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      High Risks of HIV Transmission for Men Who Have Sex with Men — A Comparison of Risk Factors of HIV Infection among MSM Associated with Recruitment Channels in 15 Cities of China

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          Abstract

          Objective

          While the HIV epidemic varies greatly by region and population group throughout China, the HIV incidence among men who have sex with men (MSM) continues to rise at an alarmingly fast pace. We seek to analyze the risk factors associated with HIV infection among MSM recruited from different channels in large urban centers across China, in an attempt to shed light on the design of future targeted intervention strategies.

          Methods

          A total of 33,684 MSM from 14 cities and one province were recruited from July to December 2011. Demographic (e.g. age, marital status, education) and behavioral (e.g. condom use, HIV testing history) data were collected using information collection cards. Blood samples were also collected to test for HIV and Syphilis.

          Results

          Participants were recruited from five different channels, and all demonstrated distinct characteristics. The overall rate of positive HIV screening was 6.27% and the rate of syphilis infection was 6.50%. Participants recruited from bathhouses had the highest HIV (11.80%) and syphilis infection rates (11.20%). Participants who were infected with syphilis had the highest HIV-positive screening rate (13.75%; 95% CI OR, 2.33-3.06). living in the southwest region of the country (11.64%; OR=2.76, 95%CI OR 2.19-3.47), Being >20 years of age (P<0.001), living in the southwest region of the country (OR=2.76, 95%CI 2.19-3.47), not having sex with female over the previous 3 months (OR=1.27, 95%CI 1.09-1.48), no condom use during the last anal intercourse (OR=1.54, 95%CI 1.39-1.70) and other factors were all associated with a higher probability of having an HIV-positive test result.

          Conclusion

          Depending on the way they are recruited, more targeted interventions are required to prevent the spread of HIV/AIDS among MSM with different characteristics and behaviors. Results from this study could provide evidence for researchers to conduct further studies and policy-makers to establish more effective and strategic interventions for MSM in China.

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          Most cited references18

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          Estimating the Population Size of Men Who Have Sex with Men in the United States to Obtain HIV and Syphilis Rates§

          Background: CDC has not previously calculated disease rates for men who have sex with men (MSM) because there is no single comprehensive source of data on population size. To inform prevention planning, CDC developed a national population size estimate for MSM to calculate disease metrics for HIV and syphilis. Methods: We conducted a systematic literature search and identified seven surveys that provided data on same-sex behavior in nationally representative samples. Data were pooled by three recall periods and combined using meta-analytic procedures. We applied the proportion of men reporting same-sex behavior in the past 5 years to U.S. census data to produce a population size estimate. We then calculated three disease metrics using CDC HIV and STD surveillance data and rate ratios comparing MSM to other men and to women. Results: Estimates of the proportion of men who engaged in same-sex behavior differed by recall period: past year = 2.9% (95%CI, 2.6–3.2); past five years = 3.9% (3.5–4.4); ever = 6.9% (5.1–8.6). Rates on all 3 disease metrics were much higher among MSM than among either other men or women (38 to 109 times as high). Conclusions: Estimating the population size for MSM allowed us to calculate rates for disease metrics and to develop rate ratios showing dramatically higher rates among MSM than among other men or women. These data greatly improve our understanding of the disproportionate impact of these diseases among MSM in the U.S. and help with prevention planning.
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            The global epidemic of HIV infection among men who have sex with men.

            In the last few years, there have been reports of new, newly identified and resurging epidemics of HIV infection among men who have sex with men (MSM). This article reviews and summarizes the global epidemic of HIV infection among MSM. In the Western world, the increase in notifications of new HIV infections among MSM is continuing. Steep increases in reports of new HIV diagnoses among MSM were also seen in the developed economies of East Asia. In the developing world, epidemiologic studies have now established the presence of MSM populations in Africa, China and Russia and a high HIV prevalence among them. High and increasing HIV prevalence was also reported from South and Southeast Asia, and Latin America and the Caribbean. HIV continues to spread among MSM on a global level. Current prevention efforts have been unable to contain or reduce HIV transmission in this population. Additional behavioral and biomedical interventions are urgently needed.
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              Current trends in Internet- and cell phone-based HIV prevention and intervention programs.

              As the reach of the Internet and cell phones increases, their use as health intervention and prevention tools has been increasingly researched. To identify recent advances in technology-based HIV prevention and intervention research, we conducted a literature search in the Spring of 2007. Only a handful of articles have been published in the last year describing evaluations of technology-based HIV programs. Nonetheless, many programs have recently been funded and are being developed or imminently evaluated. Results to date suggest the Internet and cell phones are feasible technologies to deliver HIV prevention and intervention programs for some target populations. Opportunities for future research are identified, including the development of programs for populations other than men who have sex with men who also are at risk for HIV (eg, adolescents, elderly), the integration of advances from other fields, examination of the potential for using text messaging to affect HIV behavior change, and applications of Internet-based programs in developing countries.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                2 April 2015
                2015
                : 10
                : 4
                : e0121267
                Affiliations
                [1 ]National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
                [2 ]Bill & Melinda Gates foundation China Office, Beijing, China
                Fudan University, CHINA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: JQ DZ CL SM JS. Performed the experiments: JQ DZ XF CL SM JS. Analyzed the data: JQ. Wrote the paper: JQ DZ XF HL JS. Modification of language syntax: MD.

                Article
                PONE-D-14-49343
                10.1371/journal.pone.0121267
                4383540
                25837667
                74061392-3793-4057-b008-8891e25cf966
                Copyright @ 2015

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                History
                : 13 November 2014
                : 29 January 2015
                Page count
                Figures: 1, Tables: 4, Pages: 14
                Funding
                This program was funded by the China-Gates Foundation HIV Cooperation Program (Opp 49277). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Custom metadata
                All relevant data are within the paper.

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