Study On New-type Drugs Abuse And HIV And Syphilis Infections Among Men Who Have Sex With Men In Shandong Province

ObjectiveThis study aimed to understand the demographic characteristics and HIV-related knowledge scores,analyze the new-type drug use and its related factors,analyze the HIV and syphilis infection and its related factors,explore the role of new-type drugs in promoting the spread of HIV/syphilis,and propose strategies and recommendations for HIV prevention and control among men who have sex with men(MSM)in Shandong province.MethodsThis cross-sectional survey was conducted among MSM in Jinan,Qingdao and Yantai from March to June in 2016.MSM were recruited by the snowball sampling,venue-based recruitment and Internet-based advertisement.Verbal informed consent was obtained from all participants before the interview.Survey information were collected anonymously and remained confidential.Structured questionnaire-based interviews provided demographic information,sexual and drug-use behavioral information,as well as HIV knowledge and HIV-related prevention services.A venous blood specimen was drawn from each participants and then tested by trained health professionals in the qualified laboratory.HIV was screened by enzyme-linked immunosorbent assay(ELISA)and confirmed by the Western Blot immune assay(WB).Syphilis was screened by ELISA and confirmed by the Toluidine Red No Heating Serum Test(TRUST).Survey data was double-entered and checked with the EpiData software(EpiData3.1 for Windows;The EpiData Association Odense,Denmark).All analyses were performed using the Statistical Program for Social Sciences software(SPSS software,version 20.0;SPSS Inc.,Chicago,IL).Descriptive analyses were performed for the percentages of demographic,sexual behaviors and new-type drug use.The method of univariate analysis is chi-square test.Variables that were significant in univariate analysis(p<0.05)were included in the multivariable analysis.Multivariable logistic regression models using a stepwise forward sequence were conducted to identify independent predictors of new-type drug use among MSM.Variables with p<0.05were determined as statistically significant.Results1.A total of 1306 MSM were recruited,and the average age was(28.7±8.5)year old.Of all participants,65.0%(849/1306)were 20-30 years of age,80.8%currently unmarried,86.9%(849/1306)were Shandong province residents,99.2%(1295/1306)belonged to a Han ethnic group,85.6%(1117/1305)reported living in their current location for>2 years,73.9%(964/1305)reported college or higher level of education,80.7%(1050/1301)self-identified as homosexual,83.9%(1094/1304)reported seeking male partners from the Internet,79.7%correctly answered at least 6 of 8questions on HIV knowledge test(1041/1306).2.Of all participants,28.6%(374/1306)ever used at least one type of new-type drugs,70.7%(265/374)often used new-type drugs and 55.1%(206/374)used single new-type drugs in the past 6 months.The new-type drugs used by MSM include 29MSM with methamphetamine,159 MSM with rush poppers,18 MSM with5-MeO-DIPT,13 MSM with methamphetamine+rush poppers,29 MSM with methamphetamine and zero capsules,6 MSM with ecstasy+rush poppers,108 MSM with rush poppers+zero capsules,1 MSM with methamphetamine+ketamine+5-MeO-DIPT,11 MSM with methamphetamine+rush poppers+5-MeO-DIPT.3.Of the participants,91.3%(1193/1306)reported ever having sex with a man in the past 6 months of whom 22.2%(264/1190)reported no condom use during their last sex,48.8%(582/1193)reported inconsistent condom use in the past 6 months,and 26.4%(315/1191)had≧2 episodes of anal intercourse in the past week.19.4%(253/1304)reported ever having sex with a woman in the past 6 months of whom66.8%(169/253)reported inconsistent condom use in the past 6 months and 41.5%(105/253)reported no condom use during their last sex.7.0%(84/1192)reported ever having commercial sex with a man in the past 6 months and 14.1%(53/374)had group sex after using new-type drugs.Of the participants,89.2%(1165/1306)ever received condom promotions,76.0%(928/1221)ever received HIV testing and 5.7%(74/1303)were ever diagnosed with STDs in the past 12 months.4.Compared with non-users,new-type drugs users were more likely to get<6HIV knowledge scores in the past 6 months(OR=3.031,95%CI=1.264-7.267),have≧2 episodes of anal intercourse in the past week(OR=2.366,95%CI=1.095-5.114),have inconsistent condom use with male partners in the past 6 months(OR=2.779,95%CI=1.289-5.991),ever be diagnosed with STDs in the past 12 months(OR=4.655,95%CI=1.215-17.827).The HIV antibody test showed the positive MSM new-type drug abuse rate was 27.4%,and the negative MSM was 28.7%.The difference was not considered statistically significant(χ~2=0.081,p=0.776).The syphilis antibody test showed the positive MSM new-type drug abuse rate was 34.4%,and the negative MSM was 28.2%.The difference was not considered statistically significant(χ~2=1.595,p=0.207).5.HIV and syphilis prevalence were 7.3%and 6.9%,respectively.Compared with uninfected MSM,MSM who infected HIV were more likely to have non-Shandong residencies(OR=1.840,95%CI=1.019-3.319),live in the local for≤2years(OR=1.804,95%CI=1.020-3.190),have high school and secondary school level of education(OR=1.802,95%CI=1.059-3.065),have inconsistent condom use with male partners in the past 6 months(OR=3.888,95%CI=2.303-6.564),did not receive HIV testing in the past 12 months(OR=1.639,95%CI=1.001-2.685).Compared with uninfected MSM,MSM who infected syphilis were more likely to be married(OR=1.983,95%CI=1.227-3.204),ever be diagnosed with STDs in the past 12 months(OR=4.103,95%CI=2.211-7.617).Conclusion1.In this study,MSM are young,well educated,mostly have Han ethnicity and Shandong residencies.The HIV knowledge level is low among MSM population,and health education should be further strengthened.2.Among MSM,the rate of new-type drugs use is high,and the types of new-type drugs are diverse.MSM population has the phenomenon of using two or more types of new-type drugs at the same time.New-type drugs use is not only related to the low HIV knowledge scores,but also inseparable from high frequency of anal sex and unprotected anal sex.3.HIV infection is not only related to demographic characteristics such as non-Shandong province residencies,living in the local for≤2 years and high school or secondary school level of education,but also closely related to unprotected anal sex.In the future,condom promotion and distribution services should be further carried out among these relevant groups.4.Among MSM,new-type drugs use may promote the occurrence of high-risk sexual behaviors,and the high-risk sexual behaviors such as unprotected anal sex may be important risk factors affecting HIV infection.Therefore,it is necessary to strengthen the intervention of new-type drugs,reduce the high-risk sexual behaviors,and thus reduce the AIDS epidemic among MSM in Shandong province.