Intimate relationship characteristics as determinants of HIV risk among men who have sex with regular male sex partners: a cross-sectional study in Guangzhou, China

Juan He,Jing Gu,Wei-Bin Cheng,Chun Hao,Yuan-Tao Hao,Sheng-Jie Zhang,Hui-Fang Xu

doi:10.1186/s12879-018-3044-6

Abstract

BackgroundChina faces a serious HIV epidemic among men who have sex with men (MSM), and a large proportion of new infections are attributed to their regular male sex partners (RP). The objective of this study was to investigate the association between intimate relationship characteristics and HIV-related behaviors among MSM with RP in Guangzhou, China.MethodsA convenience-sampling method was used in data collection. A total of 608 MSM were screened, of whom 406 HIV negative MSM with at least one RP in the past six months were used for data analysis. Three-step logistic regressions were used to analyze the data.ResultsThe prevalence of unprotected anal intercourse (UAI) with regular male sex partners, non-regular male sex partners, and concurrent UAI in the past six months was 53.9%, 23.6%, 20.7%, respectively. Variables associated with UAI with regular male sex partners included expectations for this relationship (adjusted odds ratio in multiple forward stepwise logistic regression, ORm = 1.66) and open communication about the sexual relationship (ORm = 1.79), while expectations for the relationship (ORm = 0.46 to 0.54) and conflicts of interest (ORm = 5.46 to 5.97) were associated with concurrent UAI and UAI with non-regular male sex partners.ConclusionIntimate relationship characteristics were related to HIV-related risk behaviors. Future HIV prevention interventions should take MSM couples into consideration, include a focus on the quality of their intimate relationships, and encourage open communication about their sexual relationships.

Highlights

China faces a serious Human immunodeficiency virus (HIV) epidemic among men who have sex with men (MSM), and a large proportion of new infections are attributed to their regular male sex partners (RP)
This study showed that greater attachment could increase unprotected anal intercourse (UAI) with RP both among concordant positive (OR = 1.09) and discordant (OR = 1.07) couples and open agreements that allow UAI with non-regular partner (NRP) could increase engaging in UAI with outside partners among men in concordant (OR = 9.08) and discordant (OR = 5.87) relationships [25]
Our findings suggested that compared with MSM whose intimate relationships had no monetary or materials exchanged with RP, MSM who had monetary or materials exchanged with RP were almost six times more likely to have UAI with NRP or have concurrent UAI

Summary

Introduction

China faces a serious HIV epidemic among men who have sex with men (MSM), and a large proportion of new infections are attributed to their regular male sex partners (RP). Without the possibility of legal marriage and lacking an accepting social environment, the regular or intimate relationship among MSM is vulnerable and fluid, and MSM who have RP will usually have other sexual relationships outside their regular relationships and will engage in concurrent UAI [15,16,17] These instances of concurrent UAI facilitate the spread of HIV among this population [18,19,20]. While HIV prevention programs targeting MSM made considerable efforts to promote the use of condoms with sex partners in general, MSM with regular or intimate relationships are substantially understudied [21,22,23]

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