Li Xinge, Chen Siyu, Zhang Zheng, Ge Shen, Wang Lijuan, Chen Xinyue, Yu Fuk-Yuen, Fang Yuan, Chen Zihuang, Li Zhennan, Sun Fenghua, Liu Yingjie, Wang Zixin
Beijing Chaoyang District Center for Disease Control and Prevention, Beijing, China.
Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.
BMC Public Health. 2025 Apr 21;25(1):1461. doi: 10.1186/s12889-025-22756-7.
BACKGROUND: Relaxing Coronavirus Disease 2019 (COVID-19) control measures and "resume normal" might have direct impacts on sexual behaviors and utilization of HIV prevention and sexual health services among gay, bisexual and other men who have sex with men (GBMSM). To address the knowledge gaps, this study aimed to compare self-reported changes in sexual risk behaviors and HIV service utilization among GBMSM in the post-pandemic era between Beijing and Hong Kong. In addition, the determinants of self-reported increase in condomless anal sex (CAS) were investigated among GBMSM in Beijing or Hong Kong. METHODS: This cross-sectional study was conducted between November 2023 and March 2024. Participants were Chinese males aged ≥ 18 years who had anal sex with at least one man in the past six months recruited through multiple sources. Eligible GBMSM completed a telephone interview. A multiple logistic regression model was then fitted. RESULTS: A total of 524 GBMSM in Beijing and 613 in Hong Kong completed the telephone interview. After adjusting for background characteristics with between-city differences, more GBMSM in Beijing self-reported an increase in the frequency of CAS with men (23.7% versus 7.8%, p < 0.001), anal sex with regular male sex partners (30.5% versus 15.5%, p < 0.001) and non-regular male sex partners (27.5% versus 16.0%, p < 0.001), seeking male partners online (28.8% versus 18.9%, p < 0.001), sexualized drug use (SDU) (9.4% versus 2.3%, p < 0.001), and using HIV testing (31.5% versus 11.7%, p < 0.001), pre-exposure prophylaxis (PrEP) (18.9% versus 3.6%, p < 0.001) and other HIV prevention services (20.2% versus 10.1%, p < 0.001). GBMSM in both cities who self-reported increases in the frequency of anal sex with regular and non-regular male sex partners, having sex with men coming from other cities, seeking male partners online, utilization of SDU, HIV testing, PrEP and other HIV prevention services were more likely to report an increase in CAS. CONCLUSIONS: More GBMSM in Beijing than their counterparts in Hong Kong reported increases in the frequency of sexual risk behaviors and HIV prevention services utilization when comparing their current situation with the time during COVID-19. Our findings highlighted the importance of strengthening HIV prevention in GBMSM in the post-pandemic era.
背景：放宽2019冠状病毒病（COVID-19）防控措施并“恢复正常”可能会对男同性恋者、双性恋者和其他与男性发生性行为的男性（GBMSM）的性行为以及艾滋病毒预防和性健康服务的利用产生直接影响。为填补知识空白，本研究旨在比较大流行后时代北京和香港的GBMSM自我报告的性风险行为变化和艾滋病毒服务利用情况。此外，还对北京或香港的GBMSM中自我报告的无保护肛交（CAS）增加的决定因素进行了调查。 方法：本横断面研究于2023年11月至2024年3月进行。参与者为年龄≥18岁的中国男性，他们在过去六个月内与至少一名男性发生过肛交，通过多种渠道招募。符合条件的GBMSM完成了电话访谈。然后拟合了一个多重逻辑回归模型。 结果：北京共有524名GBMSM和香港613名GBMSM完成了电话访谈。在调整了城市间存在差异的背景特征后，更多北京的GBMSM自我报告与男性发生CAS的频率增加（23.7%对7.8%，p<0.001）、与固定男性性伴侣发生肛交的频率增加（30.5%对15.5%，p<0.001）以及与非固定男性性伴侣发生肛交的频率增加（27.5%对16.0%，p<0.001）、在网上寻找男性伴侣（28.8%对18.9%，p<0.001）、性相关药物使用（SDU）（9.4%对2.3%，p<0.001），以及进行艾滋病毒检测（31.5%对11.7%，p<0.001）、暴露前预防（PrEP）（18.9%对3.6%，p<0.001）和其他艾滋病毒预防服务（20.2%对10.1%，p<0.001）。两个城市中自我报告与固定和非固定男性性伴侣发生肛交频率增加、与来自其他城市的男性发生性行为、在网上寻找男性伴侣、使用SDU、进行艾滋病毒检测、PrEP和其他艾滋病毒预防服务的GBMSM更有可能报告CAS增加。 结论：与香港的GBMSM相比，更多北京的GBMSM报告称，与COVID-19期间相比，性风险行为频率和艾滋病毒预防服务利用有所增加。我们的研究结果凸显了在大流行后时代加强GBMSM艾滋病毒预防工作的重要性。
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