The Sexual Transmission Behavior With Multiple Sexual Partners And Its Correlates Among HIV-positive Men Who Have Sex With Men

Objective The aims of study are to investigate status of sexual partners and sexual transmission behavior among HIV-positive men who have sex with men(MSM)and to examine the factors related to sexual transmission behavior with multiple sexual partners document for development of HIV intervention strategies.Methods HIV-positive MSM who were 18 years old or elder,lived in Chengdu,Chongqing or Guangzhou and confirmed HIV infection by the local CDC were recruited by using “snowballing” sampling.Participants completed the questionnaire assisted with computer after informed consent.Content of the study included social demographic characteristics,health status,sexual partners and sexual behaviors during past 6 months,HIV disclosure to sexual partners,symptoms assessment of depression and anxiety and assessment of sexual sensation seeking as well.?2-test,t-test and non-conditional multiple logistic regression was used to examine influencing factors of sexual transmission behavior with multiple sexual partners among participants.Results The age of 501 participants were between 18 and 63 years old and mean age was(30.24±7.70)years old.79.0%(396/501)were unmarried and 60.5%(303/501)had a residence card.Nearly two thirds(63.5%)had junior college or higher education.60.2% of them earned 1501-5000 Yuan monthly.81.4% identified themselves as homosexual orientation among participants.During past 6 months,the proportion ofhaving unprotected sexual behavior was 32.1% and 20.6%(103/501)of participants had two or more sexual partners.The proportions of participants who had unprotected sexual behavior and sexual transmission behavior with multiple sexual partners were 17.4%(87/501)and 13.2%(66/501)respectively.The univariate analysisshowed that the proportion of participants having sexual transmission behavior with multiple sexual partnersduring past 6 months was higheramong participants who were divorced or widowed(23.1%)and married(17.0%),compared with unmarried participants(11.4%).The proportion of participants having sexual transmission behavior with multiple sexual partners was higher among participants who did not receive CD4 cell counts detection(30.4%)than those whodid(11.4%).Participants who had primary male sexual partners(15.9%v.s7.5%),casual or commercial male sexual partners(21.5%v.s.5.7%),group sex(66.7%v.s.11.9%)were more likely to have sexual transmission behavior with multiple sexual partners.The proportion of participants having sexual transmission behavior with multiple sexual partners among participants whodisclosed HIV-infection to all of their primary male sexual partners was 2.9%.It is lower than those who disclosed to only some(21.5%)and to none(25.6%)of their primary male sexual partners.Participants disclosed HIV-infection in 10 days after being confirmed HIV-positive were less likely to have sexual transmission behavior with multiple sexual partners.The proportion of participants having sexual transmission behavior with multiple sexual partners was higher among participants who drank alcohol(28.3%v.s.11.4%)and took alkyl nitrite(30.0%v.s.10.4%).The sexual sensation scores were higher among participants whohad sexual transmission behavior with multiple sexual partners.The multiple analysis of logistic regression found that the risk of participants having sexual transmission behavior with multiple sexual partnersincreasedto 2.3-2.8 times among participants who had no high school diploma compared with participants who graduated from junior college or above;During past 6 months,participants who had casual or commercial male sexual partners(OR=3.654,95%CI: 1.802-7.410)were more likely to have sexual transmission behavior with multiple sexual partners;Both drinking alcohol(OR=3.395,95%CI: 1.427-8.075)and taking alkyl nitrite(OR=2.145,95%CI:0.958-4.631)could increase the risk of having sexual transmission behavior with multiple sexual partners;Participants who disclosing HIV-infection to all of their primary male sexual partners were less likely to have sexual transmission behavior with multiple sexual partners;With increasing of sexual sensation scores,the risk of participants who had sexual transmission behavior with multiple sexual partners increased accordingly(OR=1.089,95%CI:1.030-1.151).Conclusions Sexual transmission behavior with multiple sexual partners among HIV-positive MSM may drive HIV transmission rapidly,thus,to improve safe sexual transmission behavior with wives,disclosure to primary male sexual partners and intervention on psychology and biological measures based on sexual sensation are necessary.Meanwhile,to develop intervention strategiestargeted on male and female sexual partners should be taken urgently.