Study On HIV Prevalence,HIV Testing Rate And Their Associated Factors Among Men Who Have Sex With Men In Zhejiang Province

ObjectiveTo accurately know HIV prevalence,HIV testing rate and their associated factors among men who have sex with men(MSM)in Zhejiang Province for formulating targeted HIV prevention programmes and controlling HIV epidemic and scaling up HIV testing in the area.MethodsA cross-sectional study was conducted in three cities of Zhejiang Province,namely,Hangzhou,Ningbo and Wenzhou,using respondent-driven sampling(RDS)by a self-designed questionnaire.The software RDSAT 5.6 was used to calculate the rate of HIV infection and testing,and the software NetDraw 2.141 was used to draw the network chart.Bivariate and multivariate logistic regression analyses were used to identify the factors associated with the variables including HIV infection and HIV testing variables weighted by the network coefficients produced in RDSAT 5.6 in SPSS 18.0.Results1.1316 MSM were successfully recruited by RDS method(Hangzhou: 511;Ningbo: 351;Wenzhou: 454).Among 1316 MSM,39.3% of them had no less than 2 sexual partners of anal intercourse,81.2% had anal sex during the past half year and the percentage of consistent condom use was 47.5%.64.7% of these MSM had heterosexual sex in the lifetime and the percentage of consistent condom use was 36.2% during the past half year.Only 24.2% of them knew the HIV status of primary sexual partners.The prevalence of depressive symptoms was 36.6%.11.6% had suicidal inclination.2.The prevalence of HIV among MSM in Zhejiang Province was 14.0%(95%CI: 11.2%-17.3%)(Hangzhou: 8.4%;Ningbo: 5.3%;Wenzhou: 22.8%).The prevalence of current syphilis was 7.6%(95%CI: 5.6%-9.8%).Multivariate analysis indicated that HIV infection was associated with older age,lower educational level,more than 5 sexual partners of anal intercourse,the HIV status of primary male sexual partners,having suicidal inclinations,suffering male sexual violence,self-perceived higher likelihood of HIV infection,and current syphilis infection.3.The rate of HIV testing among MSM in Zhejiang Province was 56.0%(95%CI: 51.7%-60.8%)(Hangzhou: 62.6%;Ningbo: 61.9%;Wenzhou: 48.0%),and the rate of regular testing among tested MSM was 47.2%(95%CI: 41.7%-55.3%).Multivariate analysis showed HIV testing was associated with older age,higher educational level,self-reporting homosexual orientation,having suicidal inclination,self-perceived lower risk of HIV infection,and receiving AIDS/sexually transmitted diseases(STD)health education interventions in the past year.Conclusions1.Given higher HIV and syphilis prevalence,higher unprotected sex and poor psychosocial quality among MSM in Zhejiang Province by a representive sample obtained by RDS method,future HIV prevention programmes needs to continue to enhance health education about condom use and reducing sexual partners among MSM population,and be aware of the transmission risk from MSM to the general female population and provide MSM with mental support and help.2.Lower educational level,multiple sexual partners,and syphilis infection were main risk factors associated with HIV infection while knowing HIV-positive status of primary male sexual partners was a protective factor.This suggests that future HIV prevention programmes need to enhance health education about HIV risk among MSM with lower educational level,strengthen STD screening and timely treatment,and promote HIV disclosure to primary sexual partners among HIV-positive MSM.3.The rate of prior testing and regular testing for HIV among MSM was still low.Future HIV prevention programmes are still needed to continue to scale up the coverage of testing and improve regular testing rate among MSM to find more HIV-infected people and receive earlier therapy for reducing HIV transmission and acquisition.4.Lower perception of HIV infection and lower educational level were main impeditive factors associated HIV testing,and the higher frequency of received AIDS/STD health education was a protected factors.This indicates that promoting more MSM with lower educational level and lower risk perception of HIV infection to engage in testing,and improving frequency of AIDS/STD health education interventions should be included in the future HIV testing campaign.