Abstract
The HIV prevalence and incidence among men who have sex with men (MSM) in China are high. Unprotected anal intercourse (UAI) with a regular male sex partner (RP), a significant predictor of HIV sero-conversion, was high yet under-emphasized among MSM having RP (MSMRP). The present cross-sectional survey interviewed 307 HIV negative MSMRP recruited through convenient sampling from multiple sources, including venue-based outreaching, online recruitment, and referrals made by peers, in Beijing and Chengdu, China. Among MSMRP, the prevalence of UAI with RP in the last three months was 52.4%. The results of the multivariate analysis showed that trust and intimacy within the relationship with RP and presence of clinical depression symptoms were positively associated with UAI with RP in the last three months. Other associated scalar factors derived from the Theory of Planned Behavior were related to perceptions on condom use, including positive attitudes toward condom use (a negative association), subjective norm of the perception that MSM do not usually use condoms during anal intercourse with RP (a positive association), perceived behavioral control over condom use with RP (a negative association), and behavioral intention to use condoms with RP in the coming three months (a negative association). It is seen that MSMRP were at high risk of HIV/STD transmission. The associated factors hence involved those related to perceptions about condom use, mental health, and interpersonal relationship. Future interventions should take these multi-dimensional factors into account. In particular, future research to test the efficacy of couple-based interventions that include mental health elements needs to be conducted, as trust and intimacy within the relationship were associated with UAI among MSMRP, and mental health problems may exist for both the MSMRP and their RP.
Highlights
HIV prevalence among men who have sex with men (MSM) has increased sharply in China
Since we are concerned about Unprotected anal intercourse (UAI) between MSM have RP (MSMRP) and his Regular male sex partners (RP), inter-personal factors related to the regular partnership are highly relevant, and such factors should be considered when designing HIV/STD interventions targeting MSMRP
MSMRP were at very high risk of HIV/STD transmission
Summary
HIV prevalence among men who have sex with men (MSM) has increased sharply in China. Meta-analysis reported HIV prevalence of 5.3% among MSM in China (2009) [1], and prevalence was higher than 20% in provinces such as Guizhou and Chongqing [2,3]. HIV prevalence has increased at a very high speed in many Chinese cities over the last decade [4,5,6]. It increased from 0.6% in 2004 [4] to 13.1% in 2011 among MSM in Beijing [5] and from 1.06% in 2004 to >15% in 2010 in Chengdu [6]. In China, the prevalence of MSMRP among MSM ranged from 47.2% to 62.1% [14,15,16]. Slightly over half of MSMRP have had sexual intercourse outside the regular partnership in countries such as the U.K. Slightly over half of MSMRP have had sexual intercourse outside the regular partnership in countries such as the U.K. [13], the U.S [17] and in some parts of China (e.g. Nanjing) [18]
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