The Status And Trend Of HIV/AIDS Epidemic Among Men Who Have Sex With Men In Partial Area Of China

Objectives：To investigate the epidemic characteristics of HIV/AIDS andhigh-risk behavior related factors among men who have sex with men (MSM) inHunan Province.Methods：Cross-sectional study with snowball sampling method was conductedfrom May to June2009in Hengyang City and Xiangtan City in Hunan Province, theresearchers carried out face to face questionnaire about the knowledge and attitude onacquired immune deficiency syndrome (AIDS) and the high risk behaviors amongMSM, in addition collected their blood sample to test for human immunodeficiencyvirus (HIV) and other sexually transmitted diseases (STD) infection.Results：Among the536respondents,74.3%had homosexual anal sex in thepast six months and31.9%of them continuously used condom which produced a50.6%of rate of unprotected homosexual anal sex;17.9%had heterosexual sex in thepast six months and5.2%of them continuously used condom;29.5%had bought sexfrom men and5.0%had sold sex to men in the past six months.446MSM collected their blood sample for laboratory test, the results showed that the prevalence of HIVinfection was1.6%(7/536) and the prevalence of syphilis was1.1%(5/536), but notfound HCV-positive. In multivariate logistic regression model, residence time in thiscity(OR=0.63,95%CI0.43-0.90), had heterosexual sex in past six months(OR=2.01,95%CI1.25-3.24), had ever bought sex from men in past six months(OR=3.14,95%CI2.06-4.78), had ever sold sex to men in past six months(OR=0.22,95%CI0.09-0.56) and drug abuse(OR=2.92,95%CI1.31-6.49) were significantly associatedwith having unprotected homosexual anal sex in the past six months.Conclusion：The unprotected homosexual anal sex is very common amongMSM in Hunan Province. Although the prevalence of HIV infection and syphilis wasrelatively lower than the other cities in China, we must strengthen the healtheducation and behavioral intervention on target population thus reduce the risk ofHIV/AIDS spread in such population and to general population. Objectives: To study the trend of high-risk behaviors and epidemic of HIVamong men who have sex with men (MSM) in Beijing through prospective studythus to give evidence for comprehensive intervention targeted such population.Methods: A prospective study was conducted to investigate650MSM inBeijing recruited by respondent driven sampling method (RDS) from September2008to October2009. Data on demographics, awareness of AIDS and behavioralcharacteristics were collected and their blood sample was collected for HIV/STD test.As a result,611HIV seronegative MSM was enrolled in our cohort and werefollowed up by6months. Results:(1) Among611HIV seronegative MSM in our cohort,71.7%hadmultiple homosexual partners in past6months.59.7%had unprotected oral sex withregular homosexual partners in past6months and58.6%with occasional homosexualpartners.21.6%had unprotected insertive anal sex and21.8%had unprotectedreceptive anal sex with regular homosexual partners.18.5%had unprotected insertiveanal sex and16.2%had unprotected receptive anal sex with occasional homosexualpartners.12.1%had ever had group sex and51.4%of them had group sex in past6months.23.6%had sex with female partners in past6months and26.2%with regularfemale partners while5.1%with occasional female partners.(2)354MSM wasfollowed up in12month and the cohort retention rate was57.9%. Compare thebehavioral characteristics between baseline and12-month, the high risk behavior withoccasional and commercial homosexual partners, the proportion of have regularfemale paetners and drunk sexual behavior had downward trend while no significantchanges were observed in high risk behavior with regular homosexual partners.(3)19HIV seroconversion was found in245.22person years yield a7.75/100PY(95%CI=4.73~11.84) seroconversion rate while12syphilis seroconversion was foundin177.44person years yield a6.78/100PY (95%CI=3.55~11.54) seroconversion rate.(4) In multivariate logistic regression model, Nonlocal census register (OR＝4.00,95%CI2.00~8.33) and loss-to follow-up in6month (OR=27.87,95%CI17.42~44.58)was significantly associated with loss-to follow-up in12month.Conclusion: Eventhough the high risk behaviors had declined to some extentamong MSM in Beijing, the incidence of HIV/syphilis was both high and there is arisk to more server epidemic. Therefore, effective intervention measures should betaken to control further spread of HIV/AIDS in such population.