Prevalence Of High-risk Sexual Behaviors Research Articles

Sexual Behaviors in Iranian Working Children and the Correlated Risk Factors: Result of the Large-Scale Rapid Assessment and Response (RAR) Survey

This study aimed to investigate the sexual behaviors among working children and the associated factors. This cross-sectional study was conducted on a sample of 1937 working children in the 10–18 age range in 15 provincial capitals in 2019–20 (Feb–May); the Response rate was 94.9%. Univariate and multivariable logistic regression was used to examine the variable of sexual behaviors. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) are reported. The prevalence of sexual behaviors in working children was 4.2%. The results showed a significant difference between those who reported sexual behaviors and those who did not in terms of age, identity document (ID), running away from home, alcohol use, and substance use. There was a statistically significant relationship between fathers’ unemployment and sexual behaviors among working children. Furthermore, we found that having divorced parents could increase the odds of sexual behaviors by 3.74 times. The findings showed that related welfare and support organizations should design and implement effective and continuous training and interventions to raise awareness and reduce the prevalence of high-risk sexual behaviors in working children. They should also provide family counseling and promote parental supervision of children.

Human T-lymphotropic virus 1/2 infection among prisoners of a major penitentiary complex of Goiás State, Central-West Brazil.

Studies on human T-lymphotropic virus 1/2 (HTLV-1/2) infection are scarce in incarcerated population. Therefore, this study estimated the prevalence of HTLV-1/2 infection among prisoners of the major penitentiary complex of Goiás State, Central-West Brazil, comparing it with available data from other Brazilian regions. A cross-sectional study was conducted with 910 prisoners of the major penitentiary complex in the State of Goiás, Central-West Brazil. All participants were interviewed, and their serum samples were tested for anti-HTLV-1/2 using an enzyme-linked immunosorbent assay (ELISA; Murex HTLV-I + II, DiaSorin, Dartford, UK). Seropositive samples were submitted for confirmation by a line immunoassay (INNO-LIA HTLV I/II, Fujirebio, Europe N.V., Belgium). The majority of participants were males (83.1%), between 25 and 39 years old (56.1%; mean age: 31.98 years), self-reported brown ethnicity (56.2%) and reported 9 years or less of formal education (41.4%). Most reported using non-injectable illicit drugs and various sexual behaviors that present risk for sexually transmitted infections (STIs). The prevalence of anti-HTLV-1/2 was 0.33% (95% CI: 0.07-0.96), HTLV-1 (0.22%) and HTLV-2 (0.11%). The two HTLV-1 seropositive prisoners reported high-risk sexual behaviors, and the HTLV-2 seropositive individual was breastfed during childhood (> 6 months) by her mother and three other women. These data revealed a relatively low seroprevalence of HTLV-1/2 in prisoners in Central-West Brazil, and evidence of HTLV-1 and HTLV-2 circulation in the major penitentiary complex of Goiás State. Given the prevalence of high-risk sexual behaviors, there is a crucial need to intensify education and health programs in prisons to effectively control and prevent HTLV-1/2 and other STIs.

Sexual knowledge of Queensland forensic mental health patients: A cross-sectional quantitative study.

Forensic patients with serious mental illnesses (SMI) encounter significant challenges including active symptomatology, associated social and interpersonal impairments, psychotropic medication side effects and institutionalization, all of which negatively affect sexual functioning and possibly their acquirement of sexual knowledge. Evidence shows an increased prevalence of high-risk sexual behavior by this group however, there is an absence of literature examining the sexual knowledge of forensic patients. This quantitative cross-sectional study enrolled N = 50 patients currently under the treatment requirements of a Forensic Order and utilized the validated General Sexual Knowledge Questionnaire (GSKQ) to quantify the participants' sexual knowledge over the domains of physiology, sexual intercourse, pregnancy, contraception, sexually transmitted diseases, and sexuality. Male forensic patients scored lower than females on all domains of sexual knowledge. All participants had reasonable knowledge of physiology, sexual intercourse and sexuality; of concern were poor scores on pregnancy, contraception and sexually transmitted diseases. Thirty-five (70%) of the respondents indicated that they had some limited sex education, mostly at school. Only six (12%) received any sexual education from a health professional despite extensive contact with the forensic mental health services across many years. There is a need to assess the deficit in sexual knowledge of forensic patients in order to develop sexual health education, intervention and rehabilitative programmes that cater to the specific needs of this group to improve their sexual knowledge, encourage safe and positive sexual experiences, and enhance their quality of life.

