A Comparison of HIV Infection and Related Risk Factors Between Money Boys and Noncommercial Men Who Have Sex With Men in Shenzhen, China

Abstract

HIV transmission among men who have sex with men (MSM) has become an increasing concern in China. Money boys (MBs) are a subgroup of MSM who sell sex to men. Direct comparison of HIV prevalence and related risk factors between MB and noncommercial MSM (ncMSM) has rarely been done. This study was conducted to make the comparison. Eight hundred fifty MBs and 801 ncMSM were parallel recruited in Shenzhen by time-location sampling. Their behavioral and serologic data on HIV and syphilis were collected and compared. Multiple logistic regression analysis was performed to evaluate the determinants for HIV risk in MBs and ncMSM, respectively. The prevalence of HIV was 4.5% in MBs and 7.0% in ncMSM. Although MBs tended to have more male partners than ncMSM, they were more likely to report a consistent condom use in male anal intercourse, especially in commercial sex. Noncommercial MSM were more likely to visit parks and saunas instead of bars, massage centers, recreational centers, and home-based venues. Syphilis infection and recruitment venue were associated with HIV infection in both MBs and ncMSM. Being from a hometown with a high HIV prevalence and without a male partner from Hong Kong were found to be risk factors for HIV infection in MBs, and early sexual debut was a risk factor in ncMSM. Money boys differed from ncMSM in the rate of HIV infection and some sexual characteristics and behaviors. Formatting separate interventions specifically targeting the 2 subgroups may be necessary.