Effectiveness of Integrated HIV Prevention Interventions among Chinese Men Who Have Sex with Men: Evaluation of a 16-City Public Health Program

Ye, Shaodong; Xiao, Yan; Jin, Chen; Cassell, Holly; Blevins, Meridith; Sun, Jing; Vermund, Sten H.; Qian, Han-Zhu

doi:10.1371/journal.pone.0050873

Cited by 22 publications

(20 citation statements)

References 16 publications

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“…The Chinese government has taken great steps to address the growing HIV epidemic in this population, providing various HIV/AIDS prevention services[5–7]. These services include provision of free condoms and lubricant, peer education, free voluntary HIV counseling and testing (VCT), as well as diagnosis and treatment of sexually transmitted infections (STI)[8].…”

Section: Introductionmentioning

confidence: 99%

“…These services include provision of free condoms and lubricant, peer education, free voluntary HIV counseling and testing (VCT), as well as diagnosis and treatment of sexually transmitted infections (STI)[8]. These measures are effective in some extent in decreasing risk behaviors and HIV transmission[5,9,10]. However, despite high levels of self reported risk behaviors[2,11], the HIV testing rates among MSM remains low, with only about half reporting having ever been tested[1,2,11,12].…”

Section: Introductionmentioning

confidence: 99%

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Look into the HIV Epidemic of Gay Community with a Socio-Cultural Perspective: A Qualitative Study in China, 2015-2016

He¹,

Lv²,

Zhang³

et al. 2017

PLoS ONE

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BackgroundCurrent Chinese studies continue to view male homosexuality through a disease focused lens which pays limited attention to socio-cultural aspects of sexual behavior and HIV transmission. This qualitative study aimed to investigate how socio-cultural factors influence gay men’s sexual beliefs and behaviors in contemporary China, and their implications for HIV epidemic.Methods and FindingsQualitative methodology was used in this study. During 2015–2016, in-depth interviews were conducted with 61 self identified gay men in Jiangxi, Henan, Heilongjiang, Guangdong, Jiangsu provinces and Chongqing municipality of China. Our study revealed that: 1) influenced by Chinese traditional culture, gay men have conflicts on self-identity, which led to low self-acceptance and negative attitude on sex, and huge socio-psychological stress; 2) a generational differences within gay community was observed, reflected in varied sexual attitudes and practices as well as way for approaching new friends, both of which have implications and challenges on HIV control and prevention; 3) socio-cultural barriers, including open minds towards casual sex and nonmonogamous relationship, and low priority of health demands were widely observed and led to negative coping with AIDS among gay community.ConclusionsIt is essential to take a holistic view into gay men’s HIV epidemic in China. Socio-cultural barriers for HIV control and prevention found in this study call for serious and imperative consideration on integrated measures, including targeted efforts towards effective sex education and further inclusion of socio-cultural perspectives in HIV/AIDS interventions for gay men.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Look into the HIV Epidemic of Gay Community with a Socio-Cultural Perspective: A Qualitative Study in China, 2015-2016

He¹,

Lv²,

Zhang³

et al. 2017

PLoS ONE

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“…Furthermore, a special group of MSM who sell sex to other MSM, i.e., ‘money boys’ (MBs), have been noted to be at even higher risk of HIV infection than general MSM (He et al, 2007a;2007b;Wong et al, 2008). The rapid increase of HIV among MSM population in China is attributed to increasing acceptance of homosexuality, quickly growing social network of MSM, and also stigma and discrimination as barriers to HIV services (Feng et al, 2010a; Ye et al, 2012). …”

Section: Introductionmentioning

confidence: 99%

Epidemiological and molecular characteristics of HIV infection among money boys and general men who have sex with men in Shanghai, China

