Research On HIV-1 Infection And HIV-1 Molecular Epidemiology Among Msm In Shanghai, China

Part 1 Study on HIV-1 infection and associated factors among MSM in ShanghaiBackground:HIV-1 is rapidly spreading among men who have sex with men (MSM) in China. The homosexual transmission route has played a more and more important role in all infections. More attentions are payed to explore the high risk factors and prevention strategy among MSM, however, a little study has separated the population into Money boys and General MSM. In this study, we will explore the factors associacted with the infection of HIV-1 within two different subgroups of MSM.Objective:to understand the difference of Money boys and General MSM on social demographic characters, sexual behaviors, social support and depression, and explore the HIV-1 infection related factors.Methods:A total of 535 MSM were recruited using a venue-based sampling strategy in Shanghai, China. Questionnaire investigation and labortary test were used to understand participants’social demographic characters, sexual behaviors, mental status, HIV-1, HSV-2 and syphilis infection status.Results:Among 535 MSM,226 were Money boys(42.2%) and 309 General MSM (57.8%).Most of the participants were younger than 35 year old(71.6%), non-Shanghai residents(76.3%), ethnic Han(94.6%), education level as high school or below(66.5%), never married(69.2%), monthly income>3000 (yuan. RMB)(66.4%), sexual identity as gay(64.1%) and HIV/AIDS related knowledge score less than 6(81.7%). Compared to General MSM, Money boys were significant much younger, more non-Shanghai residents, lower education level and much more monthly income. On sexual behavior, Money boys had more homosexual or heterosexual partners, more anal or oral sex in the past 6 months and more often acted as acceptive role in anal sex, more sex with male/female sex workers, more sex after drinking or using drugs,less social support and more depression compared to General MSM with significant difference. But the Money boys were much more likely to use condom. The HIV-1 infection rate was 10.7%, separately 14.6% for Money boys and 7.8% for General MSM. The positive rate of HSV-1,TPPA and TRUST were 22.1%,23.6% and 2.6%. Multiple logistic regression found that Money boys were much likely to infect HIV-1 compared to General MSM(or=1.94,95%CI 1.01-3.70),the 25-34 year old group were more risk than the 35-68 year old group(OR=3.16,95%CI 1.23-8.13), the gay were more risk than non-gay(or=2.00,95%CI 1.03-3.91) and the HIV/AIDS score>6 were protect factors compared to 0-5 score(OR=2.79,95%CI 1.05-7.44).Conclusion:The HIV-1 infection rate of Shanghai MSM was relatively high, especially to the Money boys who are enduring more risk sex behaviors, less social support and more depression, they should get more attentions. We should keep an eye on the infection of younger ones, enhance and deepen the education of HIV/AIDS related knowledge in this population.Part 2 Study on the HIV-1 genotype distribution and prevalence of primary drug resistance mutation among MSM in ShanghaiBackground:As the world widely use of Highly Active Antiretroviral Therapy (HARRT), the problem of drUg resistance has gotten attention. MSM is one of the highest risk populations to infect HIV-1 and also infect priamry drug resistance strains. To survy the HIV-1 genotype distribution and transmitted drug resistance mutation will be good for the understanding of dominate strains in this population and whether the current HAART strategy fit for them.Objective:to understand the HIV-1 subtype distribution and primary drug reistance among MSM in Shanghai and provide some theoretical basis for HIV-1 prevention in this population.Methods:A total of 535 MSM were recruited using a venue-based sampling strategy, 57 of them were tested to be HIV-1 positive. All of the HIV-1 positive plasmas were used to extract RNA, do reverse transcription polymerase chain reaction (RT-PCR), and amplify the fragments of HIV-1 pol gene(including all gene of protease and part of reverse transcriptase). The sequences were analysed for genotype through loading the gene to HIV Blast websites (http://hiv-web.lanl.gov) and by using Mega 5.0, the antiretroviral resistance analysis using Stanford University HIV drug database (http://hivdb.standford.edu).Result:There was no significant difference among the 57 infected Money boys and General MSM on social demographic characters except monthly income.52 plasma samples were succeded to amplify HIV-1 pol gene. Through the analysis of HIV Blast and phylogenetic tree, three genotypes were identified, including CRF01-AE, CRF07-BC and subtype B, which separately accouted for 53.8%,36.5% and 9.6%.2 HIV-1 sequences were found to be priamry drug resistance strain, one of which belongs to a Money boy and the other a General MSM, and both with CRF01-AE subtype, additionally there is another General MSM with potential drug resistance mutation. The overall prevalence of mutations conferring resistance to any drug was 3.8%(2/52), representing 3.8% for protease inhabitor (PI) related mutations, none resistance mutation related to RTs was found. The M46L was the PI related major mutation caused the drug resistance in the study, minor mutation A71T/V, LI01, V11I, L33F and K20R were also found. RTs related mutation V118I, L210W, V179I and K101Q were found.Conclusion:The genotype of CRF01-AE is the dominated strain in Shanghai MSM, the transmitted drug resistance among this group is in low level and the current HAART strategy still fit for them.