A Cohort Study About Incidence Of HIV And Syphilis Among Men Who Have Sex With Men In Beijing, 2012-2014

Objective:To assess the incidence of HIV and syphilis among men who have sex with men in Beijing, 2012-2014 through the questionnaire follow-up survey, and discuss the related factors about completing the follow-up survey and the related risk behaviors of HIV and syphilis, aim to lay the theoretical foundations to improve the follow-up rate and carry out more targeted and effective preventive interventions. Methods:This study recruited the yearly queue baseline among MSM between July 2012 to August 2014 in Beijing and completed follow-up investigation after 6 months. 1666 MSM were recruited at baseline in three years, and six months later,1336 MSM completed the follow-up survey. Social demographic characteritics、sexual behaviors and other datas were collected by self-administered questionnaire survey, also HIV and syphilis antibody detection were applied. Third-party electronic questionnaire information database application(survey)was used to establish and organize datas and the data analysis using SAS 9.2 statistical package. Measurement data using M ± Q to describe, count data using the rate and composition ratio.The rate was adopted to represent the new infections circumstances indication. Differences in the distribution of annual recruitment groups were analyzed by Chi-square test. Univariate and multivariate analysis using the Logistic regression analysis to confirm the related factors. Results:1.Queue baseline recruit 537 MSM in 2012,602 MSM in 2013,and 527 MSM in 2014. The struction of age, household, the time living in Beijing, education, monthly income, the place to find sexual partners, whether to do the HIV antibody test in the last year, whether or not to know the test results,whether or not have steady and casual partners in last three month, the number of casual partners in the last three months,the situation of using condoms in sexing with casual partners in recently time and the condom using frequency in the last three months were statistically significant(P<0.05).2.432 MSM have completed the follow-up questionnaire survey after 6 months and the fill-up rate was 80.4% in 2012, 455 MSM have completed the follow-up questionnaire survey after 6 months and the fill-up rate was 75.6% in 2013,449 MSM have completed the follow-up questionnaire survey after 6 months and the fill-up rate was 85.2% in 2014, there were 1336 MSM have completed the follow-up questionnaire survey in totally three years and the fill-up rate was 80.2%. Multivariate Logistic regression analysis showed that MSM living in Beijing equal or less than two years(OR = 1.932, 95%CI=1.426-2.594), high school diploma or below(OR=1.611, 95%CI=1.162-1.908), HIV antibody testing were not done within the last year(OR=1.408, 95%CI=1.011-1.935), the first occurrence of penetrative sex age at equal or less than 18 years old(OR=1.554, 95%CI=1.017-1.936) and have more than two anal sex male partners in nearly three months(OR=1.732, 95%CI=1.054-1.961) were easier to complete the follow-up survey.3.9 MSM seroconverted for HIV infection,a total 225.2 person-years of follow-up, HIV prevalence was 4.0/100 person-years(95%CI=1.4-6.6) in 2012 cohort, 8 MSM seroconverted for HIV infection,a total 241.3 person-years of follow-up, HIV prevalence was 3.3/100 person-years(95%CI=1.1-5.6) in 2013 cohort. 12 MSM seroconverted for HIV infection,a total 254.9 person-years of follow-up, HIV prevalence was 4.7/100 person-years(95%CI=1.2-8.6) in 2014 cohort.The total HIV prevalence was was 4.0/100 person-years, HIV infection rates had no significant difference(χ2= 0.912, P=0.634) in three years. Logistic regression analysis showed that MSM have more than two anal sex male partners in nearly three months(OR=2.732, 95%CI=1.115-4.137),occasionally used condoms during having sex with casual partners in the last three months(OR=1.431, 95%CI=1.031-1.517), and the positive result of syphilis test(OR=1.235, 95%CI=1.045-3.465)were susceptible to HIV infection.4.11 MSM seroconverted for syphilis infection,a total 210.4 person-years of follow-up,syphilis prevalence was 5.2/100 person-years(95%CI=2.2-8.2) in 2012 cohort, 11 MSM seroconverted for syphilis infection,a total 144.1 person-years of follow-up, syphilis prevalence was 7.6/100 person-years(95%CI=3.3-11.9) in 2013 cohort. 14 MSM seroconverted for syphilis infection,a total 252.4 person-years of follow-up, syphilis prevalence was 5.6/100 person-years(95%CI=2.7-8.4) in 2014 cohort.The total syphilis prevalence was was 5.9/100 person-years, syphilis infection rates had no significant difference(χ2=0476,P=0.788) in three years. Logistic regression analysis showed that MSM at the age 30 or under 30(OR=1.560, 95%CI=1.104-1.815),have the high school diploma or below(OR=1.570, 95% CI=1.110-1.932) and no using condoms during last anal sex(OR=1.477, 95%CI= 1.018-2.145)were susceptible to syphilis infection. Conclusions:1.The time living in Beijing, education level, whether to do the HIV antibody test in the last year, whether or not to know the test results, the first occurrence of penetrative sex age and the number of anal sex male partners in nearly three months were independently associated with follow-up situation.And MSM living in Beijing equal or less than two years,high school diploma or below, HIV antibody testing were not done within the last year, the first occurrence of penetrative sex age at equal or less than 18 years old and have more than two anal sex male partners in nearly three months were easier to complete the follow-up survey.2.The number of anal sex male partners in nearly three months,the frequency of condom use during having sex with casual partners in the last three months and the result of syphilis test were independently associated risk factors of HIV infection in MSM.3.Age,education level and the satuation of using condom during last anal sex were independently associated with syphilis infection.4.The difference of incidence status of HIV and syphilis in 2012-2014 was not statistically significant, the trend showed steady situation, but prevalence levels are still high compared with other cities, the effective and scientific prevention interventions must be strengthened and generalized.