University of North Carolina Project China, 2 Lujing Road, Floor 11., Guangzhou, Guangdong, 510000, China.
The Johns Hopkins Hospital, Baltimore, USA.
BMC Public Health. 2018 Mar 2;18(1):306. doi: 10.1186/s12889-018-5214-2.
Sex tourism among men who have sex with men (MSM) may exacerbate transmission of HIV and other sexually transmitted infections (STIs). Sex tourism is defined as purchasing sex with gifts or money outside of one's hometown. Our objective was to characterize the frequency, socio-demographic characteristics, and sexual risk behaviors among Chinese MSM sex tourists.
An online, cross-sectional survey for high-risk MSM throughout China was conducted in November 2015 covering sociodemographic characteristics, sexual risk behaviors, and sex tourism. Univariate and multivariable logistic regressions were performed to identify correlates of sex tourism. The mean MSM HIV prevalence of sex tourism journey origins and destinations were compared.
Of 1189 MSM who completed the survey, 62 (5%) men identified as sex tourists; among these sex tourists, twenty (32%) traveled primarily to purchase sex and the remainder purchased sex while traveling for another purpose. There was minimal socio-demographic and behavioral difference between the two groups. In multivariable analyses, adjusting for age and income, sex tourism was correlated with high-risk sexual behaviors, higher income (aOR 4.44, 95%CI 1.77-11.18) and living with HIV (aOR 2.79, 95%CI 1.03-7.55). Sex tourism was more often from locations with lower to higher MSM HIV prevalence (mean = 4.47, SD = 2.01 versus mean = 6.86, SD = 5.24).
MSM sex tourists were more likely to have risky sexual behaviors and travel to locations with a higher HIV prevalence. MSM sex tourists may be part of core groups that are disproportionately responsible for MSM HIV transmission. Enhanced surveillance and interventions tailored to MSM sex tourists should be considered.
男男性行为者（MSM）中的性旅游可能会加剧 HIV 和其他性传播感染（STI）的传播。性旅游是指在自己的家乡以外用礼物或金钱购买性服务。我们的目的是描述中国 MSM 性旅游者的频率、社会人口统计学特征和性风险行为。
2015 年 11 月，我们在中国各地对高危 MSM 进行了一项在线横断面调查，内容包括社会人口统计学特征、性风险行为和性旅游。我们进行了单变量和多变量逻辑回归分析，以确定性旅游的相关因素。比较了性旅游旅程起源和目的地的 MSM HIV 流行率的平均值。
在完成调查的 1189 名 MSM 中，有 62 名（5%）男性被认定为性旅游者；在这些性旅游者中，有 20 名（32%）主要是为了购买性服务而旅行，其余的则是在旅行中为了其他目的而购买性服务。这两组人群在社会人口统计学和行为特征方面几乎没有差异。在多变量分析中，调整年龄和收入因素后，性旅游与高危性行为、高收入（优势比 4.44，95%置信区间 1.77-11.18）和 HIV 感染（优势比 2.79，95%置信区间 1.03-7.55）相关。性旅游更多地来自 HIV 流行率较低到较高的地区（平均值=4.47，标准差=2.01 与平均值=6.86，标准差=5.24）。
MSM 性旅游者更有可能有高危性行为，并且会前往 HIV 流行率较高的地区。MSM 性旅游者可能是核心群体的一部分，他们不成比例地对 MSM HIV 传播负有责任。应考虑加强对 MSM 性旅游者的监测和干预措施。
