Abstract
IntroductionIn China, the prevalence and incidence of HIV among men who have sex with men (MSM) in large-sized cities have drawn much attention. In contrast, there has been a paucity of research focussing on the sexual health of MSM of medium-sized cities. This study fills this important gap in the knowledge by investigating the sexual health of MSM in a medium-sized city (Yangzhou) and a large-sized city (Guangzhou).MethodsA baseline survey and a prospective cohort study were conducted among MSM in Yangzhou and Guangzhou from July 2009 to September 2010. A total of 622 MSM (317 from Yangzhou and 305 from Guangzhou) were screened for eligibility. Prevalence and incidence of HIV infection, as well as its risk factors, were investigated.ResultsBaseline HIV prevalence was 14.5%, and overall HIV incidence density was 6.78 per 100 person-years (PY) among Yangzhou MSM. Risk factors for HIV prevalence that were significant in multivariate models were older age, married status, unprotected sex with female partners, sexually transmitted disease (STD)-associated symptoms and syphilis positivity. Risk factors for HIV incidence that were significant in multivariate models were STD-associated symptom and syphilis positivity. Compared to Yangzhou MSM, Guangzhou MSM had a lower HIV prevalence (6.2%; p<0.05) and lower overall HIV incidence density (5.77 per 100 PY). Risk factors for HIV prevalence that were significant in multivariate models were married status, unprotected anal sex with men and syphilis positivity. The single risk factor for HIV incidence that was significant in multivariate models was unprotected anal sex with men.ConclusionsThis study showed a high prevalence and incidence of HIV among Yangzhou MSM, which suggest a more serious HIV epidemic than that in large-sized cities. Further investigation targeting MSM in medium-sized cites is urgently needed to prevent the spread of the HIV epidemic in China.
Highlights
In China, the prevalence and incidence of HIV among men who have sex with men (MSM) in large-sized cities have drawn much attention
Guangzhou MSM had received more sexual health services and were more likely to have been diagnosed with an sexually transmitted disease (STD) than Yangzhou MSM (Table 1)
We were able to ascertain estimates of the prevalence and incidence of HIV in MSM and examine the risk factors contributing to HIV infection in a midsized Chinese city
Summary
In China, the prevalence and incidence of HIV among men who have sex with men (MSM) in large-sized cities have drawn much attention. Risk factors for HIV prevalence that were significant in multivariate models were married status, unprotected anal sex with men and syphilis positivity. Conclusions: This study showed a high prevalence and incidence of HIV among Yangzhou MSM, which suggest a more serious HIV epidemic than that in large-sized cities. In view of the large population size of MSM, as well as high HIV prevalence and increasing incidence rates, homosexual transmission has overtaken injection drug use as the dominant route of HIV infections in China [2Á5]. Surveillance data in 2011 demonstrated an overall HIV prevalence of 6.3%, and 24 of 105 sentinel sites showed HIV prevalence rates among MSM that were higher than 10% [6] These studies are concentrated in large-sized cities and have included little data from medium-sized cities. Limited epidemiological and behavioural data are available; further studies are needed that focus on the MSM population in medium-sized cities
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