High HIV incidence epidemic among men who have sex with men in china: results from a multi-site cross-sectional study

Xu, Junjie; Tang, Weiming; Zou, Huachun; Mahapatra, Tanmay; Hu, Qinghai; Fu, Gengfeng; Wang, Zhe; Lü, Lin; Zhuang, Minghua; Chen, Xi; Fu, Jihua; Yu, Yanqiu; Lü, Jinxin; Jiang, Yongjun; Geng, Wenqing; Han, Xiaoxu

doi:10.1186/s40249-016-0178-x

Cited by 44 publications

(55 citation statements)

References 25 publications

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“…These results shed light on the findings of other studies in China that have reported alarmingly high prevalence rate of HIV, including 6.8%, 7.0% and 7.75% among MSM [1,27,28]. These results highlight the need for better prevention strategies as well as the urgency of understanding the potential challenges that may complicate prevention initiatives in this high-risk community [2,29].…”

Section: Discussionsupporting

confidence: 68%

PrEP uptake preferences among men who have sex with men in China: results from a National Internet Survey

et al. 2019

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Introduction HIV incidence among men who have sex with men (MSM) is high in China. Pre‐exposure prophylaxis (PrEP) is a promising mean to prevent HIV transmission but it is not widely available in China. We conducted a large Internet‐based online survey to assess the willingness of Chinese MSM to take PrEP and associated factors to their uptake preferences.MethodsBetween 19 January and 6 February, 2017, 4581 MSM aged over 15 years were recruited via a social networking app to take an online PrEP survey. HIV status at the time of the survey being conducted was not one of recruitment criteria. Participants were asked if they had heard of PrEP, if they had concerns about PrEP, and if they would be ready to uptake PrEP should it be provided. When asked if participants were willing to take PrEP, they were asked to select from the following responses: “definitely not,” “probably not,” “not sure,” “probably yes,” and “definitely yes.” In the final analysis, we grouped these five‐level Likert scale responses into three‐level responses as “definitely yes,” “probably yes,” and “no (definitely not/probably not/not sure).” Descriptive analysis and multinomial logistic regressions were conducted to assess the associations of PrEP adoption readiness and uptake concerns with HIV risk behaviours and demographic characteristics.Results MSM from 33 geographical regions of China participated in the survey. The majority were younger than 25 (65.2%) and had attended college (68.6%). HIV prevalence was high (6.8%) and 43.3% reported a history of unprotected anal sex. Only 22.4% of participants had heard of PrEP. When asked if they would uptake PrEP, 26.0% said “definitely yes,” 49.6% were “probably yes,” and 24.4% said “no.” PrEP adoption readiness was associated with having previously heard of PrEP and expressing concerns about accessibility and cost. Worries about side effects, low perceived HIV risk, preference for condoms, and never having received HIV testing were negatively associated with PrEP uptake willingness.ConclusionYoung and well‐educated Chinese MSM reported a low willingness to uptake PrEP despite being high‐risk for HIV. Effective education, especially through online mediums, will be critical to optimize this group's PrEP uptake.

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Section: Discussionsupporting

confidence: 68%

PrEP uptake preferences among men who have sex with men in China: results from a National Internet Survey

et al. 2019

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“…31,37,42 One of the included studies found circumcised MSM were at significantly increased odds of HIV infection. 45 Of 29 studies that examined the association between circumcision and STIs other than HIV among MSM, 19 reported non-significant associations. One study reported that circumcision was associated with significantly less multiplicity of HPV genotypes and lower prevalence of high-risk HPV genotypes.…”

Section: Resultsmentioning

confidence: 99%

Circumcision to prevent HIV and other sexually transmitted infections in men who have sex with men: a systematic review and meta-analysis of global data

