Abstract
BackgroundMen who have sex with men (MSM) are at high risk of HIV and sexually transmitted infections (STIs) in China and globally. Engaging in commercial sex put them at even greater risk. This study estimated the prevalence of HIV/STIs among three subgroups of MSM: MSM who sold sex (MSM-selling), MSM who bought sex (MSM-buying), and non-commercial MSM (NC-MSM) and evaluated the relationship between commercial sex and HIV/STIs.MethodsWe conducted a cross-sectional survey among MSM in six Chinese cities (Shenyang, Ji’nan, Changsha, Zhengzhou, Nanjing, and Kunming) from 2012 to 2013. Data on socio-demographics and sexual behaviors were collected. Serological tests were conducted to detect HIV, syphilis, and human simplex virus type 2 (HSV-2).ResultsOf 3717 MSM, 6.8% were engaged in commercial sex. The overall prevalence of HIV, syphilis and HSV-2 infections was 11.1, 8.8 and 12.1%, respectively. MSM-selling had higher prevalence of HIV (13.4%), syphilis (12.1%) and HSV-2 (17.9%) than NC-MSM (10.9, 8.7 and 11.9% for HIV, syphilis and HSV-2, respectively), though the differences are not statistically significant. Among MSM-selling, HIV prevalence was significantly higher for those who found sex partners via Internet than those did not (19.4% vs. 8.1%, P = 0.04). Compared to NC-MSM, MSM-selling were more likely to use recreation drugs (59.3% vs. 26.3%), have unprotected anal intercourse (77.9% vs. 61.7%), and have ≥10 male sex partners (46.2% vs. 6.2%) in the past 6 months (each P < 0.05).ConclusionsAll three subgroups of MSM in six large Chinese cities have high prevalence of HIV/STIs. Those who sell sex only have a particularly high risk of acquiring and transmitting disease, and therefore, they should be considered as a priority group in HIV/STIs surveillance and intervention programs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-2130-x) contains supplementary material, which is available to authorized users.
Highlights
Men who have sex with men (MSM) are at high risk of Human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) in China and globally
The risk of HIV/STIs has never been compared among MSM-selling, MSMbuying, and MSM who did not engage in commercial sex (NC-MSM)
Univariate logistic regression analyses were performed to screen factors associated with HIV, syphilis and herpes simplex virus type 2 (HSV-2) infections, respectively, and those factors which were significant at P < 0.05 and suggested as possible risk factors in the literature were included in multivariate logistic regression models with HIV, syphilis and HSV-2 infection as a dependent variable, separately
Summary
Men who have sex with men (MSM) are at high risk of HIV and sexually transmitted infections (STIs) in China and globally. The pooled data from seven low- and middle-income Asian countries including China showed that MSM were 18.7 times more likely to have HIV infection than other reproductive-age men [2]. MSM who sell sex to men for money or goods (MSM-selling), have been found to be at higher risks of HIV and other STIs due to multiple sexual partners and high frequency of UAI [9, 10]. One study in Chengdu in southwest China showed that MSM-selling were 6.4 times more likely to have HIV infection than other MSM [11].
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