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

You, Xinyi; Gilmour, Stuart; Cao, Wangnan; Lau, Joseph T. F.; Hao, Chun; Gu, Jing; Le, Phuong Mai; Peng, Liping; Dong, Wei; Deng, Yang; Wang, Xiaodong; Zou, Huachun; Li, Jibin; Hao, Yuantao; Li, Jinghua

doi:10.1186/s12889-021-10835-4

Cited by 17 publications

(16 citation statements)

References 39 publications

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“…The incidence of HIV among transgender women in two Chinese cities was 4.42 per 100 PYs, demonstrating a threefold higher odds of HIV infection than cis-MSM. HIV incidence among transgender women in this study is moderately lower than the the pooled HIV incidence rate among Chinese MSM of 5.0–5.5 PYs in the systematic review and meta-analysis in 2015 and 2016 [ 25 , 26 ], however, it is higher than that in general MSM in Beijing during 2017–2018 (3.09 per 100 PYs) [ 27 ] and general MSM in Chengdu in 2018 (3.47 per PYs) [ 28 ]. And it is higher than the HIV incidence among transgender women of 2.9/100 per PYs in New York, US, 2.3 per 100 PYs in Lima, Peru, and 3.6 per 100 PYs in 11 randomised controlled trial sites in Brazil, Ecuador, Peru, South Africa, Thailand, and the USA in 2014 [ 29 – 31 ].…”

Section: Discussionmentioning

confidence: 57%

“…In view of this, future programs should pay more attention on addressing the challenge of this population to consider their unique mental health needs and ameliorate existing cultural and social stigma they face. In addition, transgender women are still a very hidden population in China, thus, intervention delivery through social media, including mobile apps may also needed [ 28 ]. In addition to traditional interventions such as health education and condom use, newer strategies such as pre-exposure prophylaxis should also consider to include transgender women [ 55 , 56 ] to ensure that this population in China are not left behind.…”

Section: Discussionmentioning

confidence: 99%

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HIV incidence and risk factors among transgender women and cisgender men who have sex with men in two cities of China: a prospective cohort study

Shan¹,

Zhang

et al. 2022

Infect Dis Poverty

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Background HIV epidemic among men who have sex with men (MSM) remains a major public health concern in China. Despite a growing body of research on transgender women worldwide, little is known about Chinese transgender women within MSM. We sought to estimate HIV incidence and distinguish risk factors of HIV acquisition among them from that among cisgener (non-transgender) MSM (cis-MSM). Methods We conducted an open cohort study among Chinese MSM, including those who were identified as transgender in Shanghai and Tianjin. Participants were initially recruited by local community-based organizations from January to June, 2016, and were followed up approximately every 6 months until June 2018. At each visit, a structured questionnaire was used to gather information on demographics, sexual risk behaviors, and HIV status. HIV incidence was calculated as the number of seroconversions divided by total number of person-years of follow-up among HIV-negatives at baseline. Risk factors of HIV acquisition were assessed by univariate and multivariate Cox regression models with time-dependent variables. Results A total of 1056 participants contributed 1260.53 person-years (PYs) of follow-up, 33 HIV seroconversions occurred during the follow-up period, yielding an estimated HIV incidence of 2.62 (95% CI 1.80–3.68) per 100 PYs. HIV incidence among transgender women was 4.42 per 100 PYs, which was significantly higher than that of 1.35 per 100 PYs among cis-MSM, demonstrating a threefold higher odds of HIV infection than cis-MSM. For transgender women, those lived locally ≤ 2 years (adjusted hazard ratio [aHR] = 1.76, 95% CI 1.13–2.76) and unprotected anal sex last time (aHR = 4.22, 95% CI 1.82–9.79) were more likely to acquire HIV. For cis-MSM, factors associated with HIV acquisition were frequency of anal sex ≥ 3 times in past one month (aHR = 4.19, 95% CI 1.06–16.47) and unprotected anal sex last time (aHR = 5.33, 95% CI 1.52–18.73). Conclusions Compared to cis-MSM, transgender women were at higher risk of HIV acquisition, highlighting an urgent need of tailored prevention. Future HIV program should consider to include them to ensure that this population in China are not left behind. Graphical abstract

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

HIV incidence and risk factors among transgender women and cisgender men who have sex with men in two cities of China: a prospective cohort study

Shan¹,

Zhang

et al. 2022

Infect Dis Poverty

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“…App-using MSM were more likely to have multiple sexual partners ( 26 , 27 ); Second, the proportion of seeking partners via internet/social network apps showed a growing trend during the 5 years. In light of the severe HIV epidemic situation among SMSM in Nanjing, multiple sexual partners could increase the odds of HIV infection and transmission ( 5 , 28 ). The new generation is not interested in stereotyped propaganda and traditional ideas, so the government must innovate targeted health education and intervention to prevent high-risk sexual behavior based on new media among the subgroup.…”

