HIV And Syphilis Infection And Risk Factors Among Young Men Who Have Sex With Men

Objectives To know the prevalence of HIV and syphilis infection, and status of HIV/AIDS knowledge,variety and number of sexual partners, sexual behavior and condoms use among young men who have sex with men (YMSM), and to explore the factors associated with HIV and syphilis infection and comdom use among YMSM, and documented to HIV intervention for YMSM.Methods This survey was conducted in 4 cities of China including Beijing, Harbin, Zhengzhou and Chengdu. With help of MSM volunteer of the four cities, a total of 600 eligible participants (150 YMSM in each city) were recruited by"snowballing"with the cretieria of the survey inclouding male who were 16-24 years of age, and living in the 4 cities above, and having anal or oral sex with another male in the past 12 months, willing to complete the survey. After the informed consent, we carried out face-to-face sourvey followed the item of questionnaire anonymously in a private room. The participates were investigated with questionnaire which contained demographics, HIV/ AIDS related knowledge, sexual behaviors and condoms use as well as HIV and syphilis testing.EpiData 3.0 software was used to establish a data-base. Chi-Square test, Logistic Regression Analysis were applied to detect related factors of HIV and Syphilis infection and condom use in anal intercourse in past 6 months. Results The average of age was 21.48±1.86 years, with 29.7% of participants being 16-20 years of age, and 22.3% participants reporting experienced first sex with men before 18 years of age. About 1/3 were living in the city and 34.2% were students, while 46.7% completed college or higher level of education, and 36.3% had received high school or technical school education. Of participants, 70.2% self-identified as homosexual, 22.8% as bisexual, and 7.0% as heterosexual or undecied.Overall, HIV infection prevalence was 6.7%, prevalence of markers for syphilis was 8.4%. and the prevalence of concurrent infection of HIV and syphilis was 1.5%. In the past 6 months, the rates of self-report of insertive anal intercourse , receptive anal intercourse, oral intercourse and vaginal intercourse were 53.7%, 50.1%, 11.9% and 42.9% respectively; Higher rates of always using comdom were reported by HIV-positive participants (32.3%) compared to HIV-negative (55.4%) participants. (χ~2 =6.177, P<0.05). Among 548 participants who had anal intercourse with man in the last 6 month, 415 (75. 7%)used condoms in the last time when they had anal intercourse, 273 always used condoms (49.8%), 231(42.2%) used sometimes, and 44(8%) never used condoms.In Bivariate Analyses, associated factors of HIV prevalence are as follows, age older than 20 , non-students, high school educational background, age of having experienced first sex with men less than 18, syphilis infection, more than 5 male sex partners in past 6 month, having casual male sexual partners, not always using condoms when having insertive anal intercourse, looking for sexual partners through bathhouse/ sauna / reflexology /massag in the past 6 months (P<0.05). The rate of HIV of participants who had found sexual partners in past 6 month at home, school, workplace is lower than those who had not(19.3% vs 5.3%,χ~2=13.986, P<0.05). Syphilis infections ratio of participants who are not students,HIV infected,or whose having vaginal intercourse are higher than those are not(P<0.05).Logistic Regression Analysis demonstrated that the risk of HIV infection of participants who are 21~24 years old is 3.7 times as those who are younger (OR= 3.754,95% CI:1.313～10.737), compared with participants who has junior or lower education background,the risk of those with senior high school raised to 5 times(OR=5.165,95% CI:1.367～19.511)and college or higher(OR=5.305,95% CI:1.250～22.514). Compared with those who experienced first sex with men under 18 years of age,the risk of those who experienced in an older age raise to 3.5 times. The risk of infection among those who Found sex partners through bathhouse / sauna / reflexology /massage raised to 3.2times as those who did not(OR=3.209,95% CI:1.333～7.725);The risk of HIV infection among students are 2.5 times as those are not(OR=2.474,95% CI:0.902-6.786).The risk raised to about 3 times among those who are syphilis infected(OR=3.488,95% CI:1.419～8.571) and those who has more than 5 sexual partners in anal intercourse (OR=2.997,95% CI:1.396～6.432) in past 6 months compared to those are not,The HIV infection rate were reported lower when they found sex partner at home,school and work place(OR=0.154,95% CI=0.020～1.188)and the risk reduced(P<0.1).The Results from Non-conditional Multi-variable Logistic Regression of Syphilis Infections among YMSM show that:Associated factors are HIV possitive(OR=3.183,95% CI:1.392～7.278),non student(OR=2.159,95% CI:1.040～4.483),finding sex partner through internet (OR=1.976,95% CI:1.010～4.182)and having women sex partner in the last 6 months(OR=1.898,95% CI:1.031～3.493).In Bivariate Analyses of associated factors of alwayes comdom use when having anal intercourse in past 6 months show that:The self-reported rate of always using condoms when having anal intercourse are higher among those who are older than 18,those having commercial sex partner than those are not(P<0.05), and the rate are reported lower among those who had BF,casual male sexual partners, found sex partners through home/school/ Workplace, found sex partners through Internet than those who did not.Logistic Regression Analysis of related factors of alwayes comdom use when having anal intercourse in past 6 months show that:The probability of alwayes comdom use when having anal intercourse in past 6 months among 21~24 years old participants are 1.5 times as those who are younger(OR=1.528,95% CI=1.023～2.2823), the probability among those who had male commercial sexual parneters are 2.3 times than those did not(OR=2.284,95% CI=1.211～4.308), The probability was reported lower in those who had more than 5 male sex anal partners(compared with those who had less than 5 male sex anal partners,OR=0.594,95% CI=0.358～0.986), had boy friend(OR=0.505,95% CI=0.336～0.761), had steady male sexual partners(OR=0.544,95% CI=0.350～0.846), had casual male sexual partners(OR=0.555,95% CI=0.369～0.835)(P<0.1).Among all 600 participants, the self-reported rate of accepting condom distribution, lubricant distribution, peer eduction, screening or treatment for HIV and STI , voluntary HIV counseling and testing services, distribution of materials for HIV/STD prevention are 56.5%,50.0%,48.3%,32.3%,41.3% and 55.7%, and the detection ratio of syphilis infection are reported 10.9%,10.7%,13.4%,11.3% and 10.5%, which are higher than those who did not receive those(P<0.05 ).Conclusions The prevalence of HIV and syphilis infencion in YMSM is at high level and no significant difference between different sexal roles during anal intercourse。The risk of HIV and syphilis infection is common among YMSM whatever who are receptive or insertive in anal intercourse. Preventive interventions are urgently needed for controlling HIV spreading among YMSM and from them to females.