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

BMC Infectious Diseases

Ming Wang¹  Huifang Xu¹  Hao Wu¹  Lirui Fan¹  Caiyun Liang¹  Yuteng Zhao¹  Huixia Mai¹  Kai Gao¹  Faju Qin¹  Zhigang Han¹  Giridhar R Babu²  Fei Zhong⁴  Weiming Tang³  Weibin Cheng¹ 

[1] Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Jiahe, Baiyun District, Guangzhou 510440, Guangdong Province, China;Department of Epidemiology, Public Health Foundation of India, IIPH H, Bangalore Campus, SIHFW Premises, 1st cross, Magadi road, Bangalore 560023, Karnataka, India;University of North Carolina Project-China, No.2 Lujing Road, Yuexiu District, Guangzhou 510095, Guangdong Province, China;School of Public Health, Sun Yat-Sen University, No.74 2nd Yat-Sen Road, Yuexiu District, Guangzhou 510080, Guangdong, Province, China

关键词: China;    Serial cross-sectional study;    Trend;    Human immunodeficiency virus (HIV);    Men who have sex with men (MSM);    Unprotected anal intercourse (UAI);   

Others  :  1090540
DOI  :  10.1186/s12879-014-0696-8

 received in 2014-07-22, accepted in 2014-12-11,  发布年份 2014

【 摘 要 】

Background

China experiencing an increasing HIV epidemic among men who have sex with men (MSM), and unprotected anal intercourse (UAI) has played a key role in this process. The aims of this study were to examine the trend of UAI and to explore the factors correlated with UAI among MSM in Guangzhou, China.

Methods

Data from 2008 to 2013 were retrieved from the annual serological and behavioral surveys system. We collected information on demographic, HIV related sexual behavior with men and women, access to HIV prevention services, and symptoms of sexually transmitted infections. Chi-square test was used to examine the similarity of the participants during the study period. Univariate and multivariate logistic regression were conducted to test the factors associated with UAI. Trend test was used to check the change of UAI in different characteristic stratums during the study period.

Results

In total, 58.4% (range from 54.5% to 62.0%) of the participants reported that they engaged in UAI in the past six months. Participants who aged less than 20 [Adjusted Odds Ratio (AOR): 2.22, 95% Confidential Interval (CI): 1.07-4.61], only attended elementary school (or less) (AOR: 1.41, 95% CI: 1.04-1.90), cohabiting with male partner (AOR: 2.15, 95% CI: 1.66-2.79), divorced or widowed (AOR: 2.80, 95% CI: 1.54-5.07), did not test for HIV in the past year (AOR: 1.36, 95% CI: 1.12-1.65), and had 10 or more partners in the past six months (AOR: 1.85, 95% CI: 1.18-2.91) had higher odds of UAI. However, the proportions of UAI were stable in different stratums during the study period.

Conclusions

The proportion of MSM engaged in UAI was consistently high during the study period. Effective intervention strategies, which include but not limit to risk reduction counseling and testing services, are urgently needed to bring down the risk behaviors of the MSM in Guangzhou, in order to control HIV/STIs epidemic in this specific population.

