Abstract
HIV and AIDS incidence in China is high among men who have sex with men (MSM) and ours was one of few studies in China to evaluate the role of HIV risk reduction counseling and testing. Respondent-driven sampling (RDS) was used to recruit 430 MSM. Participants were followed up at 6, 12 and 18 months to evaluate behavioral changes after counseling to reduce risk behaviors. At baseline, HIV prevalence was 4.7%, whereas HIV incidence was 5.2 per 100 person-years. The incidence was 3.8 during six to 12 months, and 1.1 during 12 to 18 months. During the study period, the reported unprotected anal intercourse (UAI) significantly decreased from 60.9% to 42.9%. The proportion of participants who had one or no partner significantly increased from 40.9% to 48.0%. The study also found that some risk behaviors decreased between baseline and 12 months, followed by a slight increase between 12 and 18 months. Reductions in UAI can be achieved through counseling and testing, but may wane over time. Future programs should consider HIV risk-reduction counseling and testing for interventions in MSM in China.
Highlights
The proportion of HIV infections and AIDS cases is increasing among men who have sex with men (MSM) in China. [1,2,3,4,5,6,7] It is estimated that among all the cases, new HIV infections in MSM increased from 12.2% in 2007 to 32.5% and 29.4% in 2009 and 2011. [8,9] The number of MSM living in China is approximately 2–8 million, [10] with data from several major urban areas showing a rapid increase in prevalence of HIV among them
The prevalence increased in Shenzhen from 0.9% in 2002 to 2.7% in 2005, [11] from 0.4% in 2004 to 6.5% in 2007 in Beijing, [12,13] and from 10.4% in 2006 to 16.7% in 2008 in Chongqing. [14,15] The HIV epidemic in MSM poses a serious threat to the general population, as MSM may have unprotected sex with women. [16,17,18] This trend underscores the need for implementation and evaluation of interventions to prevent the spread of HIV infection from and within this risk group
Our study found that reported unprotected anal intercourse (UAI) significantly decreased, from 60.9% to 42.9%, during the study period
Summary
The proportion of HIV infections and AIDS cases is increasing among men who have sex with men (MSM) in China. [1,2,3,4,5,6,7] It is estimated that among all the cases, new HIV infections in MSM increased from 12.2% in 2007 to 32.5% and 29.4% in 2009 and 2011. [8,9] The number of MSM living in China is approximately 2–8 million, [10] with data from several major urban areas showing a rapid increase in prevalence of HIV among them. The proportion of HIV infections and AIDS cases is increasing among men who have sex with men (MSM) in China. [19] It has been documented that targeted interventions including reducing alcohol, drug use, risk sexual behaviors and other environmental risk factors can be useful in addressing the epidemic among MSM. Using TTM as a theoretical guide, HIV risk reduction counseling sessions can be tailored to encourage behavior changes among participants. Individualized HIV risk reduction counseling sessions provide an opportunity for participants to discuss sexual information and risky behaviors in private. The sessions play a role in preparing participants to positively contribute towards reducing their risk for HIV and other sexually transmitted diseases (STDs). [9] few studies have examined the role of counseling in reducing the risk behavior of MSM in China. The sessions play a role in preparing participants to positively contribute towards reducing their risk for HIV and other sexually transmitted diseases (STDs). [9] few studies have examined the role of counseling in reducing the risk behavior of MSM in China. [35]
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