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

Abstract

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.

Molecular transmission network analysis of newly diagnosed HIV-1 infections in Nanjing from 2019 to 2021

“…Similar to the findings of a study conducted in Zhangjiajie [ 41 ], we found that older patients aged 60 years and above were more likely to acquire or transmit HIV within their own region. This can be attributed to the limited activities of the elderly within their local area and the common occurrence of unprotected non-marital sex among them [ 42 ], which further promotes the spread of HIV. Hence, we will carry out prospective continuous monitoring of molecular transmission networks, timely identify expanding molecular clusters and core sources of transmission, and seek key places in combination with in-depth interviews, so as to carry out targeted interventions to curb the HIV epidemic.…”

Awareness of mpox-related knowledge among men who have sex with men in China

“…Furthermore, there may be a link between the increase in STIs, including HIV, and the high prevalence of MPXV outside of Africa; a high proportion of current global mpox cases also involve a history of HIV infection [ 36 , 50 ]. Studies showed that several initial risk factors for emerging outbreaks of mpox infection, mainly including men who have sex with men, people living with HIV, a history of STIs, including syphilis, and behavioral and health risk factors such as condomless anal intercourse, having multiple sexual partners [ 51 – 53 ]. A study analyzed mpox patients in eight health departments in the United States from May 17 to July 22, 2022, and found that people with HIV infection or sexually transmitted diseases accounted for a high proportion of mpox patients [ 54 ].…”

Combining molecular transmission network analysis and spatial epidemiology to reveal HIV-1 transmission pattern among the older people in Nanjing, China

“…Clusters with a bootstrap value higher than 0.90 (90%) were de ned as the same subtype. The ML phylogenetic tree was imported to FigTree v 1.4.4 for visualization [15].…”