A Study on the Association Between Family Support and High-Risk Sexual Behavior of Elderly Men in Rural China.

Our study aimed to understand the relationship between the status of high-risk sexual behaviors of male ≥50 years old (elderly men) and their family support in a rural county-level city in Chengdu. Multi-stage sampling was used to select rural elderly men from six towns to conduct an interview questionnaire survey. Ordinal logistic regression was used to analyze the relationship between high-risk sexual behavior and family factors. A total of 790 samples were included, and the prevalence of high-risk sexual behavior was 16.2%. Two-hundred thirty-nine men (30.3%) had three close family members. More than half of the men (n = 397) had never been provided financial support by family members (50.3%). More than half of men (n = 406) never communicate deeply with family members (51.4%). Logistic analysis reported that 50−59 years old (odds ratio [OR] = 1.928, 95% confidence interval [CI] = [1.070, 3.477]), unmarried, divorced/widowed, married and separated (OR = 8.232, 95% CI = [2.640, 25.673]; OR = 3.589, 95% CI = [1.713, 7.520]; OR = 3.003, 95% CI = [1.238, 7.280]) elderly men were more likely to be involved in commercial sex. Meanwhile, either never or often family financial support (OR = 0.435, 95% CI = [0.228, 0.830]; OR = 0.288, 95% CI = [0.095, 0.876]) helped elderly men to avoid commercial sex. This study predicts family factors may be affected by loneliness, life satisfaction, disposable economic condition, family responsibilities as the middle path, thus affect high-risk sexual behaviors in elderly men.

Change in the profile of the service utilizers of a community-based drug treatment clinic: a retrospective study from India

ABSTRACT Background Community-based drug treatment clinics (CB-DTC) aim to reduce the barriers to treatment-seeking among substance users. Literature is lacking in assessing the change in the profile of the clients seeking treatment from the CB-DTC over time. The current study aimed to assess the change in the profile of the service utilizers of a CB-DTC located in an urban slum in the northern part of India. Methods A retrospective chart review of the profile of the patients (n = 631) who were enrolled at a CB-DTC at two different periods (n = 330, 2003; n = 301, 2017). Results As compared to 2003, enrolees of 2017 had better socio-demographic profiles; earlier age of initiation of substance use and early treatment-seeking (p < .0001); relatively higher prevalence of alcohol (p < .0001) and volatile substance-dependence (p < .001); lower prevalence of opioid dependence (p < .0001); and lower prevalence of substance-related complications (injection drug use, illegal activities, and broken families) (p < .001). However, there was no difference in prevalence of high-risk sexual behaviors (HRSB) and polysubstance use. Conclusion Changing profile of the service utilizers of the CB-DTC reflect the changing dynamics of the substance use pattern and the putative role a CB-DTC can play. Interventions need to be tailored to address these changing requirements.

Gender Differences in the Relationship between Methamphetamine Use and High-risk Sexual Behavior among Prisoners: A Nationwide, Cross-sectional Survey in Japan