Hong

Ding

Wong

et al. 2015

Infection, Genetics and Evolution

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To examine and compare the epidemiological and molecular characteristics of HIV infection between money boys (MBs) and general men who have sex with men (MSM) in Shanghai, China. Using a venue-based sampling strategy, a total of 535 MSM including 226 MBs and 309 general MSM were recruited to participate in a cross-sectional survey including a face-to-face questionnaire interview and HIV testing. Genotyping of HIV-1 pol gene was performed for HIV-positive participants. Compared with general MSM, MBs reported more sexual partners, more alcohol and drug use and more sex after alcohol or drug use. HIV prevalence was 10.7% overall, 14.6% for MBs and 7.8% for general MSM (p=0.011). Two independent multiple logistic regression analyses indicated that HIV infection was positively associated with non-Han ethnicity (Odds Ratio [OR]=4.79, 95% Confidence Interval [CI]: 1.08–21.28) and sex after drug use in the past 6 months (OR=3.59, 95%CI: 1.50–8.61) among MBs, and with sex after drug use in the past 6 months (OR=3.38, 95%CI: 1.10–10.34) among general MSM as well. HIV-1 pol gene was successfully amplified and sequenced for 52 (91.2%) of HIV-positive participants. Of them, 53.8% were genotyped as CRF01_AE, 36.5% as CRF07_BC and 9.6% as subtype B. Two CRF01_AE subtype-infected participants (3.8%), a 50 years old MB and a 24 years old general MSM, harbored viruses with a M46L mutation conferring resistance to protease inhibitors (PI). MSM particularly MBs in Shanghai, China were at high risk of HIV infection, underscoring an urgent need for joint intervention efforts for drug use and sexual behaviors. HIV drug resistance surveillance is also warranted although the relatively low prevalence of HIV drug resistance implies the effectiveness of current antiretroviral treatment regimen.

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“…Now people in China tend to be more tolerant towards homosexuality which has begun to be considered as a legitimate lifestyle choice. Although Chinese government has prioritized HIV prevention programs for MSM population, these programs often do not involve gay community and their community based organizations (CBOs), and therefore, their impact may be limited [7]. Unprotected sex and frequent change of sexual partners are prevalent among Chinese MSM, particularly among young MSM [8], and abuse of alcohol and club drugs further increase unprotected sex in a group of MSM [9], [10], [11] and put MSM at higher risk of contracting and transmitting HIV.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of HIV Risk Reduction Interventions among Men who have Sex with Men in China: A Systematic Review and Meta-Analysis

Liu

Dahiya

et al. 2013

PLoS ONE

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ObjectiveTo evaluate the effect of risk reduction interventions on HIV knowledge, attitudes and behaviors among men who have sex with men (MSM) in China.MethodsWe performed a systematic review and meta-analysis of HIV risk reduction intervention studies among Chinese MSM. The summary difference of standardized mean differences (SMD) between both study arms or between pre- and post-intervention assessments were defined as the effect size (ES); ES was calculated using standard meta-analysis in random effects models.ResultsThirty-four eligible studies were included in the analysis, including two randomized clinical trials (RCT), six quasi-experimental studies, six pre-and-post intervention studies, and twenty serial cross-sectional intervention studies. These studies showed an increase in consistent condom use with any male sexual partners (mean ES, 0.46; 95% confidence interval [CI], 0.35–0.56), with regular sexual partners (mean ES, 0.41; 95% CI, 0.18–0.63), and casual sexual partners (mean ES, 0.52; 95% CI, 0.24–0.79). The analysis of ten studies that measured the impact on uptake of HIV testing also showed a positive result (mean ES, 0.55; 95% CI, 0.38–0.71). The risk reduction interventions also improved HIV/AIDS-related knowledge (mean ES, 0.77; 95% CI, 0.60–0.94) and attitudes (mean ES, 1.35; 95% CI, 0.91–1.79), but did not reduce prevalence of HIV (mean ES, 0.23; 95% CI, 0.02–0.45) and syphilis infections (mean ES, −0.01; 95% CI, −0.19–0.17). There was significant heterogeneity among these studies.ConclusionsOn aggregate, HIV risk reduction interventions were effective in reducing risky behaviors and improving knowledge and attitudes among Chinese MSM, but were not associated with a change in the prevalence of HIV and syphilis. Future studies should use incidence as definitive study outcome.

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Effectiveness of Integrated HIV Prevention Interventions among Chinese Men Who Have Sex with Men: Evaluation of a 16-City Public Health Program

Cited by 22 publications

References 16 publications

Look into the HIV Epidemic of Gay Community with a Socio-Cultural Perspective: A Qualitative Study in China, 2015-2016

Look into the HIV Epidemic of Gay Community with a Socio-Cultural Perspective: A Qualitative Study in China, 2015-2016

Epidemiological and molecular characteristics of HIV infection among money boys and general men who have sex with men in Shanghai, China

Effectiveness of HIV Risk Reduction Interventions among Men who have Sex with Men in China: A Systematic Review and Meta-Analysis

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