Abstract
BackgroundMen who have sex with men (MSM) represent the fastest growing key population for incident HIV cases in China. We examined five consecutive years of HIV and syphilis prevalence and risk factors data among MSM in Guangxi Province with the second highest estimated number of people living with HIV/AIDS (PLWHAs) in China in 2011.MethodsWe collected demographic and behavioral data from national sentinel surveillance and HIV/syphilis blood samples in five annual cross-sectional surveys from 2008 to 2012. We analyzed HIV and syphilis prevalence trends stratified by social/behavioral characteristics.ResultsHIV prevalence climbed steadily from 1.7% (95% confidence interval [CI]: 1.0 to 3.0) in 2008 to 3.7% (95% CI: 3.0 to 5.0) in 2012. Syphilis prevalence increased steadily from 5.1% (95% CI: 4.0 to 6.0) in 2008 to 8.4% (95% CI: 7.0 to 10.0) in 2012. HIV prevalence rose notably among MSM who were ≤25 years of age, never married, did not engage in sexual intercourse with women in the past six months, and had not been tested for HIV in the past year. Syphilis prevalence rose notably among MSM who were >25 years of age, ever married or living with a partner, and engaged in sexual intercourse with women in the past six months. HIV prevalence was much higher in MSM with current syphilis than without. Finally, current syphilis was the most significant predictor of HIV infection, and age was the most significant predictor of syphilis infection.ConclusionsHIV and the syphilis prevalence expansion among MSM suggest an urgent public health prevention challenge for Guangxi provincial health officials. Risk factors for each infection differed such that all MSM, each of whom might be at risk of HIV, syphilis or both, should be targets for heavy intervention.
Highlights
Men who have sex with men (MSM) represent the fastest growing key population for incident HIV cases in China
Heterosexual transmission is mainly responsible for the spread of HIV in recent years in China, the prevalence of HIV among MSM is rising at an alarming rate [7] and the epidemic is in a rapid expansion phase [1]
Subjects were recruited by local Centers for Disease Control and Prevention (CDC) staff in partnership with local community-based organizations (CBO) via internet-based recruiting, and peer referral
Summary
Men who have sex with men (MSM) represent the fastest growing key population for incident HIV cases in China. The global HIV epidemic continues to expand disproportionately among men who have sex with men (MSM) [1]; the prevalence ranging from 3-25% [1,2]. Sentinel surveillance in China in 2012 showed that the national HIV prevalence among MSM was 6.7%. Data from the 2011 surveillance system report indicate a much higher prevalence among MSM in some cities: 16.3% in Chengdu (Sichuan Province in the southwest), 12.5% in Zhengzhou (Henan Province in the center), and 10.3% in Harbin (Heilongjiang Province in the northwest) [6]. Sentinel surveillance data in five provincial capitals in China showed that the percent of HIV-positive MSM had increased annually from 0.9% in 2003 to 6.3% in 2011 [6]. Of the newly reported HIV/AIDS cases nationwide, the proportion of MSM cases climbed from 15% in 2011 to 21.1% in 2012
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