Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, China.
PLoS One. 2020 Apr 2;15(4):e0231026. doi: 10.1371/journal.pone.0231026. eCollection 2020.
Currently, human immunodeficiency virus (HIV) sentinel surveillance among men who have sex with men (MSM) in China conducted in large and medium-sized cities, and no HIV sentinel surveillance conducted in rural areas. HIV testing and intervention is predominantly conducted in urban areas, there have been a limited number of studies in rural areas MSM, it is necessary to conduct the investigation of HIV risk sexual behavior, HIV testing among rural and urban MSM.
Between December 2013 and August 2015, a cross-sectional study was conducted in rural and urban areas in Zhejiang Province using respondent-driven sampling (RDS). Participants completed face-to-face interviewer-administered questionnaire surveys and were tested for HIV.
A total of 710 MSM participants were recruited, of whom 36.1% were from rural areas. The overall HIV prevalence was 16.6%, and was considerably lower among MSM living in rural areas (3.9%) than those living in urban areas (24.2%). 61.1% participants had not condom use with male sexual behavior in the past 6 months (86.7% in rural areas and 46.7% in urban areas). The social demographic and behavioral characteristics had significance difference among rural and urban MSM. Multivariate logistic regression revealed that, compared to men living in urban areas, MSM living in rural areas MSM were more likely to use dating apps to find sexual partners, were more likely to engage in bisexual behavior, and had lower condom use. 43.0% participants had been tested for HIV in the past year (41.8% in rural areas and 43.6% in urban areas). Multivariate logistic regression also revealed that among participants living in rural areas, having rural health insurance and not accepting HIV intervention were associated with lower HIV testing rates, while a higher monthly income and through use of internet to find sexual partner were associated with higher rates of HIV testing.
High risk behavior was prevalent, and HIV testing rates were low among MSM living in rural areas compare to urban areas in Zhejiang Province, therefore, preventative intervention measures should be immediately among rural MSM urgently to reduce HIV transmission and to promote HIV testing.
目前，中国对男男性行为者（MSM）的艾滋病哨点监测主要在大中城市进行，农村地区尚未开展。艾滋病检测和干预主要集中在城市地区，农村地区 MSM 的研究较少，有必要对农村和城市 MSM 的艾滋病风险性行为、艾滋病检测进行调查。
2013 年 12 月至 2015 年 8 月，采用应答驱动抽样（RDS）方法在浙江省城乡地区开展了一项横断面研究。参与者完成了面对面的访谈式问卷调查，并接受了 HIV 检测。
共招募了 710 名 MSM 参与者，其中 36.1%来自农村地区。总体 HIV 感染率为 16.6%，农村地区 MSM 的 HIV 感染率（3.9%）明显低于城市地区（24.2%）。在过去 6 个月中，61.1%的参与者在与男性发生性行为时没有使用安全套（农村地区为 86.7%，城市地区为 46.7%）。城乡 MSM 的社会人口学和行为特征存在显著差异。多变量逻辑回归显示，与居住在城市地区的男性相比，居住在农村地区的 MSM 更有可能使用约会应用程序寻找性伴侣，更有可能从事双性恋行为，且安全套使用率较低。在过去一年中，43.0%的参与者接受过 HIV 检测（农村地区为 41.8%，城市地区为 43.6%）。多变量逻辑回归还显示，在农村地区的参与者中，拥有农村医疗保险和不接受 HIV 干预与较低的 HIV 检测率相关，而较高的月收入和通过互联网寻找性伴侣与较高的 HIV 检测率相关。
浙江省农村地区 MSM 中普遍存在高危行为，HIV 检测率较低，因此应立即针对农村 MSM 采取预防干预措施，以减少 HIV 传播并促进 HIV 检测。
