Analysis On Characteristics And HIV Infection Among Men Who Have Sex With Men And Women

Objective To investigate the socio-demographics, sexual behaviors, prevention services, HIV knowledge, HIV-related attitudes, psychological characteristics and HIV infection status among men who have sex with men and women (MSMW) and assess the risk for HIV infection among them.To examine the potential factors which may impact on HIV infection and unprotected anal intercourse.among MSMW and discuss the epidemiologic bridge role of MSMW which played in HIV transmission from high-risk population to the general population.Method An anonymous cross-sectional study was conducted to 256 men who have sex with men and women (MSMW) and 869 men who have sex with men and women only (MSMO) selected by non-randomly sampling method in Chongqing Municipality during April 2013 to October 2014. Chi-square tests and Wilcoxon rank tests were performed to examine the differences in demographic, sexual behaviors,HIV knowledge,attitudes and psychological characteristics among MSMW and MSMO.Multivariate stepwise logistic regression analyses were performed to evaluate the odds ratio of HIV infection among MSMW. Univariate and multivariate logistic regression were employed to examine the potential factors associated with HIV infection and unprotected anal intercourse.Results Of the total 1125 MSM,869 MSM who had not sex with women in the past 6 months were classified as MSMO and the remaining256 were classified as MSMW. MSMO were younger than MSMW (mean age:28.49 vs.33.91 years, p<0.0001). Compared with MSMO,MSMW were less educated (p<0.0001) and were more likely to be married (p<0.01)and come from villages (p=0.0003).;In the last six month, MSMW were more likely to have multiple anal sex men partners and casual male partners, engage in transactional sex, drug and alcohol use;MSMW were more likely to have anxiety and depression symptoms,but less likely to take HIV testing. A small proportion of MSMW had used condoms consistently with female partners in the past 6 months (35.16%). The HIV infection rate among MSMW (28.52%) is higher than that of MSMO(19.79%) and MSMW had 1.5 time odds of HIV infection than MSMO(OR=1.536,P=0.0257); Logistic regression analysis demonstrated: MSMW who used illicit drug were more likely to be infected (OR=1.515,P=0.0238);MSMW who reported used condoms consistently with male partners were less likely to be infected (OR=0.543,P=0.0194). On this basis,we make further analysis of unprotected anal intercourse among MSMW, the result of multivariate analysis showed that:having regular male partners (OR=0.445,P=0.0358), and using condoms consistently with casual male partners in the last six month (OR=2.350, P=0.0081), using illicit drug (OR=1.414, P=0.0405), using the Internet to seek sex partner(OR=8.522,P=0.0031),have anxiety symptoms (OR=1.93, P=0.0309), and HIV knowledge (OR=0.65,P=0.0161) were the independent influencing factors associated with unprotected anal intercourse.Conclusion HIV prevalence was high among MSMW in Chongqing.It was relatively common to not use condoms consistently with male and female partners among MSMW. MSMW is a potentially larger risk group, placing their female and male partners in great vulnerability to HIV. Interventions target to MSMW are urgently needed to reduce HIV risk and prevent HIV from high-risk group to general population. In order to change the risk behaviors and decrease HIV infection rates,governmental organizations should carry out health education behavior and psychological interventions to promote sexual health. Health education and internet inventions may contribute to improve the level of self-perceived HIV risk. mplementing psychological interventions to treat and prevent mental problems could helps to increase the sense of identity and transform behavior motivates.Furthermore,efforts such as peer education and free condom distribution, are warranted to change the risk behavior, combine the knowledge with behavior,and reduce HIV transmission and infection.