Prevalence, trends, and correlates of HIV, syphilis, and HCV infections among male attendees at STD clinics in Southwest China: a 13-year cross-sectional study (2010-2022).

BACKGROUND

Sexually transmitted infections (STIs) impose a substantial health burden and pose a significant threat to human health. However, data regarding long-term epidemiology patterns of STIs among high-risk groups are scarce. This study aimed to evaluate the prevalence, trends, and correlates of HIV, syphilis, and HCV among male attendees at sexually transmitted disease (STD) clinics in Southwest China.

METHODS

Serial cross-sectional surveys were performed annually among male STD clinic attendees in Southwest China from 2010 to 2022. Blood specimens were collected to test HIV, syphilis, and HCV infections. Mann-Kendall trend test was used to assess the trends of HIV, syphilis, and HCV prevalence. Rare even logistic regression model (relogit) was used to identify correlates of HIV, syphilis, and HCV infections.

RESULTS

This study included a total of 23,964 male attendees at STD clinics. The prevalence of HIV, syphilis, and HCV among participants was 0.98%, 2.16%, and 0.61%, respectively. While the prevalence of syphilis and HCV decreased from 3.64% to 1.81% in 2010 to 1.05% and 0.38% in 2022, the HIV prevalence did not show a downward trend. Relogit analysis revealed that participants with a history of STD had significantly increased risks of HIV (aOR = 1.90, 95%CI: 1.14-3.15) and HCV (aOR = 4.91, 95%CI: 3.22-7.49) infections. Participants who had ever engaged in homosexual behavior had significantly increased risks of HIV (aOR = 14.66, 95%CI: 5.49-39.14) and syphilis (aOR = 3.95, 95%CI:1.41-13.71) infections. Age also played a role, with those aged 50 years and above having a higher likelihood of HIV infection (aOR = 2.55, 95%CI: 1.91-3.39), while those under 50 years were more likely to be infected with HCV (aOR = 1.94, 95%CI: 1.19-3.16). Moreover, individuals of Han ethnicity were more likely to be infected with syphilis (aOR = 2.12, 95%CI: 1.75-2.57) and HCV (aOR = 1.65, 95%CI: 1.16-2.33). Being married or cohabiting increased the likelihood of syphilis infection (aOR = 1.40, 95%CI: 1.09-1.80), and a history of intravenous drug use (IDU) significantly increased the risk of HCV infection (aOR = 10.97, 95%CI: 5.21-23.12).

CONCLUSIONS

This study found a low prevalence of HIV, syphilis, and HCV among male attendees at STD clinics. Despite the declining prevalence of syphilis and HCV, HIV prevalence did not show a downward trend. This underscores the crucial need for continued and targeted prevention efforts, especially promoting STIs testing for men who have sex with men (MSM) and individuals with a history of intravenous drug use (IDU).