Abstract
BackgroundHIV prevalence has increased rapidly among men who have sex with men (MSM) in China reaching alarmingly high levels in some cities. Bisexual MSM have potential to transmit HIV and syphilis to their female partners through condomless vaginal intercourse (CVI). Thus, estimation of the burden of CVI and identification of its associates seemed necessary to control this cross-gender transmission.MethodIn a cross-sectional study, using respondent-driven-sampling and snowball sampling, 2958 MSM were recruited from seven Chinese cities, interviewed and tested for HIV and syphilis. Descriptive analysis of the socio-demographic and behaviors followed by simple and multiple logistic regressions [adjusted for income, city, race and social network size to determine adjusted odds ratio (aOR)] were performed using SAS-9.1.ResultsAmong participating MSM, 19.03% were engaged in CVI. Prevalence of HIV and syphilis among participants involved in CVI were 5.86% and 14.74% respectively. MSM who were older [aOR for aged 40–49 = 2.60 (95% CI: 1.54–4.37)], married [aOR = 6.13 (4.95–7.58)], attended primary school or below [aOR = 3.86 (2.26–6.69)], met male partners at spa/bathhouse/sauna/massage parlor [aOR = 3.52 (2.62–4.72)] and had heterosexual orientation [aOR = 13.81 (7.14–26.70)] were more likely to have CVI. Furthermore, correct knowledge regarding HIV [aOR = 0.70 (0.55, 0.88)] and exposure to HIV prevention interventions [aOR = 0.67 (0.54, 0.82)] were negatively associated with CVI.ConclusionsCVI was found to be common among MSM in China. To minimize the transmission of HIV and syphilis from bisexual MSM to their relatively female partners, targeted interventions should specifically focus on bisexual MSM especially the older and married subgroups.
Highlights
Worldwide it has been observed that Men who have Sex with Men (MSM) are quite vulnerable for acquisition of HIV
MSM who were older [adjusted odds ratio (aOR) for aged 40–49 = 2.60], married [aOR = 6.13 (4.95–7.58)], attended primary school or below [aOR = 3.86 (2.26–6.69)], met male partners at spa/bathhouse/sauna/massage parlor [aOR = 3.52 (2.62–4.72)] and had heterosexual orientation [aOR = 13.81 (7.14–26.70)] were more likely to have condomless vaginal intercourse (CVI)
To minimize the transmission of HIV and syphilis from bisexual MSM to their relatively female partners, targeted interventions should focus on bisexual MSM especially the older and married subgroups
Summary
Worldwide it has been observed that Men who have Sex with Men (MSM) are quite vulnerable for acquisition of HIV. This scenario was evident from the data that the proportion of heterosexual marriages among MSM in China has increased from 19.3% in 2008 to 27.9% in 2011[3] Under this circumstance, Chinese MSM have become a crucial bridge population for the transmission of HIV/STDs from their male partners to their relatively heterosexual female partners through condomless sexual contacts, and to their children through vertical transmission. Chinese MSM have become a crucial bridge population for the transmission of HIV/STDs from their male partners to their relatively heterosexual female partners through condomless sexual contacts, and to their children through vertical transmission This hidden cross-gender bridging behavior often results in a relatively non-traceable spread of HIV/STDs, increasing the challenges for the HIV/STD control programs in this country. Estimation of the burden of CVI and identification of its associates seemed necessary to control this cross-gender transmission
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