Abstract
BackgroundThe HIV prevalence among men who have sex with men (MSM) in China has increased yearly. This study aimed to explore the association between the characteristics of social communication and condomless anal intercourse (CAI) among MSM and the implications for prevention and control of HIV among MSM in China using an egocentric network framework.MethodsThe data were collected in Guangzhou between November 2016 and May 2017 through standardized face-to-face interviews. The participants were recruited among MSM who received voluntary counselling and testing services (VCT) provided by nongovernmental organizations (NGOs) and the local Centers for Disease Control and Prevention (CDC). We used the framework of the egocentric network analysis, the odd ratios of CAI were analyzed using generalized estimating equations (GEE).ResultsIn total, 1073 MSM who nominated 2667 sexual partners were sampled. MSM who were approximately 30 years old and chose sexual partners of different age category were more likely to engage in CAI. Participants with high level education who were in partnerships with individuals with lower education levels had a higher risk of CAI. Participants who reported having a strong relationship with their sexual partners(AOR = 1.31) were associated with a higher probability of experiencing CAI during sex; while having sexual partners who were unmarried (OR = 0.56), and participants who reported meeting sexual partners online (AOR = 0.74) or, having sex with an occasional partner (AOR = 0.44)were less likely to engage in CAI.ConclusionOur study indicates that the strength of sexual dyadic relational ties and different social communication mixing patterns across ages, educational categories, and marital status were associated with CAI.
Highlights
The Human Immunodeficiency Virus (HIV) prevalence among men who have sex with men (MSM) in China has increased yearly
According to the annual sentinel surveillance survey conducted by the National Center for Acquired Immune Deficiency Syndrome (AIDS)/STD Control and Prevention in China, the HIV prevalence over the years among MSM increased from 0.9% in 2003 to 7.75% in 2014 [3, 4], indicating an increasing trend of HIV prevalence among MSM community members
Based on our risk factor analysis, frequently, MSM who were approximately 30 years old and chose younger or older (41 years or older) partners were more likely to engage in condomless anal intercourse (CAI)
Summary
The HIV prevalence among men who have sex with men (MSM) in China has increased yearly. This study aimed to explore the association between the characteristics of social communication and condomless anal intercourse (CAI) among MSM and the implications for prevention and control of HIV among MSM in China using an egocentric network framework. The implementation of HIV prevention interventions in China has achieved substantial results in recent years, and the proportion of condom use among sexual partners of MSM has increased, adherence to condom use is difficult to achieve [7]. The specific social communication characteristics of sexual networks among MSM who usually engage in condomless anal intercourse (CAI) with their sexual partners may play an important role. According to a meta-analysis conducted by Hess KL, CAI with an HIV-unknown partner has become an increasing trend among MSM [8], and the increasing trend of HIV-related risk behaviours may help explain the increase in the HIV epidemic
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