Study On AIDS Prevention Knowledge, Behavioral Characteristics, HIV Infection And Its Influencing Factors Among Men Who Have Sex With Men (MSM) In Hangzhou City

Background Due to multiple sex partners and unprotected anal intercourse, men who have sex with men(MSM) have a high risk to infect HIV. In the world, the first HIV infector who was reported in 1981 was gay in USA. The same situation happened in China in 1989. In recent years, China's AIDS epidemic appears a several characteristics, and the rate of homosexual transmission presents a rapid rising trend. On November 29,2010, the Ministry of Health informed that ratio of male homosexual transmission raised from 5.9% in 2008 to 8.6% in 2009. In the 61 cities of China, the screening for HIV infection in MSM shows, the rate of HIV infection was 4.9% in 2008 and the figure reached 5.0% in 2009. There was a high rate of HIV infection in the southwest of China, which was over 10% in Guiyang, Kunming, Chengdu and Chongqing. The prevention does not permit of any delay because of heterosexual sex that may spread the HIV to other people. Hangzhou is the capital city of Zhejiang province. There is a certain number of MSM. Therefore, it is necessary to deveolp education and intervention to local MSM.Objective To investigate the prevention knowledge about AIDS, behavior characteristic and HIV infection situation of MSM, analyze the factors of HIV infection. Then, to provide scientific basis for AIDS prevention and control among MSM.Methods It is selected as sample that the man (older than 18 years old) had anal intercourse with another man in past 6 months. With the help of volunteers, we recruited various types of MSM in Hangzhou and used a snowball sampling method during June 2009 to June 2010. We strictly follow informed consent and privacy principle. Information regarding the basic Demographic characteristics, AIDS knowledge, behavior characteristics and coverage of preventive measures were surveyed through a self-design survey questionnaire.5ml venous blood was extracted which was send to the Xiacheng CDC HIV screening laboratory to detect HIV, syphilis and HCV infection. We had established a database using Epidata 3.02. Univariate and multivariate logistic regression analysis were done by SPSS 17.0 to analyze the association between HIV infection and knowledge, counseling, testing, number of sexual partners, commercial sex, using condom and other factorsResults 530 MSM participated effectively in the survey, in which 20.38% for bar type,21.32% for bathroom type,4.90% for park type,50.57% for network type and 2.83% for others. MSM ranged from 20 to 39 years old accounted for 84.53%.81.32% of MSM were floating population.33.77% received college or higher education. 27.92% took part in commercial sex services. Gay accounted for 60.75%.The average rate of awareness about AIDS prevention knowledge was 94.72%. Six points of them were over 90% including transmission, but the knowledge point that mosquito could not spread HIV, which was only 74.91%. The awareness of AIDS prevention knowledge was associated with time in this city, education, sexual orientation, commercial sex and accepting counseling and testing.In the past 6 months,28.87% of MSM existed commercial sex, and 22.64% reported having sex with a female. When having sex with male, the utilization of condom was 75.47% for the last one and 54.15% for last 6 months. Type of MSM, type of homosexual behavior and sex partner had relationship with condom using.3.77% of MSM had history of drugs addiction, and 7.74% had STD-related symptoms. The highest proportion was 75.85% for promotional materials among AIDS prevention measures. AIDS prevention knowledge mainly came from internet that accounted for 54.72%.8.49% of MSM were HIV-infected,11.89% were syphilis-infected,1.32% wereinfected with both and 0.19% were HCV-infected. Univariate and multivariate logistic regression analysis showed that bathroom type and network type, more than 10 sexual partners in past 6 months were risk factors for HIV infection. On the contrary, using condoms was a protective factor in every sex. Bathroom type was 6.599 times the bar type and network type was bar type 3.422 times. In addition, more than 10 sexual partners were 4.379 times more dangerous than less than 10 sexual partners. Each sex using condoms was 0.403 times compared to never or sometimes using.Conclusion HIV prevalence had existed in the local MSM. It should be done to strengthen the propaganda and intervention by Internet, peer education, counseli ng, testing and so on. Especially, in bathroom, Internet and existing commercial sex.