Trends in sexual risk behavior and HIV and syphilis prevalence among men who have sex with men in Nanning, China, 2008-2009
Y. Xu1, J.E. Mantell2, E. Kelvin2, H. Yi2, T. Sandfort2, C.-S. Leu2, X. Lin1
1Nanning Center for Disease Control and Prevention, HIV/AIDS, Nanning, China, 2HIV Center for Clinical and Behavioral Studies, Columbia Univ, Psychiatry, New York, United States
Background: HIV prevalence among men who have sex with men (MSM) in China has increased dramatically. We conducted serial surveys among MSM in Nanning to examine trends in sexual risk behavior and HIV/STI prevalence.
Methods: We interviewed 452 MSM March-May 2008 and 469 March-May 2009. Seventy men were interviewed at both times. Men were recruited from diverse venues such as gay bars, saunas, parks and a CDC MSM support center. The interviews asked about sexual practices, and participants were tested for HIV and syphilis. We used logistic regression with GEE to account for within-subject correlations in comparison of differences across time.
Results: Consistent condom use with male partners was significantly higher in 2009 than 2008 (34.6% versus 44.0%; OR=1.48, p=0.006), while the proportion of MSM with ≥5 male sex partners in the past 6 months was also higher (21.0% versus 18.5%; OR=2.18, p=0.001). Consistent condom use with female partners did not differ significantly between the two time periods; the proportion of MSM engaging in vaginal intercourse with a female partner in the past six months was significantly lower in 2009 compared to 2008 (14.3% versus 19.8%; OR=0.68, p=0.030). There was no significant difference in the prevalence of HIV (1.8% versus 1.7%; OR=0.85, p=0.73) nor syphilis (8.18% to 10.4%, OR=1.31, p=0.21) between the 2008 and 2009 surveys. The odds of having been tested in past year for HIV was significantly higher in 2009 than 2008 (38.7% to 50.5%, OR=1.62, p=0.0003).
Conclusions: Consistent condom use is considerably lower with female than male partners, but seems to have increased over time with both male and female partners. In addition, HIV testing seems to have increased, suggesting heightened awareness of HIV in this population. Despite increases in consistency of condom use with male partners among MSM in Nanning, intensive efforts are needed to further reduce HIV transmission.
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