Bai Xue, Xu Jie, Yang Jie, Yang Bo, Yu Maohe, Gao Yongjun, Dong Willa M, Wu Zunyou
School of Public Health, Anhui Medical University, Hefei, China; National Centre for AIDS/STD Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China.
National Centre for AIDS/STD Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China.
J Int AIDS Soc. 2014 Jul 2;17(1):18848. doi: 10.7448/IAS.17.1.18848. eCollection 2014.
Little is known about HIV testing, HIV infection and sexual behaviour among bathhouse patrons in China. This study aims to assess differences in HIV prevalence and high-risk sexual behaviours between repeat and first-time testers among men who have sex with men (MSM) attending bathhouse in Tianjin, China.
Between March 2011 and September 2012, a HIV voluntary counselling and testing station was established in a gay bathhouse, which provided HIV testing and conducted a survey among participants recruited through snowball sampling. Differences in demographic and high-risk sexual behaviours between repeat and first-time testers were assessed using the chi-square test. Univariate and multivariate logistic regression analyses were conducted to identify predictors for HIV infection.
Of the 1642 respondents, 699 (42.6%) were repeat testers and 943 (57.4%) were first-time testers. Among repeat testers, a higher proportion were men aged 18 to 25, single, better educated, had a history of STIs and worked as male sex workers or "money boys" (MBs). Repeat testers were less likely to report having unprotected anal intercourse in the past six months. The overall HIV prevalence was 12.4% (203/1642). There was no difference in HIV prevalence between repeat (11.2%, 78/699) and first-time (13.3%, 125/943) testers. The HIV prevalence increased with age among first-time testers (χ(2)trend=9.816, p=0.002). First-time MB testers had the highest HIV prevalence of 34.5%.
MSM attending bathhouse had an alarmingly high HIV infection rate, particularly in MB. Targeted interventions are urgently needed especially focusing on older MSM and MBs.
在中国，人们对澡堂顾客的艾滋病毒检测、艾滋病毒感染及性行为知之甚少。本研究旨在评估在中国天津光顾澡堂的男男性行为者（MSM）中，复诊检测者与初次检测者在艾滋病毒感染率及高危性行为方面的差异。
2011年3月至2012年9月期间，在一家同志澡堂设立了艾滋病毒自愿咨询检测站，为通过滚雪球抽样招募的参与者提供艾滋病毒检测并开展调查。采用卡方检验评估复诊检测者与初次检测者在人口统计学特征及高危性行为方面的差异。进行单因素和多因素逻辑回归分析以确定艾滋病毒感染的预测因素。
在1642名受访者中，699人（42.6%）为复诊检测者，943人（57.4%）为初次检测者。在复诊检测者中，年龄在18至25岁、单身、受教育程度较高且有性传播感染病史以及从事男妓或“金钱男孩”（MB）工作的男性比例更高。复诊检测者在过去六个月内报告发生无保护肛交的可能性较小。总体艾滋病毒感染率为12.4%（203/1642）。复诊检测者（11.2%，78/699）与初次检测者（13.3%，125/943）的艾滋病毒感染率无差异。初次检测者的艾滋病毒感染率随年龄增长而升高（χ(2)趋势=9.816，p=0.002）。初次检测的MB感染艾滋病毒的比例最高，为34.5%。
光顾澡堂的男男性行为者艾滋病毒感染率高得惊人，尤其是男妓群体。迫切需要针对性干预措施，尤其应关注年龄较大的男男性行为者和男妓。