Section: Discussionmentioning

confidence: 99%

Trends in HIV Prevalence and HIV-Related Risk Behaviors Among Male Students Who Have Sex With Men From 2016 to 2020 in Nanjing, China: Consecutive Cross-Sectional Surveys

et al. 2022

Front. Public Health

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BackgroundThe growing HIV epidemic among student men who have sex with men (MSM) necessitates immediate attention from public health. In China, male students who have sex with men (SMSM) were also at an increasing risk of HIV transmission. The aim of this study was to investigate the trends in HIV prevalence, HIV-related risk behaviors, and HIV testing, as well as analyze the factors associated with HIV infection among SMSM in Nanjing.MethodsData were collected through face-to-face questionnaire interviews and laboratory testing in Nanjing. The participants were recruited among SMSM by snowball sampling and internet-recruited convenience sampling annually from 2016 to 2020. The self-report data primarily included demographics, HIV knowledge, HIV-related behaviors, and HIV testing, while the laboratory test results of HIV and syphilis were collected. Linear-by-linear chi-square test was used to analyze the trends of HIV/syphilis prevalence and its risk behaviors. The binary logistic regression model was used to explore the factors associated with HIV infection.ResultsDuring the 5 years from 2016 to 2020, a total of 775 SMSM were recruited in our survey (220, 112, 171, 142, and 120, respectively). The HIV prevalence was 5.2, 6.3, 5.3, 7.0, and 8.3%, without a significant increasing trend (P = 0.277). Syphilis prevalence fluctuated from 5.7% in 2016 to 4.2% in 2020, without a significant decreasing trend (P = 0.318). The proportion of consistent condom use in anal intercourse (48.5 to 56.2%, P < 0.05), and HIV testing in the past 12 months (51.0 to 59.2%, P < 0.05) were increasing. A remarkable growing trend has been reported in the percentage of MSM with more than one male sex partner (46.2 to 59.2%, P < 0.05). Multivariate analysis showed that HIV testing in the past 12 months was a protective factor against HIV infection. MSM who had unprotected anal intercourse (UAI) in the past 6 months, recreational drug use, and currently syphilis infection were risk factors for HIV infection.ConclusionsWe observed stable HIV/ syphilis prevalence, increasing consistent condom use, increasing HIV testing rate, and increasing multiple male sex partners dramatically among SMSM in China. The original comprehensive intervention measures should be continuously strengthened for the subgroup. To satisfy the current HIV prevention requirements, new biological interventions should be introduced and carried out as major components of combination prevention programs.

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“…The overall HIV prevalence among MSM in Chengdu between 2009 and 2014 was 15.5% [33] . Between 2012 and 2018, the HIV incidence density among MSM decreased annually, but the total incidence density was as high as 5.95 (95% CI: 5.37-6.56)/100 person-years [34] . Moreover, in 2013, 17.9% of MSM reported that they had sex with both men and women(MSM/W), and living in Chengdu was found out as risk factor [35] .…”

Section: Study Sitementioning

confidence: 99%

How Many Sexual Partners Are Too Many for Elderly Men From Rural China Who Visit Female Sex Workers Becoming HIV-Positive?

Yang

Fan

Liang

et al. 2021

Preprint

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Objectives. To make clear how many sexual partners (SPs) are too many for elderly (≥50 years old) men becoming HIV-positive from rural China.Methods. We conducted a case-control study: 99 newly HIV (+) vs. 88 HIV (-) elderly men with similar age who visited female sex workers (FSW). Receiver-operating characteristics (ROC) curves and backward binary logistic regression was applied. Results. Cases had more SPs (315.66±401.33) than controls(14.63±25.63)in their lifetime, mainly commercial SPs(313.98±401.38 vs.12.81±25.85), similarly in the last three years. AUCs for HIV infection at number of accumulated SPs and of commercial SPs were 0.89 and 0.90, and correspondingly 0.79 and 0.81 in the last three years. Cut-off values were identified as 51.5, 52.5, 5.5 and 4.5 based on Youden’s indexes (0.715, 0.705, 0.612 and 0.601). Risky factors for HIV infection among elderly men were having 52-2002 SPs in their lifetime (AOR (95%CI): 56.33(11.36-279.25)), having 5-289 commercial SPs in the last three years (11.55(2.78-47.94)). Conclusions. ≥52 SPs in their lifetime and ≥5 FSW in the last three years are too many for elderly men from rural China becoming HIV-positive.

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

Cited by 17 publications

References 39 publications

HIV incidence and risk factors among transgender women and cisgender men who have sex with men in two cities of China: a prospective cohort study

HIV incidence and risk factors among transgender women and cisgender men who have sex with men in two cities of China: a prospective cohort study

Trends in HIV Prevalence and HIV-Related Risk Behaviors Among Male Students Who Have Sex With Men From 2016 to 2020 in Nanjing, China: Consecutive Cross-Sectional Surveys

How Many Sexual Partners Are Too Many for Elderly Men From Rural China Who Visit Female Sex Workers Becoming HIV-Positive?

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