Abstract
BackgroundMen who have sex with men (MSM) are at a substantial risk of HIV, given rising HIV prevalence in urban China. Adolescent and adult students often take HIV-related risk as part of sexual exploration. We compared the risks of HIV and syphilis infections and risky sexual behaviors between student and non-student among urban MSM.MethodsRespondent driven sampling approach was used to recruit men who were self-identified as MSM in Chongqing Metropolitan City in southwestern China in 2009. Each participant completed a computer-assisted self-interview which collected demographic and behavioral data, and provided blood specimens for HIV and syphilis testing. Multivariable logistic regression analyses identified predictors for HIV and syphilis infections while comparing student and non-student MSM.ResultsAmong 503 MSM participants, 36.4% were students, of whom 84.2% were in college. The adjusted prevalence of HIV infection was 5.5% (95% confidence interval [CI]: 2.1%–10.2%) in students and 20.9% (95% CI: 13.7%–27.5%) in non-students; the adjusted prevalence of syphilis was 4.4% (95% CI: 0.7%–9.0%) in students and 7.9% (95% CI: 3.6%–12.9%) in non-students (P = 0.12). Two groups had similar risky sexual behaviors such as number of sexual partners and exchanging sex for money. Multivariate analysis showed that students had lower HIV prevalence than non-students (adjusted odds ratio [AOR]: 0.3; 95% CI: 0.1–0.8) adjusting for age, ethnicity and other variables.ConclusionStudent MSM have lower HIV and similar syphilis prevalence compared with non-student MSM. However, due to a shorter duration of sexual experience and high prevalence of at-risk sexual behaviors among student MSM, HIV risk might be quite high in students as in non-students.
Highlights
Men who have sex with men (MSM) represent an increasing proportion of newly reported human immunodeficiency virus (HIV) infections in China [1,2]
Sociodemographic and behavioral characteristics may be associated with prevalent HIV infection, e.g. older age, less education, unprotected anal intercourse (UAI), multiple male and/or female sex partners, and co-infection with other sexually transmitted infections (STIs) [12,13,14]
Some studies suggest that a significant proportion of MSM in large Chinese cities are college students [15,16], and that college student MSM may have a lower risk of syphilis compared with nonstudent MSM [16]
Summary
Men who have sex with men (MSM) represent an increasing proportion of newly reported human immunodeficiency virus (HIV) infections in China [1,2]. HIV prevalence among MSM is high in some large Chinese cities, varying from 0.4– 9.9% in Beijing [3,4,5] to 8.5–16.8% in Chongqing [6,7 8]. In comparison, it remains relatively low in other cities: 0.9–2.2% in Harbin, Heilongjiang Province [9] and 0.5–3.1% in Jinan, Shandong Province [10,11].
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