ABSTRACT This study aimed to examine the relationship between methamphetamine (MA) use and high-risk sexual behavior among newly incarcerated prisoners in Japan. We conducted a secondary analysis using cross-sectional survey data, which constituted a nationwide prison sample surveyed between July and November 2017. In total, 699 participants (462 male and 237 female prisoners), who completed the self-administered questionnaire during imprisonment were recruited for the study. The prevalence of high-risk sexual behaviors was as follows: inconsistent condom use (78.4% male, 81.7% female), multiple sexual partners (61.3% male, 41.3% female), history of sexually transmitted diseases (14.1% male, 23.6% female), and trading sex for drugs (15.6% male, 17.7% female). A logistic regression analysis showed that MA use during sex increased the likelihood of high-risk sexual behavior in both male (adjusted odds ratio [AOR] = 5.86; 95% confidence interval [CI] = 3.41–10.07) and female prisoners (AOR = 2.58; 95% CI = 1.33–5.00). Additionally, in female prisoners, a history of sharing MA injection (AOR = 1.60; 95% CI = 1.06–2.42) increased high-risk sexual behavior. Our results indicate that harm reduction programs tailored according to the specific necessities of each gender to reduce high-risk sexual behaviors among MA users should be included in Japanese drug policies.

High-Risk Sexual Behaviors Among Transgender Individuals in Tehran, Iran

Global evidence indicates that transgender people are disproportionately at risk for HIV infection. However, limited data are available characterizing sexual behaviors and HIV infection among transgender people in Iran. This study aims to determine the prevalence of high-risk sexual behaviors and HIV infection among transgender people in Iran. In 2009, we assessed data of 58 transgender individuals (41 female-to-male (FTM) and 17 male-to-female (MTF)). Their demographic characteristics and risky sexual behaviors, and other risky behaviors such as substance use were gathered using a structured questionnaire. Rapid tests were used to confirm HIV seropositivity. Fifty-four participants who provided blood samples, none were positive (exact 95% confidence intervals: 0.0, 0.07). 75.6% of FTM and 64.7% of MTF reported having sex in the past six months, respectively. Of the sample who reported having sex in the past six months (n=42), only 19% reported using condoms. No participants reported a history of injection. In this study of HIV infection among a small sample of transgender people in Iran, no one was HIV positive. Some reasons for these findings can be outlined as a lack of history of intravenous drug use and related behaviors, limited high-risk relationships and behaviors, and the limited number of males among the samples.

Prevalence of high-risk sexual behavior among Iranian young people: A systematic review and meta-analysis

Abstract Sex out of marriage is considered to be illegal, non-religious, immoral, and taboo in Iran. Risky sexual behaviors, such as condomless sex, multiple sexual partners, starting sex at an early age, adversely affect young people's health and expose them to sexually transmitted infections and unwanted pregnancy to females. These behaviors could lead to deleterious health, social and economic consequences. We conducted a systematic review to estimate the prevalence of extra/premarital sex and high-risk sexual behaviors among Iranian young people. We systematically searched seven databases to identify relevant studies up to 22nd of December 2019 and we found 28 eligible studies implemented in Iran. The pooled prevalence of life-time extra/premarital sex was estimated at 24% (95% CI: 17–30) overall, 33% (95% CI: 25–40) in male and 14% (95% CI: 8–19) in female. Moreover, the prevalence of high-risk sexual behaviors such as having condomless sex (12.8% to 89.6%), multi-sex partners (7.7% to 62.9%), sex in return for payment (1.3% to 7.0%), and starting sexual activity at under 15 years (24.0% to 60.5%) was varied between studies. These findings suggested relatively high extra/premarital sex and unsafe sex behaviors among young people and the need for targeted, appropriate sex education programs.

Patterns of high-risk behaviors associated with HIV among male prisoners: A latent class analysis.

