Abstract
ObjectiveThe purpose of this review was to assess the prevalence of unprotected anal intercourse (UAI) among men who have sex with men (MSM) in China.MethodsA comprehensive search was conducted including online databases like “Wanfang”, Chinese National Knowledge Infrastructure, PubMed and manual searches. Analyses using random-effects models were performed to estimate the prevalence of UAI among MSM in China.ResultsSixty-two articles reporting eighty-two studies were selected. The pooled prevalence rates of UAI with any male partner, with regular male partners, with non-regular male partners, with casual male partners, and with commercial male partners among MSM were 53%(95%CI: 51–56%), 45%(95%CI: 39–51%), 34%(95%CI: 24–45%), 33%(95%CI: 30–36%), 12% (95%CI: 5–26%), respectively. A cumulative meta-analysis found that the pooled UAI prevalence decreased over time.ConclusionsAlthough the prevalence of UAI with male partners among MSM in China presents a decreasing trend over the past decade, the concomitant rise in HIV prevalence and incidence indicates that current prevention intervention efforts are insufficient to effectively contain the spread of HIV. Therefore, the persistently high prevalence of risky sexual behaviors underscores the need for innovative and effective prevention strategies among MSM.
Highlights
7.3%, 11.0%, 14.7% and 17.4% of the estimated number of people living with HIV/AIDS in China were infected through unprotected male-to-male sexual contact in 2005, 2007, 2009 and 2011, respectively, reflecting a rapid expansion of the HIV epidemic among men who have sex with men (MSM) in recent years [1,2,3,4]
Estimated HIV prevalence and incidence increased to 6.0% (4.4–8.2) and 1.0 (0.7–1.3) per 100 person-years, respectively, in 2010 [8], which highlights the magnitude of the HIV epidemic in this population
The disproportionately high prevalence of HIV and sexually transmitted infections (STIs) among MSM is associated with the prevalence of unprotected anal intercourse (UAI) [16,17], which has been the leading high-risk behavior for HIV infection [18,19,20,21]
Summary
7.3%, 11.0%, 14.7% and 17.4% of the estimated number of people living with HIV/AIDS in China were infected through unprotected male-to-male sexual contact in 2005, 2007, 2009 and 2011, respectively, reflecting a rapid expansion of the HIV epidemic among men who have sex with men (MSM) in recent years [1,2,3,4]. The disproportionately high prevalence of HIV and STIs among MSM is associated with the prevalence of unprotected anal intercourse (UAI) [16,17], which has been the leading high-risk behavior for HIV infection [18,19,20,21]. The reproduction number is defined as the average number of secondary cases caused by a typical HIV case during its infectious period [33]
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