Yuan

Fitzpatrick

et al. 2019

The Lancet Global Health

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Background Men who have sex with men (MSM) are disproportionately affected by HIV and other sexually transmitted infections (STIs) worldwide. Previous reviews investigating the role of circumcision in preventing HIV and other STIs among MSM were inconclusive. Many new studies have emerged in the past decade. To inform global prevention strategies for HIV and other STIs among MSM, we reviewed all available evidence on the associations between circumcision and HIV and other STIs among MSM.Methods In this systematic review and meta-analysis, we searched PubMed, Web of Science, BioMed Central, Scopus, ResearchGate, Cochrane Library, Embase, PsycINFO, Google Scholar, and websites of international HIV and STI conferences for studies published before March 8, 2018. Interventional or observational studies containing original quantitative data describing associations between circumcision and incident or prevalent infection of HIV and other STIs among MSM were included. Studies were excluded if MSM could not be distinguished from men who have sex with women only. We calculated pooled odds ratios (ORs) and their 95% CIs using random-effect models. We assessed risk of bias using the Newcastle-Ottawa scale. (0·99, 0·90-1·09; k=20; I²=40%). Circumcision was associated with reduced odds of herpes simplex virus (HSV) infection among MSM overall (0·84, 0·75-0·95; k=5; I²=0%) and penile human papillomavirus (HPV) infection among HIV-infected MSM (0·71, 0·51-0·99; k=3; I²=0%). Findings We identified 62 observational studies including 119 248 MSM. Circumcision was associated with 23% reduced odds of HIV infection among MSM overall (OR 0·77, 95% CI 0·67-0·89; number of estimates [k]=45; heterogeneity I²=77%). Circumcision was protective against HIV infection among MSM in countries of low and middle income (0·58, 0·41-0·83; k=23; I²=77%) but not among MSM in high-income countries Interpretation We found evidence that circumcision is likely to protect MSM from HIV infection, particularly in countries of low and middle income. Circumcision might also protect MSM from HSV and penile HPV infection. MSM should be included in campaigns promoting circumcision among men in countries of low and middle income.In view of the substantial proportion of MSM in countries of low and middle income who also have sex with women, well designed longitudinal studies differentiating MSM only and bisexual men are needed to clarify the effect of circumcision on male-to-male transmission of HIV and other STIs.

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“…Located in southwest China, Chongqing has an increased HIV prevalence among MSM, precipitously from 11.6% in 2009 to 15.4% in 2010[38]; Henan Province is in the middle China, with a HIV infection rate among MSM increased from 4.69% in 2008 to 8.33% in 2013[39]; Zhengzhou, as the provincial capital of Henan province, has a HIV incidence rate of 7.4/100 Person Years among MSM[4]. Located in northeast China, Harbin has a moderate HIV epidemic compared to other areas[40], its prevalence among MSM increased from 1.0% in 2006 to 7.5% in 2010[41]; Both Jiangxi and Jiangsu province are located in southeast China.…”

Section: Methodsmentioning

confidence: 99%

“…Jiangxi Province had a HIV prevalence of 8.44% among MSM population, with low rate of consistent condom use rate and HIV testing[42]; for the two study sites of Jiangxi, Nanchang had a dramatically increased HIV prevalence among MSM population, from 5.91 in 2013 to 12.56% in 2014, whereas Xinyu had a relatively low prevalence: from 0 in 2013 to 0.5% in 2014[43]; HIV incidence in Jiangsu Province increased from 5.10% in 2011 to 6.62% in 2015[13]. Nanjing, which is the provincial capital of Jiangsu province, has a HIV incidence rate of 5.4/100 Person Years[4]; Suzhou, together with Nanjing, were reported had the top two most HIV positive cases among MSM in Jiangsu province in 2011[44]. Guangzhou, the capital of Guangdong province located in south China, is remarkable for its rapid economic growth and attracts gay men from all over the country for its relatively tolerant social atmosphere.…”

Section: Methodsmentioning

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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High HIV incidence epidemic among men who have sex with men in china: results from a multi-site cross-sectional study

Cited by 44 publications

References 25 publications

PrEP uptake preferences among men who have sex with men in China: results from a National Internet Survey

PrEP uptake preferences among men who have sex with men in China: results from a National Internet Survey

Circumcision to prevent HIV and other sexually transmitted infections in men who have sex with men: a systematic review and meta-analysis of global data

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

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