School of Public Health, Key Laboratory of Environmental Pollution Monitoring Control ministry of Education, Guizhou Medical University, Guiyang, 550000, People's Republic of China.
Center for Disease Control and Prevention of Yunyan of Guiyang City, Guizhou, People's Republic of China.
AIDS Res Ther. 2021 Oct 10;18(1):68. doi: 10.1186/s12981-021-00392-6.
Men who have sex with men (MSM) are potentially at high risk for HIV infection, their HIV prevalence far exceeds the national prevalence rate. There are also a number of MSM who have sex with women, mostly unprotected, which can transmit HIV to their female sexual partners and even to the next generation. The purpose of this article is to evaluate the prevalence of heterosexual behaviors in Chinese men who have sex with men and the status of condom utilization as well as HIV infection among MSM with heterosexual behaviors, so as to further improve the investigation and prevention and control of AIDS in MSM population. We systematically searched China National Knowledge Infrastructure, Wanfang Data, VIP Database for Chinese Technical Calligraphy (VIP), Pubmed, and Embase following certain retrieval strategies to find relevant articles published from January 1, 2015 to November 18, 2019, The useful information extracted from qualified articles, Stata 15.1 and Review Manager 5.3 were employed for further meta analysis. The estimated prevalence of heterosexual behaviors among MSM in the past year was 19.0% (95% CI 17.0%, 22.0%). The estimated condom utilization rate of the last heterosexual behavior among MSM and condom adherence rate of heterosexual behaviors among MSM were 51.0% (95% CI 44.0%, 58.0%) and 31.0% (95% CI 25.0%, 38.0%), respectively. And the pooled HIV prevalence in MSM with heterosexual behaviors was 9% (95% CI 6%, 13%). The sensitivity analysis showed that the results were stable. No publication bias was found by Egger's test. There is a high proportion of MSM with heterosexual behaviors and low condom utilization in China. HIV prevalence in MSM with heterosexual behaviors is also high. Therefore, adequate attention should be given to this particular group and measures should be taken in order to reduce the risk of transmission of HIV from subpopulations to the general population.
男男性行为者（MSM）感染 HIV 的风险较高，其 HIV 感染率远远超过全国平均水平。还有一些 MSM 与女性发生性行为，且大多不使用安全套，这可能会将 HIV 传播给他们的女性性伴侣，甚至传播给下一代。本文旨在评估中国男男性行为者异性性行为的流行情况以及具有异性性行为的 MSM 人群中安全套的使用情况和 HIV 感染情况，从而进一步完善 MSM 人群艾滋病的调查和防控工作。我们系统地检索了中国知网、万方数据、维普中文科技期刊数据库（VIP）、PubMed 和 Embase 数据库，根据特定的检索策略，检索了 2015 年 1 月 1 日至 2019 年 11 月 18 日发表的相关文章，提取合格文章中的有用信息，使用 Stata 15.1 和 Review Manager 5.3 进行进一步的荟萃分析。估计过去一年 MSM 中异性性行为的流行率为 19.0%（95%CI：17.0%，22.0%）。估计 MSM 最近一次异性性行为的安全套使用率和 MSM 异性性行为的安全套坚持率分别为 51.0%（95%CI：44.0%，58.0%）和 31.0%（95%CI：25.0%，38.0%），具有异性性行为的 MSM 中的 HIV 总流行率为 9%（95%CI：6%，13%）。敏感性分析显示结果稳定。Egger 检验未发现发表偏倚。中国有相当比例的 MSM 存在异性性行为且安全套使用率低，具有异性性行为的 MSM 中的 HIV 流行率也较高。因此，应充分关注这一特殊人群，并采取措施降低从亚人群向普通人群传播 HIV 的风险。
