HIV incidence and sexual behavioral correlates among 4578 men who have sex with men
      (MSM) in Chengdu, China: a retrospective cohort study

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Abstract

Background

The prevalence of HIV among men who have sex with men (MSM) in southwest China is still increasing. This study aimed to investigate the trend in HIV incidence and its associated risk factors among MSM in Chengdu, China.

Method

Incidence data were collected from the largest local non-governmental organization (NGO) serving MSM in Chengdu between 2012 and 2018, while information on sexual behaviors was collected from 2014. All MSM who received voluntary counseling and testing services (VCT) in the collaborating NGO at least twice during the study period were included. We calculated the HIV incidence density among MSM every 2 years and the overall incidence rate. A Cox proportional hazards regression model was employed to identify risk factors for HIV infection.

Result

A total of 4578 HIV-negative participants were included in the cohort. The total incidence density was 5.95 (95% CI: 5.37–6.56)/100 person-years (PYs) between 2012 and 2018. The segmented incidence density was 9.02 (95% CI: 7.46–10.78), 5.85 (95% CI: 4.86–6.97), 5.43 (95% CI: 4.53–6.46), and 3.09 (95% CI: 2.07–4.41)/100 PYs in 2012–2013, 2014–2015, 2016–2017, and 2018, respectively. After adjusting for sociodemographic characteristics, compared to participants without sexual partners within 6 months, MSM with one fixed partner (Adjusted Hazard Ratio, AHR = 1.18, 95% CI: 0.44–3.19) and more than five partners (AHR = 2.24, 95% CI: 0.81–6.20) had increased risk of HIV infection. MSM who used condom inconsistently had a higher risk of HIV infection (AHR = 1.87, 95% CI: 1.46–2.38) compared to consistent condom users.

Conclusion

The decreased HIV incidence density among MSM was potentially related to the successful comprehensive HIV prevention strategies in Chengdu. Multiple male sexual partnerships and inconsistent condom use during anal intercourse were risk factors associated with HIV occurrence.

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Most cited references 44

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Global epidemiology of HIV infection in men who have sex with men.

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Epidemics of HIV in men who have sex with men (MSM) continue to expand in most countries. We sought to understand the epidemiological drivers of the global epidemic in MSM and why it continues unabated. We did a comprehensive review of available data for HIV prevalence, incidence, risk factors, and the molecular epidemiology of HIV in MSM from 2007 to 2011, and modelled the dynamics of HIV transmission with an agent-based simulation. Our findings show that the high probability of transmission per act through receptive anal intercourse has a central role in explaining the disproportionate disease burden in MSM. HIV can be transmitted through large MSM networks at great speed. Molecular epidemiological data show substantial clustering of HIV infections in MSM networks, and higher rates of dual-variant and multiple-variant HIV infection in MSM than in heterosexual people in the same populations. Prevention strategies that lower biological transmission and acquisition risks, such as approaches based on antiretrovirals, offer promise for controlling the expanding epidemic in MSM, but their potential effectiveness is limited by structural factors that contribute to low health-seeking behaviours in populations of MSM in many parts of the world. Copyright © 2012 Elsevier Ltd. All rights reserved.

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Population-level effectiveness of rapid, targeted, high-coverage roll-out of HIV pre-exposure prophylaxis in men who have sex with men: the EPIC-NSW prospective cohort study

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HIV pre-exposure prophylaxis (PrEP) is highly effective in men who have sex with men (MSM) at the individual level, but data on population-level impact are lacking. We examined whether rapid, targeted, and high-coverage roll-out of PrEP in an MSM epidemic would reduce HIV incidence in the cohort prescribed PrEP and state-wide in Australia's most populous state, New South Wales.

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Beyond detuning: 10 years of progress and new challenges in the development and application of assays for HIV incidence estimation.

T Rehle, Gaby H. Vercauteren, T. P. Busch … (2010)

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Author and article information

Contributors

Chun Hao: haochun@mail.sysu.edu.cn

Jinghua Li:

ORCID: http://orcid.org/0000-0002-9571-7359

lijinghua3@mail.sysu.edu.cn

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 26 April 2021

Publication date PMC-release: 26 April 2021

Publication date Collection: 2021

Volume: 21

Electronic Location Identifier: 802

Affiliations

[1 ]GRID grid.12981.33, ISNI 0000 0001 2360 039X, School of Public Health, Sun Yat-sen University (North Campus), ; No.74, Zhongshan second road, Guangzhou, China

[2 ]GRID grid.419588.9, ISNI 0000 0001 0318 6320, Graduate School of Public Health, , St. Luke’s International University, ; Tokyo, Japan

[3 ]GRID grid.40263.33, ISNI 0000 0004 1936 9094, Center for Evidence Synthesis in Health, School of Public Health, , Brown University, ; Providence, RI USA

[4 ]GRID grid.10784.3a, ISNI 0000 0004 1937 0482, Centre for Health Behaviours Research, JC School of Public Health and Primary Care, , The Chinese University of Hong Kong, ; Hong Kong, China

[5 ]GRID grid.12981.33, ISNI 0000 0001 2360 039X, Sun Yat-sen Global Health Institute, , Sun Yat-sen University, ; Guangzhou, China

[6 ]Chengdu Tongle Health Consulting Service Center, Chengdu, China

[7 ]GRID grid.12981.33, ISNI 0000 0001 2360 039X, School of Public Health (Shenzhen), , Sun Yat-sen University, ; Shenzhen, China

[8 ]GRID grid.12981.33, ISNI 0000 0001 2360 039X, Department of Clinical Research, , Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, ; Guangzhou, China

Author information

Jinghua Li http://orcid.org/0000-0002-9571-7359

Article

Publisher ID: 10835

DOI: 10.1186/s12889-021-10835-4

PMC ID: 8077884

PubMed ID: 33902499

SO-VID: 61e04101-cb17-4cb5-b73b-ac186b922255

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 12 June 2020

Date accepted : 13 April 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;

Award ID: 81803334, 71774178, 71974212

Funded by: FundRef http://dx.doi.org/10.13039/501100013076, National Major Science and Technology Projects of China;

Award ID: 2018ZX10715004

Award Recipient : Yuantao Hao

Funded by: Science and Technology Planning Project of Guangdong Province (CN)

Award ID: 2017A020212006

Funded by: Science and Technology Research Project of Guangzhou

Award ID: 201607010332, 201607010368

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ScienceOpen disciplines: Public health

Keywords: hiv/aids,incidence,men who have sex with men,cohort studies,sexual behavior

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ScienceOpen disciplines: Public health

Keywords: hiv/aids, incidence, men who have sex with men, cohort studies, sexual behavior

HIV incidence and sexual behavioral correlates among 4578 men who have sex with men (MSM) in Chengdu, China: a retrospective cohort study

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Annual Reviews HIV/AIDS: Public Health and Society

Most cited references 44

Global epidemiology of HIV infection in men who have sex with men.

Population-level effectiveness of rapid, targeted, high-coverage roll-out of HIV pre-exposure prophylaxis in men who have sex with men: the EPIC-NSW prospective cohort study

Beyond detuning: 10 years of progress and new challenges in the development and application of assays for HIV incidence estimation.

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