HIV prevalence and high‐risk sexual behaviours among MSM repeat and first‐time testers in China: implications for HIV prevention

Abstract

IntroductionLittle is known about HIV testing, HIV infection and sexual behaviour among bathhouse patrons in China. This study aims to assess differences in HIV prevalence and high-risk sexual behaviours between repeat and first-time testers among men who have sex with men (MSM) attending bathhouse in Tianjin, China.MethodsBetween March 2011 and September 2012, a HIV voluntary counselling and testing station was established in a gay bathhouse, which provided HIV testing and conducted a survey among participants recruited through snowball sampling. Differences in demographic and high-risk sexual behaviours between repeat and first-time testers were assessed using the chi-square test. Univariate and multivariate logistic regression analyses were conducted to identify predictors for HIV infection.ResultsOf the 1642 respondents, 699 (42.6%) were repeat testers and 943 (57.4%) were first-time testers. Among repeat testers, a higher proportion were men aged 18 to 25, single, better educated, had a history of STIs and worked as male sex workers or “money boys” (MBs). Repeat testers were less likely to report having unprotected anal intercourse in the past six months. The overall HIV prevalence was 12.4% (203/1642). There was no difference in HIV prevalence between repeat (11.2%, 78/699) and first-time (13.3%, 125/943) testers. The HIV prevalence increased with age among first-time testers (χtrend2=9.816, p=0.002). First-time MB testers had the highest HIV prevalence of 34.5%.ConclusionsMSM attending bathhouse had an alarmingly high HIV infection rate, particularly in MB. Targeted interventions are urgently needed especially focusing on older MSM and MBs.

Frequent HIV Testing: Impact on HIV Risk Among Chinese Men Who Have Sex with Men

“…In our Beijing urban study, we observed an HIV prevalence of 12.7%, substantially higher than the latest national estimate (7.3%), 48 and similar to the findings documented in recent studies among Chinese MSM in other metropolitan areas (12.4%–14.5%). 43,49–51 MSM had a high HIV prevalence in Beijing, confirming our mathematical projection that the HIV epidemic continues to grow in this key population. 24 Consistent with other findings, 42,51–54 we found familiar risk factors among HIV-positive MSM, including younger age of sexual debut, lower educational level, never married, transient residence, more lifetime male sexual partners, ever engaging in condomless anal sex, drug use, and alcohol use before sex.…”

“…Some studies have found that younger age was associated with higher HIV testing rates. 43,44 A possible explanation is that younger men visit MSM venues (e.g., gay bars, bathhouses) more frequently and would be more likely to expose to venue-based VCT. 43 However, consistent with other studies, 59 we found younger MSM were less likely to ever test for HIV.…”

“…43,44 A possible explanation is that younger men visit MSM venues (e.g., gay bars, bathhouses) more frequently and would be more likely to expose to venue-based VCT. 43 However, consistent with other studies, 59 we found younger MSM were less likely to ever test for HIV. Student MSM seemed to be more represented among non-testers than in testers (7.6% vs. 18.5%; P <0.001), perhaps due to stigma, peer discrimination, and low HIV risk perception.…”

Prevalence and associated factors of HIV infection among men who have sex with men in Hefei, China, 2013–2014: a cross-sectional study

“…As the risk of acquiring and transmitting HIV is amplified in the presence of STIs, it is necessary for post-test counselling to address risk among those who are chronically engaging in sexual risk behaviours. 36,37 In this study, HIV test was associated with a lower risk of HIV infection (P < 0.001, AOR ¼ 0.33, 95% CI: 0.19-0.60). Balaji et al 38 found that, compared to young MSM who had their recent HIV testing in the last 12 months, those who had their recent HIV testing more than 12 months ago were more likely to be infected with HIV.…”

Seeking Male Sexual Partners via Internet and Traditional Venues among Chinese Men Who Have Sex with Men: Implications for HIV Risk Reduction Interventions

“…Risk reduction interventions were often venue-based to reach the largest number of vulnerable men [17]. The rapid development of greater economic purchasing power and affordable technologies have resulted in 45.8 % of China's 1.3 billion person population using the Internet in 2013, the highest absolute number of users of any nation in the world [18].…”