Background: Acquired Immunodeficiency Syndrome (AIDS) is one of the most important health challenges worldwide. Moreover, the prevalence of the Human Immunodeficiency Virus (HIV) infection differs among Iranian prisoners and the general population. The present study aimed to identify the patterns of HIV-related high-risk behaviors in male prisoners. Methods: In this cross-sectional study, 2832 inmates were examined for HIV-related high-risk behaviors. The required data were collected using a questionnaire on high-risk behaviors, including a history of heterosexual and homosexual intercourse, and a history of drug use disorders. A Latent Class Analysis (LCA) was performed to analyze the obtained data in WinLTA software. Results: Five latent classes were defined for the male prisoners, as follows: low-risk (20%), moderate-risk (23%), Injection Drug Use (IDU) (8%), heterosexual intercourse/methamphetamine use (38%), and high-risk (11%). The LCA results revealed that high-risk sexual behaviors, IDU, and sharing injection equipment in prisons significantly influence the classification. The obtained data suggested that a history of imprisonment was not frequent in class 2 (OR=1.0033, %95CI:0.9936–1.01) and class 4 members (OR=1.0053, %95CI:0.9929–1.0179). However, it was more prevalent in class 3 (OR=1.0164, %95CI:1.0068–1.0262), and 5 (OR=1.0211, %95CI:1.0129–1.0293). Heterosexual contact had the highest prevalence (75%) in this regard. The results showed that the lowest prevalence of high-risk behaviors was associated with morphine use (0.3%). Among illicit drugs, methamphetamine was the most prevalent drug (42%) in the studied subjects. Conclusion: The present study indicated a high prevalence of high-risk sexual behaviors and methamphetamine use in the investigated participants. We observed the co-occurrence of HIV-related high-risk behaviors in male prisoners. Thus, providing safe sex education for prisoners is highly recommended. It is also necessary to pursue care programs about IDU as a key risk factor for HIV transmission in prisons.

HIV prevention barriers in transgender women: a qualitative study*

Sexual contact is still one of the most important routes of HIV transmission. The aim of this study was identify the factors that underlie the higher prevalence of high-risk sexual behaviors in a sample of transgender women in Iran. The qualitative study used face-to-face, semi-structured, in-depth interviews in a sample of 15 transgender women. Our participants used sexual practices as a way to be approved/accepted as a woman. Using sex for this purpose led them to engage in high-risk sexual relationships. It is essential to consider these issues in consulting and education about high-risk behaviors.

The Impact of a High-risk Sexual Behavior Prevention Program via Mobile Application on Sexual Knowledge and Attitude of Female Students

Background & aim: The prevalence of high-risk sexual behaviors among different social groups has been considered as a serious health-related threat in recent years. Given the importance of raising awareness and health among the youth and preventing high-risk behaviors, the present study was conducted to investigate the effect of a high-risk sexual behavior prevention program via mobile application on sexual knowledge and attitude in undergraduate female students. Methods: This quasi-experimental study was conducted among two groups of female students with a pretest-posttest design. A total number of 200 undergraduate eligible female students of Mashhad University of Medical Sciences, Mashhad, Iran were recruited in 2016. The subjects were randomly assigned to an intervention group receiving education through a mobile application (N=100) and a control group (N=100). To collect data a self-structured demographic questionnaire as well as sexual knowledge and attitude questionnaires were used. In the intervention group, the participants received a prevention program through a mobile application. Knowledge and attitude towards high-risk sexual behaviors were assessed and compared before and two weeks after the intervention. To analyze the data, paired t-test, independent t-test, Mann-Whitney U test, Wilcoxon signed-rank test, and Chi-square test were run in SPSS, version 16. Results: The mean scores of sexual knowledge and attitude after education increased compared to the pre-intervention stage (p 0.05). Conclusion: The study results reflected the favorable effect of education via mobile application. The implementation of high-risk sexual behavior prevention programs using mobile applications could enhance sexual knowledge and attitude in students and promote community health

Cervical cancer risk perceptions, sexual risk behaviors and sexually transmitted infections among Bivalent Human Papillomavirus vaccinated and non-vaccinated young women in Uganda - 5\xa0year follow up study

