Prevalence Of And Factors Associated With HIV And Syphilis Infection Among Currently Married Men Who Have Sex With Men

Objectives To determine prevalence of HTV and syphilis infection among currently married men who have sex with men, to know the characteristics, sexual behavior and condoms use, status of HIV/AIDS knowledge, and acceptance of HTV intervention services among currently married men who have sex with men. To explore the factors associated with syphilis and HIV infection documented for developing the STD and HIV intervention strategies targeting currently married MSM.Methods This survey was conducted in4cities of China including Beijing, Harbin, Zhengzhou and Chengdu. The participants were aged18or over currently married MSM, using "snowballing" sampling to recruit a total of858eligible participants. The participants were investigated with questionnaire which contained demographics, HIV/AIDS related knowledge, number and type of sexual partners, same-and opposite-sex behaviors and condoms use, STD and AIDS intervention services. After participants completed the questionnaire, they got HIV and syphilis testing.EpiData and SPSS13.0were used for establishing a data-base and data analysis respectively. Statistical analysis methods included frequency distribution, Chi-Square test, Univariate and Multivariate Logistic Regression Analysis.Results Of858participants, the average age is38.3(SD=9.1) years, Nearly three-quarters are in the age of26～between45years old; One half did not have a residence card; About a quarter had completed the College school or higher. The percentage of participants who identified themselves as homosexual, bisexual, and heterosexual or undecided is40.9%,54.3%and4.8%, respectively.HTV and syphilis infection prevalence of participants was8.0%and17.9%, accordingly. The results of Logistic Regression analysis showed that syphilis infection could increase the risk of HIV infection (OR=2.25); Participants who resided in Harbin, had no commercial sex behavior in the last6months, accepted4～6kinds of HIV/STD intervention services could decrease the risk (the range of OR value is0.37～0.44). The factors associated with syphilis infection were included the growth of age, resided in Harbin, looked for sexual partner in MSM venues, had male, female and commercial sexual partners and HTV infection (the range of OR value is1.57～15.04). Compared with Beijing, partipants resided in Chengdu (OR=0.32) and Zhengzhou (OR=0.27) decreased risk of syphilis infection; Participants whose first sexual partners was female could decrease the risk of syphilis infection (OR=0.67).More than half of the married MSM (59.7%) whose first sexual partner was woman. During the past six months,85.1%and59.4%of the respondents had homosexual or heterosexual behavior,11.4%and29.6%of them never used condom in homosexual or heterosexual sex,31.2%and37.2%of them last homosexual or heterosexual sex without using condoms. Evaluation of the AIDS knowledge showed that90.0%of the participants answered correct6problems or more HIV/AIDS knowledge.45.8%of them accepted HIV test,61.1%and53.3%of them got free condoms and lubricant last year. The survey showed that36.8%participants never used condom in same-or opposite-sex. The participants who had anal sex with men in the last6months,13.4%reported never using condom. The participants who had sex with female partners in the last6months,49.8%reported never using condom.The results of Logistic Regression analysis showed that over the age of46years old (OR=3.18), did not have a residence card of the cities (OR=1.66), both have same-and opposite-sex last6months(OR=4.76) could increase risk of never using condom in same-or opposite-sex; Had education of college and higher, had first sex after18years old, accepted HIV/STD prevention services could decrease the risk of high risky sexual behavior (the range of OR value is0.40-0.63); The participants who were bisexual identified, had first sex after18years or older, only had same-sex in the last6months and accepted HIV/STD prevention services could decrease the risk of never using condom in anal sex (the range of OR value is0.32-0.60); Growth of age and had no a residence card of the cities could increase risk of never using condom in the sexual behavior with female (the range of OR value is2.05-5.86) and accepted4-6of HIV/STD prevention services could decrease the risk(OR=0.55).In this survey, Comparing the demographics and sexual behaviors between Gay and Non-gay identified participants, results showed that the proportion of Gay and Non-gay (including bisexual, and heterosexual sexual orientation or undecided) were40.9%and59.1%respectively; The prevalence of syphilis infection among Gay is21.7%, which is higher than Non-gay (15.4%); The proportions of some kinds of sexual behavior in Gay identified participants were higher than that of Non-gay, including had the first insert sex before age of18years, the first sex partner was male, had anal sex in the last6months, without using condoms in the last anal sex and never used condom in anal sex in the last6months. Of non-gay identified participants, the proportion of had opposite-sex is higher than that of Gay. The proportion of gay identified participants who got full scores of knowledge related HTV/AIDS and accept the HTV/STD prevention services were higher than those of non-gay.Conclusions The prevalences of both HIV and syphilis infection were high and unprotected sexual behaviors widespread among corrently married MSM. They can spread HIV widely through intra-and extra-marital sex, same-and opposite-sex. Gay and non-gay subset of currently married MSM had different demographic characteristics and syphilis infection prevalence. In non-gay subset, the proportion of opposite-sex was higher than those of gay subset, and HIV/AIDS related knowledge and intervention service coverage were lower among non-gay subset than gay subsets. Therefore, it’s need to distinguish the characteristics between MSM subsets in developing STD and AIDS prevention and intervention strategies targeting married and effective intervention should consider HIV epidemic among MSM, as well as from MSM to their femle sexual partners.