HIV Incidence And Using Of Oral Rapid Test Kits For Regular Male Sexual Partner Among Men Who Have Sex With Men In Beijing

Objective:1 To assess the prevalence and risk factors of unprotected anal intercourse(UAI)with regular and casual male sexual partners among men who have sex with men in baseline;2 To estimate the incidence of HIV and syphilis and to assess the correlates of incidence infection for HIV among MSM in Beijing,and to reveal the retention rate of corhort study as well;3 To explore the related factors of taking HIV oral rapid test kits to their regular male sexual partners among MSM in Beijing.Method:From May 2015 to April 2016 and at VCT clinic of Beijing Capital Dermatology Hospital,workers who have accepted special trainings recruited MSM to participate in the cohort study through such methods as recruitment at site,companion recommendation,and information release on Internet(QQ groups,gay forums and chat rooms).Participants were required to be at least 18 years old,man,had anal sex or oral sex with males over the past 6 months,as well as agreed to sign a consent form.The baseline and two times of follow-up survey were conducted every three months,including questionaries,serological detection and rapid HIV test for regular sesual partners.We used the anonymous survey to investigate the sociodemographic characteristics(age,marriage status,census register,nationality,education degree,career,monthly income),sexual behavior characteristics and high risk sexual behavior situation(sexual orientation,amount of regular sex partner/casual sex partner over recent three months,the use condition of condoms for anal sex with regular sex partner/casual sex partner over recent three months)and HIV test experiences(whether the participant takes HIV test in the recent year,his regular sex partner takes HIV test in the recent year,and he knows the test results of his regular sex partner).All the participants were tested for HIV and syphilis with the blood specimens.The participants who had regular male sexual partners were persuaded to take an HIV oral rapid test kit to their partner and asked to return the test results to workers in time.In the study of rapid oral HIV test kits for the regular sexual partner,we reviewed the data from 2011 to 2015: each year a corhort study of MSM in Beijing was established from July 2011 to April 2016.The recruitment method,serological detection and questionaries were same as previous.We motivated the participants who have regular male sexual partner to take part in this study,then the data of rapid oral HIV test kits for the regular sexual partners in the five years was evaluated comprehensively.The input of data adopted SurveyAn e-questionnaire software and was integrated and analyzed by use of SAS 9.2 software.The statistical analysis method included frequency distribution,Chi-Square test,Logistic Regression Analysis,Cox Regression Analysis and Chi-Square trend test(CochranArmitage method).Results:1 A total of 495 participants were recruited in the baseline of 6-months follow up cohort study among MSM,the prevalence of HIV and syphilis was 3.6%(18/495)and 18.8%(93/495)respectively.The rate of UAI with regular and casual male sexual partners over recent three months was 46.1%(142/308)and 40.4%(86/213)respectively.The multivariate Logistic regression analysis showed that higher education degree(OR=1.87,95%CI :1.10-3.50)and higher awareness of self HIV infection(OR=2.74,95%CI:1.19-6.32)were significantly associated with conduct UAI with regular male sexual partners;the census register(OR=2.39,95%CI:1.22-4.71),not test HIV in recent 1 year(OR=2.57,95%CI:1.30-5.12),higher awareness of self HIV infection(OR=3.11,95%CI:1.27-7.63)and have more than 2 male sexual partner in recent three months(OR=2.12,95%CI:1.17-3.85);2 Among 477 HIV-negative participants,6 HIV seroconversion were occurred in 227.52 person years,the HIV incidence rate was 2.64 per 100 person-years(95%CI:0.96-5.74);Among 402 syphilis-negative participants,14 syphilis seroconversion were occurred in 183.46 person years,the HIV incidence rate was 7.63 per 100 person-years(95%CI:4.17-12.80).The multivariate Cox regression analysis showed that the lower education degree(HR=12.04,95%CI:1.41,103.08)and have more than 2 sexual partners in recent three months(HR=6.65,95%CI:1.22-36.33)were significantly associated with HIV infection;3 Of all the 477 participants,84.9%(405/477)were retained in the cohort at the 3-month follow-up visit,and 78.2%(373/477)finished the 6-month follow-up visit.The multivariate Logistic regression analysis showed that more than 25 years old(OR=1.87,95%CI:1.15-3.05),usually meet sexual partners in park or bathhouse(OR=4.59,95%CI:1.37-15.33)?take HIV test in the recent year(OR=1.94,95%CI:1.17-3.22)and have anal intercourse with male sexual partners during follow-up period were significantly associated with 6-month retention;4 A total of 1044 HIV oral rapid test kits were provided for the participants with regular male sexual partner in 2011-2015 MSM cohort study,17 HIV positive(1.6%)and 2 HIV suspected positive(0.2%)results were found,and 761 HIV negative(72.9%)results were also revealed.The rate of regular sex partners tested for HIV in the past one year rose significantly(except 2013),from 51.7%(163/315)to 72.5%(169/233)in 2011,from 50.4%(194/338)to 77.9%(202/259)in 2012,from 82.6%(185/224)to 88.3%(172/191)in 2014,and from 60.2%(207/344)to 77.6%(201/259)in 2015;5 The baseline data of 2011-2015 was merged,and the multivariate Logistic regression analysis showed that the higher education degree(OR=3.28 95%CI:1.73-6.21)and the regular sex partner tested for HIV in recent one year were significantly associated with taking in HIV rapid test kits for their regular sexual partners(OR=2.71,95%CI:1.49-4.93).Conclusion:1 High incidence rate of HIV and syphilis were found among MSM in Beijing,and effective prevention measures are needed to keep down the epidemic.2 There is a high prevalent of risk behaviors among MSM in Beijing,and the prevalence of UAI with regular and casual male sexual partners was different.The implementation of strategies to motivate MSM to use condoms is urgently required to control the prevalence of HIV/AIDS and other STD among MSM.3 The strategy of taking oral fluid HIV rapid test kits to regular sex partners,in a manner,expanded the coverage of HIV testing and promoted the HIV test rate between regular partners,as well as provided evidences for developing new intervention policies and strategies against HIV/AIDS.