BackgroundPrevious studies were conflicting regarding the associations between HPV vaccination, cervical cancer risk perceptions, high-risk sexual behaviors and STIs. This study compared the HPV-vaccinated and non-vaccinated young women in Uganda regarding cervical cancer risk perceptions, high-risk sexual behaviors, syphilis and HIV infections 5 years after vaccine implementation.MethodsThis was a population-based comparative cross-sectional survey conducted in Uganda. The 438 participants were sexually active young women aged 15–24 years and mean age was 18.6 (SD 1.4). The majority (53.0%) were HPV-vaccinated in 2008 without assessment of sexual activity prior to HPV vaccination. Upon verbal assessment of sexual activity at the time of follow-up, data were collected using a questionnaire and laboratory testing of blood samples for syphilis and HIV infections.ResultsThere were no significant differences between the HPV-vaccinated and non-vaccinated groups regarding the prevalence of high-risk sexual behaviors, syphilis and HIV infections. Cervical cancer risk perceptions and age at sexual debut were nonetheless significantly lower among the vaccinated group compared to their non-vaccinated counterparts. However, HPV vaccination was not significantly associated to cervical cancer risk perceptions and early age at sexual debut in multivariate logistic regression analysis.ConclusionsWe found no associations between HPV vaccination, cervical cancer risk perceptions, high-risk sexual behaviors, syphilis and HIV infections among young women in Uganda 5 years after vaccine implementation. Young girls in the study population were found to be sexually active at a young age, affirming the importance of targeting girls of younger age for HPV vaccination.

High-risk sexual behavior among people living with HIV/AIDS attending tertiary care hospitals in district of Northern India

Context:Prevention with a positive approach has been advocated as one of the main strategies to diminish the new instances of HIV and the target are those who are engaged in high-risk sexual behavior. Therefore, understanding the risky behaviors of the HIV-infected individual is important.Aims:This study aimed to assess the prevalence and the predictors of high-risk sexual behavior among people living with HIV/AIDS (PLHA).Settings and Design:A hospital-based cross-sectional study was conducted at antiretroviral therapy centers of two tertiary care hospitals in Lucknow.Materials and Methods:A total of 322 HIV-positive patients were interviewed about their sexual behaviors during last 3 months using a pretested questionnaire.Statistical Analysis Used:Probability (p) was calculated to test for statistical significance at 5% level of significance. Association between risk factors and high-risk sexual behavior was determined using bivariate analysis followed by multivariate logistic regression.Results:Prevalence of high-risk sexual behavior was 24.5%. Of these patients, multiple sexual partners were reported by 67.3% whereas about 46.9% were engaged in unprotected sex. Multivariate logistic regression analysis revealed that high-risk sexual behavior was significantly associated with nonsupporting attitude of spouse (odds ratio [OR]: 18; 95% confidence interval [CI]: 1.4–225.5; P = 0.02) and alcohol consumption (OR: 9.3; 95% CI: 2.4–35.4; P = 0.001).Conclusions:Specific intervention addressing alcohol consumption and encouragement of spouse and family support should be integrated in the routine HIV/AIDS care and treatment apart from HIV transmission and prevention knowledge.

Prevalence of High-Risk Sexual Behaviors Among Monoracial and Multiracial Groups from a National Sample: Are Multiracial Young Adults at Greater Risk?

Prevalence of High-Risk Sexual Behaviors Among Monoracial and Multiracial Groups from a National Sample: Are Multiracial Young Adults at Greater Risk?

High-risk sexual behavior among people living with HIV/AIDS attending tertiary care hospitals in district of Northern India.

Prevention with a positive approach has been advocated as one of the main strategies to diminish the new instances of HIV and the target are those who are engaged in high-risk sexual behavior. Therefore, understanding the risky behaviors of the HIV-infected individual is important. This study aimed to assess the prevalence and the predictors of high-risk sexual behavior among people living with HIV/AIDS (PLHA). A hospital-based cross-sectional study was conducted at antiretroviral therapy centers of two tertiary care hospitals in Lucknow. A total of 322 HIV-positive patients were interviewed about their sexual behaviors during last 3 months using a pretested questionnaire. Probability (p) was calculated to test for statistical significance at 5% level of significance. Association between risk factors and high-risk sexual behavior was determined using bivariate analysis followed by multivariate logistic regression. Prevalence of high-risk sexual behavior was 24.5%. Of these patients, multiple sexual partners were reported by 67.3% whereas about 46.9% were engaged in unprotected sex. Multivariate logistic regression analysis revealed that high-risk sexual behavior was significantly associated with nonsupporting attitude of spouse (odds ratio [OR]: 18; 95% confidence interval [CI]: 1.4-225.5; P = 0.02) and alcohol consumption (OR: 9.3; 95% CI: 2.4-35.4; P = 0.001). Specific intervention addressing alcohol consumption and encouragement of spouse and family support should be integrated in the routine HIV/AIDS care and treatment apart from HIV transmission and prevention knowledge.

