Prevalence and correlates of HIV and syphilis infections among men who have sex with men in seven provinces in China with historically low HIV prevalence.

Abstract

To assess HIV and syphilis infection among men who have sex with men (MSM) in Chinese regions with historically low HIV prevalence. A cross-sectional survey was conducted in 20 cities or districts across 4 provinces, 2 autonomous regions, and a municipality. Socioeconomic/behavioral risk factors were measured. Blood samples were tested for HIV via enzyme-linked immunosorbent assay and Western blot confirmation and syphilis via rapid plasma reagin and passive particle agglutination test for detection of Treponema pallidum Antibodies. Of 4983 MSM participants, 2.9% were HIV infected (range: 0%-15.1%) and 9.8% were syphilis infected (1.3%-29.3%). Syphilis infection was associated with older age [adjusted odds ratio (AOR) = 2.9; 95% confidence interval (CI): 2.0 to 4.3], not being married or cohabiting (AOR = 0.7; 95% CI: 0.5-0.9), less education (AOR = 1.3; 95% CI: 1.0 to 1.7), inconsistent condom use during anal sex with men (AOR = 1.4; 95% CI: 1.0 to 1.8), and living in inner Mongolia (AOR = 23.9; 95% CI: 9.7 to 58.6), Jilin (AOR = 7.9; 95% CI: 3.4 to 18.3), Heilongjiang (AOR = 7.1; 95% CI: 3.1 to 16.6), Liaoning (AOR = 6.1; 95% CI: 2.6 to 14.2), or Chongqing (AOR = 5.9; 95% CI: 2.5 to 13.9). HIV infection was associated with older age (AOR = 3.7; 95% CI: 2.0 to 6.7), less education (AOR = 2.9; 95% CI: 1.8 to 4.7), inconsistent condom use during anal sex with men (AOR = 1.9; 95% CI: 1.2 to 3.2), syphilis infection (AOR = 2.1; 95% CI: 1.3 to 3.4), and living either in Liaoning (AOR = 8.2; 95% CI: 1.1 to 61.4) or Chongqing (AOR = 57.2; 95% CI: 7.9 to 414.4). HIV and syphilis have reached alarming rates in China's MSM population, thus, appropriate responses are urgently needed.