Acquired Immunodeficiency Syndrome Epidemiological Research Among Men Who Have Sex With Men In Beijing

HIV/AIDS is sustainedly transmitted among men who have sex with men (MSM) in the world. The proportion of nationally reported HIV/AIDS cases among MSM increased from0.7%in2005to3.5%in2007,10.0%in2009,15.0%in2011and19.1%in2012. The serial cross-sectional studies found HIV prevalence among MSM in Beijing increased from1.2%in2000, to3.2%in2005,4.8%in2006,6.2%in2009and7.8%in2010. Since generally unprotected sexual contact, complexed sexual partners and higher STD infection rates among MSM, which makes MSM to be high risk population. AIDS epidemic among MSM is severe and MSM have the trend of younger age. The history of sex among young MSM is short, so the result of HIV infection among young MSM may reflect recent infection. Also they are in the most sexually active phase, and would do more sex in the future. So knowing the HIV infection among young MSM is very important for guiding future work. In addition to sociodemographic, sexual behavior and HIV testing history, factors affecting MSM HIV infection may also including psychology (such as whether they are self-confidence) may also be correlated. In China, drinking is common and people sometimes drinks a lot. Studies have shown that the type of alcohol consumption and alcohol will not only increase HIV-related risk behaviors, but also increased the HIV and other sexually transmitted diseases. Therefore, we conducted behavioral and serological survey among MSM in Beijing in order to realize alcohol consumption and its relationship with behavior, the relationship between self-efficacy and HIV infection, Beijing young MSM HIV infection and its impact factors, so as to develop and provide measures for AIDS prevention. Objective1. To understand the alcohol consumption and and its relationship with behavior among MSM in Beijing2. To understand the relationship between self-efficacy and HIV infection.3. To understand HIV infection and its impact factors among Beijing young MSM.MethodContinuous three cross-sectional study was conducted among MSM in Beijing from in2009,2010and2011. Respondent-driven sampling (RDS) was used to recruit participant. A computer-assisted self-administered questionnaire was used to collect data, including demographic information, sexual behaviors, general self-efficacy, attitudes and perceptions on safe sex and alcohol use. At the completion of the interview, a blood sample was obtained to test for HIV and syphilis. Variables were evaluated by using RDSAT and SAS software.ResultOf the502participants were screened for the study, two were not eligible for the study. All500eligible participants completed the questionnaire and provided blood samples. Almost half of MSM in our study area (42.1%,95%CI35.8,49.0) never had a drink containing alcohol in the past year. In the past year,38.5%(95%CI31.9,45.1),12.0%(95%CI7.6,16.6) and4.2%(95%CI2.0,6.9) have had a drink containing alcohol monthly or less, at2-4times a month, at2-3times a week and at4or more times a week, respectively. In terms of a typical day of drinking,89.0%(95%CI85.2,92.5) had1or2drinks containing alcohol on a typical day when drinking,In terms of binge drinking,11.8%(95%CI8.0,15.6) had six or more drinks on one occasion. For binge drinking alone positive significant associations (p≤0.05) were found with time of living in Beijing (OR1.8,95%CI1.0,3.3), number of gay/bisexual men known (OR2.1,95%CI1.2,3.7), number of male partners in the past six months (OR1.9,95%CI1.0,3.5) and alcohol with sex (OR7.6,95%CI4.0,14.3).The crude HIV prevalence was7.2%, and the adjusted one by RDSAT was6.1%in the recruited MSM. In multivariable analysis, the protective factors associated with HIV infection were:High scores of General Self-Efficacy Scales (GSES)(AOR=0.4,95%CI:0.2-0.9), HIV testing in the last year (AOR=0.5,95%CI:0.2-0.9), the risk factor associated with HIV infection was:unprotect receptive anal sex in the past6months. Cronbach’s Alpha of GSES is0.92.In total,474participants were enrolled. The overall prevalence rate of HIV was7.4%, which in2009,2010, and2011were6.4%8.4%and7.5%, respectively. In multivariable analysis, HIV infection was associated with self-reporting rightly HIV status (OR=0.06,95%CI:0.02-0.18), a higher score of attitudes and perceptions on safe sex (score>55:OR=0.44,95%CI:0.20-0.98), had sexually transmitted disease symptoms in the past year (OR=6.78,95%CI:1.92-23.95), syphilis infection (OR=4.19,95%CI:1.49-11.80). The Cronbach’s alpha coefficient for the internal consistence of the cognitive scale on safe sex was0.92.ConclusionWhile overall rates of drinking appear to be high among Chinese MSM, a relative small proportion of MSM in our study were identified by the AUDIT measures as problem drinkers. Future studies or interventions that wish to throw the largest net around problem drinking may benefit from using binge drinking as their definition of problem drinking. Future studies will need to incorporate standard measures of problem drinking and HIV risk taking in order to identify those persons and behaviors most in need of HIV prevention interventions that incorporate alcohol use reduction in their design. The HIV prevalence among MSM in Beijing was high. Improvements in General Self-Efficacy Scales may help control HIV transmission among MSM, and can be achieved by greater access to mental health services. Innovative interventions are required to promote regular HIV testing and reduce unprotect receptive anal sex.Compared to the elderly MSM, young MSM may occurs more often and more easily and also more easily leading to the spread of HIV.The cognitive promotion of safe sex and the prevention of sexually transmitted disease could control rapid spread of HIV among young MSM.