Prevalence of High-Risk Sexual Behaviors Among Monoracial and Multiracial Groups from a National Sample: Are Multiracial Young Adults at Greater Risk?

The present study compared the prevalence and variation in high-risk sexual behaviors among four monoracial (i.e., White, African American, Asian, Native American) and four multiracial (i.e., White/African American, White/Asian, White/Native American, African American/Native American) young adults using Wave IV data (2008-2009) from the National Longitudinal Study of Adolescent to Adult Health (N = 9724). Findings indicated differences in the sexual behavior of monoracial and multiracial young adults, but directions of differences varied depending on the monoracial group used as the referent and gender. Among males, White/African Americans had higher risk than Whites; White/Native Americans had higher risk than Native Americans. Otherwise, multiracial groups had lower risk or did not differ from the single-race groups. Among females, White/Native Americans had higher risk than Whites; White/African Americans had higher risk than African Americans. Other comparisons showed no differences or had lower risk among multiracial groups. Variations in high-risk sexual behaviors underscore the need for health research to disaggregate multiracial groups to better understand health behaviors and outcomes in the context of experiences associated with a multiracial background, and to improve prevention strategies.

Determinants of Chlamydia, Gonorrhea, and Coinfection in Heterosexual Adolescents Attending the National Public Sexually Transmitted Infection Clinic in Singapore.

Amidst recent trends in rising rates of chlamydia and gonorrhea among Singaporean adolescents, there are limited data on risk factors associated with these infections that may inform prevention strategies in this population. A cross-sectional study of chlamydia and gonorrhea positivity was conducted among 1458 sexually active heterosexual adolescents between 14 and 19 years old attending the national public sexually transmitted infection clinic from 2006 to 2013. The association with demographic and behavioral characteristics was assessed by crude prevalence ratio, and negative binomial regression modeling was used to obtain adjusted prevalence ratios (aPRs). Chlamydia positivity was found in 23.6% of males and 36.6% of females, gonorrhea positivity in 33.1% of males and 15.9% of adolescent girl, and coinfection positivity in 10.2% of males and 10.1% of females. In multivariable analysis, chlamydia was positively associated with being Malay (aPR, 1.6; 95% confidence interval [CI], 1.1-2.1) and inconsistent condom use for vaginal sex (aPR, 6.5; 95% CI = 2.4-17.4) in males and with being Malay (aPR, 1.9; 95% CI = 1.5-2.4), inconsistent condom use for vaginal sex (aPR, 2.0; 95% CI = 1.1-3.9), and number of lifetime partners in females (aPR, 1.1; 95% CI = 1.0-1.1). Gonorrhea was positively associated with being Malay (aPR, 3.2; 95% CI = 2.4-4.4), inconsistent condom use for vaginal sex (aPR, 5.4; 95% CI = 2.1-14.4), and number of lifetime partners (aPR, 1.1; 95% CI = 1.0-1.1) in males and with being Malay (aPR, 3.7; 95% CI = 2.4-5.7) in females. Malays had a higher proportion of sexual risk behaviors compared with the non-Malays. Ethnicity and high-risk sexual behaviors are important determinants of chlamydia, gonorrhea, and coinfection for adolescents attending this clinic. Targeted interventions are needed to lower the prevalence of high-risk sexual behaviors for the Malay adolescents in this clinic.

Is higher risk sex common among male or female youths?

