National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
Chin Med J (Engl). 2013 Apr;126(7):1257-63.
Men who have sex with men (MSM) in China remain at high risk for HIV infection, the proportion of reported HIV/AIDS cases that occurred among MSM rose greatly from 2005 to 2011. HIV testing and counseling is a critical HIV prevention strategy among HIV related high-risk population, including MSM in China. This article aimed to assess the association between receiving HIV testing and high-risk sexual behaviors among MSM in Langfang, Hebei Province, China.
Between September and November 2007, 233 MSM were recruited to receive an HIV testing intervention. Face-to-face interviews were conducted before HIV testing and 3 months later HIV-related risk behaviors were assessed. Serological testing for HIV and other sexually transmitted infections (STIs) was performed.
Of the recruited 233 MSM, 200 completed follow-up. Baseline prevalence was 7.8% for HIV, 21.0% for syphilis, 15.8% for gonorrhea, and 5.0% for chlamydia. Multivariate analysis indicated that inconsistent condom use (OR = 7.9, 95%CI: 0.9 - 66.7, P = 0.059) and bleeding during anal sex (OR = 5.9, 95%CI: 1.3 - 26.2, P = 0.019) were risk factors for HIV infection, and group sex (OR = 6.6, 95%CI: 2.2 - 19.7, P = 0.001) was a risk factor for syphilis infection at baseline. At 3 months follow-up, among STI-positive MSM, self-reported anal sex fell from 73.1% to 38.5% (P < 0.001); group sex fell from 19.2% to 5.8% (P < 0.001); and bleeding during anal sex fell from 23.1% to 5.8% (P < 0.001). Among STI-negative MSM, the frequency of one-night stands fell from 32.5% to 17.2% (P < 0.001), and oral sex rose from 57% to 78.5% (P < 0.001). STI-positive MSM were less likely to engage in anal sex compared to STI-negative MSM (χ(2) = 5.189, P = 0.023).
HIV testing is an important intervention strategy among MSM. HIV testing services among MSM need to be scaled up, along with comprehensive, tailored interventions including condom promotion and STI treatment.
男男性行为者（MSM）在中国仍然面临着较高的 HIV 感染风险，自 2005 年至 2011 年，报告的 HIV/AIDS 病例中 MSM 所占比例大幅上升。HIV 检测和咨询是 HIV 相关高危人群（包括中国的 MSM）的重要 HIV 预防策略。本文旨在评估河北省廊坊市 MSM 中接受 HIV 检测与高危性行为之间的关联。
2007 年 9 月至 11 月，招募了 233 名 MSM 接受 HIV 检测干预。在 HIV 检测前和 3 个月后进行面对面访谈，评估与 HIV 相关的风险行为。对 HIV 和其他性传播感染（STI）进行血清学检测。
在招募的 233 名 MSM 中，有 200 名完成了随访。基线时 HIV 的流行率为 7.8%，梅毒为 21.0%，淋病为 15.8%，衣原体为 5.0%。多变量分析表明， condom 使用不一致（OR = 7.9，95%CI：0.9-66.7，P = 0.059）和肛交时出血（OR = 5.9，95%CI：1.3-26.2，P = 0.019）是 HIV 感染的危险因素，而群交（OR = 6.6，95%CI：2.2-19.7，P = 0.001）是梅毒感染的危险因素。在 3 个月随访时，在 STI 阳性的 MSM 中，自我报告的肛交从 73.1%降至 38.5%（P < 0.001）；群交从 19.2%降至 5.8%（P < 0.001）；肛交时出血从 23.1%降至 5.8%（P < 0.001）。在 STI 阴性的 MSM 中，一夜情的频率从 32.5%降至 17.2%（P < 0.001），口交从 57%升至 78.5%（P < 0.001）。与 STI 阴性的 MSM 相比，STI 阳性的 MSM 进行肛交的可能性较小（χ(2) = 5.189，P = 0.023）。
HIV 检测是 MSM 的一项重要干预策略。需要扩大 MSM 的 HIV 检测服务，并结合 condom 推广和 STI 治疗等综合、量身定制的干预措施。
