Su Rong, Liu Yi, Shan Duo, Li Peilong, Ge Lin, Li Dongmin
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
BMC Public Health. 2025 Apr 7;25(1):1297. doi: 10.1186/s12889-025-22499-5.
Men who have sex with men (MSM) are key populations for HIV and syphilis infection, and co-infection with both diseases significantly increases health risks. However, the co-infection of HIV/syphilis among this population in China has not been systematically evaluated. We aimed to conduct a meta-analysis to ascertain the prevalence of HIV/syphilis co-infection among MSM in China.
We conducted a systematic literature search involving PubMed, Web of Science, CNKI and Wanfang to identify publications reporting HIV/syphilis co-infection among MSM in China. Our search encompassed articles available from the establishment of these databases up to December 31, 2022. Additionally, we examined the references of retrieved articles to identify additional relevant records. The random-effects model fitting Freeman-Tukey double arcsine transformation was employed to estimate the prevalence of HIV/syphilis co-infection and its 95% confidence interval (CI). Heterogeneity was assessed utilizing the I statistics and Cochran's Q test. To explore the potential sources of heterogeneity, we conducted subgroup and meta-regression analyses.
A total of 46 studies were included, with a total sample size of 50,187 MSM, including1,459 co-infected individuals. The pooled prevalence of HIV/syphilis co-infection among MSM in China was 2.7% (95% CI: 2.2-3.4%), with significant heterogeneity (I = 90.5%, Q = 474.65, P < 0.01). Across China's four regions, the Central region exhibited the highest co-infection prevalence (4.5%, 95% CI: 0.0-17.7%), followed by the Eastern region (3.1%, 95% CI: 2.4-3.9%) and Western region (2.4%, 95% CI: 1.8-3.1%). In contrast, the Northeast region reported the lowest co-infection prevalence (0.6%, 95% CI: 0.3-1.0%). Studies utilizing multiple sampling methods (4.7%, 95% CI: 3.6-6.0%) and recruiting MSM from sexually transmitted disease (STD) clinics (9.1%, 95% CI: 3.2-17.6%) showed higher prevalence of co-infection. Furthermore, the co-infection prevalence among MSM in China demonstrated a progressive increase with age.
The prevalence of HIV/syphilis co-infection among MSM in China was elevated, with certain regional disparities. Notably, the STD clinics attendees and older MSM were more likely to be co-infected. Urgent and targeted measures are needed to enhance interventions for these vulnerable populations to control HIV/syphilis co-infection.
男男性行为者（MSM）是艾滋病毒和梅毒感染的重点人群，两种疾病的合并感染会显著增加健康风险。然而，中国该人群中艾滋病毒/梅毒合并感染情况尚未得到系统评估。我们旨在进行一项荟萃分析，以确定中国男男性行为者中艾滋病毒/梅毒合并感染的患病率。
我们对PubMed、Web of Science、中国知网和万方进行了系统的文献检索，以查找报告中国男男性行为者中艾滋病毒/梅毒合并感染情况的出版物。检索涵盖了这些数据库建立至2022年12月31日期间的文章。此外，我们查阅了检索文章的参考文献以识别其他相关记录。采用拟合Freeman-Tukey双反正弦变换的随机效应模型来估计艾滋病毒/梅毒合并感染的患病率及其95%置信区间（CI）。利用I统计量和Cochran's Q检验评估异质性。为探究异质性的潜在来源，我们进行了亚组分析和荟萃回归分析。
共纳入46项研究，样本总量为50187名男男性行为者，其中1459人合并感染。中国男男性行为者中艾滋病毒/梅毒合并感染的合并患病率为2.7%（95%CI：2.2 - 3.4%），存在显著异质性（I = 90.5%，Q = 474.65，P < 0.01）。在中国四个地区中，中部地区合并感染患病率最高（4.5%，95%CI：0.0 - 17.7%），其次是东部地区（3.1%，95%CI：2.4 - 3.9%）和西部地区（2.4%，95%CI：1.8 - 3.1%）。相比之下，东北地区报告的合并感染患病率最低（0.6%，95%CI：0.3 - 1.0%）。采用多种抽样方法的研究（4.7%，95%CI：3.6 - 6.0%）以及从性传播疾病（STD）诊所招募的男男性行为者（9.1%，95%CI：3.2 - 17.6%）显示出较高的合并感染患病率。此外，中国男男性行为者中的合并感染患病率随年龄增长呈逐步上升趋势。
中国男男性行为者中艾滋病毒/梅毒合并感染患病率较高，存在一定的地区差异。值得注意的是，到性传播疾病诊所就诊者和年龄较大的男男性行为者更易合并感染。需要采取紧急且有针对性的措施，加强对这些脆弱人群的干预，以控制艾滋病毒/梅毒合并感染。