There are several studies that showed the high prevalence of high-risk sexual behaviors among youths, but little is known how significant the proportion of higher risk sex is when the male and female youths are compared. A meta-analysis was done using 26 countries’ Demographic and Health Survey data from and outside Africa to make comparisons of higher risk sex among the most vulnerable group of male and female youths. Random effects analytic model was applied and the pooled odds ratios were determined using Mantel–Haenszel statistical method. In this meta-analysis, 19,148 male and 65,094 female youths who reported to have sexual intercourse in a 12-month period were included. The overall OR demonstrated that higher risk sex was ten times more prevalent in male youths than in female youths. The practice of higher risk sex by male youths aged 15–19 years was more than 27-fold higher than that of their female counterparts. Similarly, male youths in urban areas, belonged to a family with middle to highest wealth index, and educated to secondary and above were more than ninefold, eightfold and sixfold at risk of practicing higher risk sex than their female counterparts, respectively. In conclusion, this meta-analysis demonstrated that the practice of risky sexual intercourse by male youths was incomparably higher than female youths. Future risky sex protective interventions should be tailored to secondary and above educated male youths in urban areas.

Risk and protective factors related to HIV-risk behavior: A comparison between HIV-positive and HIV-negative young men who have sex with men

The objective of this study was to assess and compare the prevalence of high-risk sexual behaviors among young HIV-negative (n=8064) and HIV-positive (n=171) men who have sex with men (MSM) on predictors of unprotected anal intercourse (UAI). Using venue-based time-space sampling, 8235 MSM aged 15–25 were anonymously surveyed as a part of the Community Intervention Trial for Youth (CITY). The Project was conducted in 13 communities across the USA from 1999 to 2002. Forty percent of HIV-positive men and 34% of HIV-negative men reported that they had UAI in the previous 3 months. HIV-positive MSM were more likely than their uninfected peers to have traded sex within the previous year, to have had sex while high during their last sexual encounter, and to have UAI with a greater number of partners. Multivariate analyses indicated that for HIV-negative men, positive peer norms regarding safer sex and being Black or Latino predicted avoidance of UAI. Among HIV-positive men, having social support for safer sex and positive peer norms predicted avoidance of UAI. Young HIV-positive MSM are a relevant subgroup for prevention because they constitute a significant source from which future infections could be generated.

Syphilis and HIV Seroconversion Among a 12-Month Prospective Cohort of Men Who Have Sex With Men in Shenyang, China

Cross-sectional studies have found a high prevalence of syphilis and HIV infection among men who have sex with men (MSM) in China. A total of 218 HIV-negative MSM participated in this prospective cohort study. Interviewer-administered questionnaires were completed, and blood samples were obtained for HIV and syphilis testing, both upon enrollment and at 12-month follow-up. Of enrolled participants, 56% (122) were retained for the full 12-month follow-up period. The cohort had an HIV incidence density of 5.4 (95% CI: 2.0-11.3)/100 person-year (PY) and a syphilis incidence density of 38.5(95% CI: 27.7-50.2)/100 PY. Having syphilis (odds ratio [OR]: 11.4, 95% CI: 1.2-104.7) and more than 5 male sexual partners within the past 12 months (OR: 6.5, 95% CI: 1.1-39.8) were independent risk factors for HIV seroconversion (each P < 0.05). Being married (OR: 3.5, 95% CI: 1.4-8.2) and having more than 5 male sexual partners within the past 12 months (OR: 4.7, 95% CI: 2.0-6.2) were risk factors for syphilis seroconversion, while age > or =30 (OR 2.1, 95% CI 0.7-9.5) and having recently engaged in unprotected receptive anal sex (OR: 2.4, 95% CI: 0.7-13.1) were marginally associated with syphilis seroconversion. The high incidence rates of HIV and syphilis in the Shenyang MSM community are significant cause for concern. The seroconversion rate for syphilis, in particular, indicates the high prevalence of high-risk sexual behaviors and the potential for increased HIV transmission. Appropriate interventions that address MSM-specific issues, including stigma, pressures from traditional society, and bisexual behavior, need to be tailored to inform and empower MSM in order to prevent HIV and syphilis in this community.