The impact of VCT services on HIV-related high-risk behaviors among men who have sex with men (MSM) in Hebei province, China
W. Guo1, A. Liau2, A.-J. Song3, H.-D. Meng3, Z.Y. Wu4
1National Center for AIDS/STD Control and Prevention, Division of Epidemiology, Beijing, China, 2National Center for AIDS/STD Control and Prevention, Division of Education and Prevention, Beijing, China, 3Center for Diseases Control and Prevention in Langfang City, Langfang, China, 4National Center for AIDS/STD Control and Prevention, Beijing, China
Background: The effect of voluntary counseling and testing (VCT) services on high-risk behaviors among MSM is unknown and little researched in most places of China. This study was designed to estimate the impact of VCT intervention services on the characteristics of high-risk behaviors and behavioral changes among MSM in Langfang City, China.
Methods: Two hundred and thirty-three MSM were recruited from the internet and gay bars between September to November, 2007, to participate in VCT services. Two hundred MSM completed the 3-month follow-up. Face-to-face interviews at pre-VCT baseline and post-VCT 3-month follow-up were conducted for data collection. Serological testing for HIV and other sexually transmitted diseases (STDs) were also conducted.
Results: The prevalence of HIV, syphilis, gonorrhea and condyloma acuminatum were 6.7%, 21.0%, 14.8% and 5.6% respectively. Multivariate logistic regression models showed that inconsistent condom use (OR=3.53, 95% CI: 1.102-11.312, P=0.034) and bleeding or scratches during anal intercourse (OR=9.967, 95% CI: 2.203-45.104, P=0.003) were risk factors for HIV infection, while group sex (OR=5.886, 95% CI: 2.250-15.395, P< 0.001) was a risk factor for syphilis infection. At 3-month follow-up, the number of multiple partners, one-night stands, anal sex and bleeding/mucosal scratches after sex dropped significantly. Among STD-positive MSM, anal intercourse activity was reduced from 73% to 38%, and group sex and bleeding during intercourse dropped from 19.2% and 23.1% to 5.8% and 5.8% respectively. Among STD-negative MSM, the frequency of one-night stands fell from 32.5% to 17.2%, but oral sex rose from 57% to 78.5%. STD-positive MSM were less likely to engage in anal sex compared to STD-negative MSM (χ2=5.189, P=0.023).
Conclusions: The data suggest that VCT services are able to reduce high-risk behaviors among STD-positive MSM; however, findings for STD-negative MSM are mixed. Further exploration on the intervention effects of VCT services are needed for possible enhancement and scale-up in Langfang City.