS, Dinenno EA, Salazar LF, Sanchez TH: Number of casual male sexual partners and associated factors among men who have sex with men: results from the National HIV Behavioral Surveillance system. BMC Public Health 2011, 11:189. BioMed Central Full Text
  • [24]Wilson DP, Hoare A, Regan DG, Law MG: Importance of promoting HIV testing for preventing secondary transmissions: modelling the Australian HIV epidemic among men who have sex with men. Sex Health 2009, 6(1):19-33.
  • [25]Crawford JM, Kippax SC, Mao L, Van de Ven PG, Prestage GP, Grulich AE, Kaldor J: Number of risk acts by relationship status and partner serostatus: Findings from the HIM cohort of homosexually active men in Sydney, Australia. AIDS Behav 2006, 10(3):325-331.
  • [26]Mao L, Crawford JM, Hospers HJ, Prestage GP, Grulich AE, Kaldor JM, Kippax SC: "Serosorting" in casual anal sex of HIV-negative gay men is noteworthy and is increasing in Sydney, Australia. AIDS 2006, 20(8):1204-1206.
  • [27]Zhou YR: Homosexuality, seropositivity, and family obligations: perspectives of HIV-infected men who have sex with men in China. Cult Health Sex 2006, 8(6):487-500.
  • [28]Gay Literature from China: In Search of a Happy Ending. http://www.iias.nl/iiasn/31/IIASN31_27.pdf webcite
  • [29]Liu H, Feng T, Ha T, Cai Y, Liu X, Li J: Chinese Culture, Homosexuality Stigma, Social Support and Condom Use: A Path Analytic Model. Stigma Res Action 2011, 1(1):27-35.
  • [30]Zhang QP, Ding XB, Feng LG, Xu J, Lu RR, Guo XJ, Xu SM, Xheng JQ: The prevalence of HIV and syphilis and influencing factors among male sex workers. Acta Academiae Medicinae Militaris Tertiae 2011, 33(3):318-320.
  • [31]Ruan Y, Jia Y, Zhang X, Liang H, Li Q, Yang Y, Li D, Zhou Z, Luo F, Shi W, et al.: Incidence of HIV-1, syphilis, hepatitis B, and hepatitis C virus infections and predictors associated with retention in a 12-month follow-up study among men who have sex with men in Beijing, China. J Acquir Immune Defic Syndr 2009, 52(5):604-610.
  • [32]Shang H, Xu JJ, Zhang M, Brown K, Reilly K, Wang HL, Hu QH, Ding HB, Chu ZX, Bice T: Syphilis and HIV Seroconversion Among a 12-Month Prospective Cohort of Men Who Have Sex With Men in Shenyang, China. Sex Transm Dis 2010, 37(7):432-439.
  • [33]Hao C, Yan H, Yang H, Huan X, Guan W, Xu X, Zhang M, Tang W, Wang N, Gu J, et al.: The incidence of syphilis, HIV and HCV and associated factors in a cohort of men who have sex with men in Nanjing, China. Sex Transm Infect 2011, 87(3):199-201.
  • [34]Yang H, Hao C, Huan X, Yan H, Guan W, Xu X, Zhang M, Tang W, Wang N, Lau JT: HIV Incidence and Associated Factors in a Cohort of Men Who Have Sex With Men in Nanjing, China. Sex Transm Dis 2010, 37(4):208-213.
  • [35]Li H-M, Peng R-R, Li J, Yin Y-P, Wang B, Cohen MS, Chen X-S: HIV Incidence among Men Who Have Sex with Men in China: A Meta-Analysis of Published Studies. PLoS One 2011, 6(8):e23431.
  • [36]Bao YG, Zhang YH, Zhao JK, Sun JP, Tan HZ: HIV infection and KAP status among men who have sex with men in 14 Chinese cities. Zhonghua Yu Fang Yi Xue Za Zhi 2009, 43(11):981-983.
  • [37]Chen XS, Yin YP, Jiang N, Wang B: Setting typologies and HIV prevalence among men who have sex with men in China: implication for surveillance and intervention. Sex Transm Dis 2012, 39(3):226-228.
  • [38]Tao T, Cao Y, Yin W, Yan H, Liu JF: Comparative study on AIDS related knowledge and behavior among MSM in different sites. Journal of Public Health and Preventive Medicine 2011, 22(6):5-8.
  • [39]Zhang D, Bi P, Lv F, Zhang J, Hiller JE: Differences between Internet and community samples of MSM: implications for behavioral surveillance among MSM in China. AIDS Care 2008, 20(9):1128-1137.
  • [40]Xi SJ, He YF: Prevalence Study on HIV Infection among MSM in Different Public Areas in Hangzhou. Zhejiang Journal of Preventive Medicine 2009, 21(9):1-2. 15
  • [41]Xu J, Han DL, Liu Z, Ma XY, Wang LL, Xu J, Pang L, Zhang HB, Wu ZY: The prevalence of HIV infection and the risk factors among MSM in 4 cities, China. Zhonghua Yu Fang Yi Xue Za Zhi 2010, 44(11):975-980.
  • [42]Xiao Y, Sun J, Li C, Lu F, Allen KL, Vermund SH, Jia Y: Prevalence and correlates of HIV and syphilis infections among men who have sex with men in seven provinces in China with historically low HIV prevalence. J Acquir Immune Defic Syndr 2010, 53(Suppl 1):S66-73.
  • [43]Wang L, Wang N, Li D, Jia M, Gao X, Qu S, Qin Q, Wang Y, Smith K: The 2007 Estimates for People at Risk for and Living With HIV in China: Progress and Challenges. J Acquir Immune Defic Syndr 2009, 50(4):414-418.
  • [44]Zhu MQ, Zhang BC, Li XF, Shu TX, Wu SW: High Risk Behaviors Related HIV/AIDS and Education Variables of Men Who Have Sex with Men (MSM) in China. Ningxia Medical Journal 2005, 27(1):27-29.
  文献评价指标  
  下载次数:52次 浏览次数:21次