【 授权许可】

   
2014 Cheng et al.; licensee BioMed Central.

【 参考文献 】

• [1]YH Li: Subculture of homosexuality. In China Today Press. China Today Press, Beijing China; 1998.
• [2]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.
• [3]Chen X-S, Peeling RW, Yin Y-P, Mabey DC: The epidemic of sexually transmitted infections in China: implications for control and future perspectives. BMC Med 2011, 9(1):111. BioMed Central Full Text
• [4]Huan X, Tang W, Babu GR, Li J, Zhang M, Liu X, Yan H, Fu G, Zhao J, Yang H: HIV risk-reduction counseling and testing on behavior change of MSM. PLoS One 2013, 8(7):e69740.
• [5]Wang L, Tang W, Wang L, Qian S, Li Y-g, Xing J, Li D, Ding Z, Babu GR, Wang N: The HIV, Syphilis, and HCV Epidemics Among Female Sex Workers in China: Results From a Serial Cross-Sectional Study Between 2008 and 2012. Clin Infect Dis 2014: ciu245. [Epub ahead of print].
• [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 L, Chow EP, Jing J, Zhuang X, Li X, He M, Sun H, Li X, Gorgens M, Wilson D: HIV prevalence in China: integration of surveillance data and a systematic review. Lancet Infect Dis 2013, 13(11):955-963.
• [8]Zhong F, Liang B, Xu H, Cheng W, Fan L, Han Z, Liang C, Gao K, Mai H, Qin F: Increasing HIV and Decreasing Syphilis Prevalence in a Context of Persistently High Unprotected Anal Intercourse, Six Consecutive Annual Surveys among Men Who Have Sex with Men in Guangzhou, China, 2008 to 2013. PLoS One 2014, 9(7):e103136.
• [9]He Q, Peng WJ, Zhang JQ, Wang BX, Wang J: Prevalence of unprotected anal intercourse and unprotected vaginal intercourse among HIV-positive men who have sex with men in China: a meta-analysis. Sex Transm Infect 2012, 88(3):229-233.
• [10]Beyrer C, Baral SD, van Griensven F, Goodreau SM, Chariyalertsak S, Wirtz AL, Brookmeyer R: Global epidemiology of HIV infection in men who have sex with men. Lancet 2012, 380(9839):367-377.
• [11]Jones RH: Imagined comrades and imaginary protections: Identity, community and sexual risk among men who have sex with men in China. J Homosex 2007, 53(3):83-115.
• [12]Tang W, Yang H, Mahapatra T, Huan X, Yan H, Li J, Fu G, Zhao J, Detels R: Feasibility of recruiting a diverse sample of men who have sex with men: observation from Nanjing, China. PLoS one 2013, 8(11):e77645.
• [13]Zhong F, Lin P, Xu H, Wang Y, Wang M, He Q, Fan L, Li Y, Wen F, Liang Y: Possible increase in HIV and syphilis prevalence among men who have sex with men in Guangzhou, China: results from a respondent-driven sampling survey. AIDS Behav 2011, 15(5):1058-1066.
• [14]Tang W, Huan X, Mahapatra T, Tang S, Li J, Yan H, Fu G, Yang H, Zhao J, Detels R: Factors associated with unprotected anal intercourse among men who have sex with men: results from a respondent driven sampling survey in Nanjing, China, 2008. AIDS Behav 2013, 17(4):1415-1422.
• [15]Feng L, Ding X, Xu J, Ou Y, Xu S, Zheng J, Guo X, Yang M, Liu X: Study on HIV, syphilis and HCV prevalence and its associated factors among internet MSM comparison to non-internet MSM in Chongqing. J Trop Med 2010, 10(1):78-82.
• [16]Wu J, Hu Y, Jia Y, Su Y, Cui H, Liu H, Wang N: Prevalence of Unprotected Anal Intercourse among Men Who Have Sex with Men in China: An Updated Meta-Analysis. PLoS One 2014, 9(5):e98366.
• [17]Tang W, Yan H, Liu X, Wang N, Zhang M, Zhao X, Zhang J, Li L, Huan X, Yang H: Factors associated with HIV infection among men who have sex with men in Nanjing, Suzhou and Yangzhou: a 1: 4 matched case–control study. Zhonghua Liu Xing Bing Xue Za Zhi 2009, 30(5):448-451.
• [18]Feng Y, Wu Z, Detels R, Qin G, Liu L, Wang X, Wang J, Zhang L: HIV/STD prevalence among MSM in Chengdu, China and associated risk factors for HIV infection. J Acquir Immune Defic Syndr 2010, 53(Suppl 1):S74-S80.
• [19]Suarez T, Miller J: Negotiating risks in context: a perspective on unprotected anal intercourse and barebacking among men who have sex with men—where do we go from here? Arch Sex Behav 2001, 30(3):287-300.
• [20]Hart G, Williamson L, Flowers P, Frankis J, Der G: Gay men’s HIV testing behaviour in Scotland. AIDS Care 2002, 14(5):665-674.
• [21]Waldo CR, McFarland W, Katz MH, MacKellar D, Valleroy LA: Very young gay and bisexual men are at risk for HIV infection: the San Francisco Bay Area Young Men’s Survey II. J Acquir Immune Defic Syndr 2000, 24(2):168-174.
• [22]Li X, Shi W, Li D, Ruan Y, Jia Y, Vermund SH, Zhang X, Wang C, Liu Y, Yu M: Predictors of unprotected sex among men who have sex with men in Beijing, China. Southeast Asian J Trop Med Public Health 2008, 39(1):99-108.
• [23]Li H, Lau JT, Holroyd E, Yi H: Sociocultural facilitators and barriers to condom use during anal sex among men who have sex with men in Guangzhou, China: an ethnographic study. AIDS Care 2010, 22(12):1481-1486.