High Prevalence of HIV Infection and Bisexual Networks among a Sample of Men Who Have Sex with Men in Eastern China

Haijiang Lin; Yingying Ding; Xing Liu; Qionghai Wu; Weiwei Shen; Na He

doi:10.1371/journal.pone.0129300

High Prevalence of HIV Infection and Bisexual Networks among a Sample of Men Who Have Sex with Men in Eastern China

PLoS One. 2015 Jun 8;10(6):e0129300. doi: 10.1371/journal.pone.0129300. eCollection 2015.

Authors

Haijiang Lin¹, Yingying Ding², Xing Liu², Qionghai Wu³, Weiwei Shen³, Na He⁴

Affiliations

¹ Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China; Taizhou City Center for Disease Control and Prevention, Taizhou city of Zhejiang Province, China; Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China.
² Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China.
³ Taizhou City Center for Disease Control and Prevention, Taizhou city of Zhejiang Province, China.
⁴ Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China.

Abstract

Objective: To examine homosexual and heterosexual behaviors, behavioral networks and HIV infection among men who have sex with men (MSM) in Eastern China.

Methods: A cross-sectional survey was conducted among MSM in 2013 in a rural prefecture of Zhejiang province. Participants were interviewed for their sexual behaviors and sexual networks and were tested for HIV infection.

Results: A total of 620 MSM from gay bath houses and bars participated in the survey. Of them, 58.2% aged 18 to 39 years and 49.5% were currently married with a female. The age of first homosexual contact was 26.7 years on average, ranging from 12 to 66 years. 91.0% had multiple male sex partners and 86.1% also had female sex partners in lifetime. 70 (11.3%) of the participants were tested HIV-positive. A total of 620 independent egocentric sexual networks involving 620 study participants and 1,971 reported sexual partners in the past 12 months were constructed, including 70 networks for the 70 HIV-positive participants with their 221 sexual partners and 550 networks for the 550 HIV-negative participants with their 1,750 sexual partners. The median network degree was 3 (IQR 2-4) overall and was not different between HIV-positive participants (Median: 3; IQR: 2-4) and HIV-negative participants (Median: 3; IQR: 2-4) (Mann-Whitney test, Z=-0.015, P=0.998). The proportion of networks with a multiple male sexual partnership was 63.7% overall, 62.8% for HIV-positive participants and 63.8% for HIV-negative participants (χ2=0.025, P=0.875). The proportion of networks with both male and female sexual partners was 44.8% overall, 47.1% for HIV-positive participants and 44.5% for HIV-negative participants (χ2=0.169, P=0.681). Consistent condom use and knowledge of HIV infection status were rare within the network partners.

Conclusions: The currently high HIV prevalence and complicated bisexual networks among MSM in the study area provides enhanced evidence for developing tailored prevention strategies for HIV transmission among and beyond the MSM population.

MeSH terms

Adolescent
Adult
Bisexuality*
China / epidemiology
Counseling
Cross-Sectional Studies
Female
HIV Infections / diagnosis
HIV Infections / epidemiology*
Homosexuality, Male*
Humans
Male
Middle Aged
Prevalence
Sexual Behavior
Sexual Partners
Socioeconomic Factors
Surveys and Questionnaires
Young Adult

Grants and funding

This study was supported by Shanghai Municipal Health Bureau (grant no. XBR2011043) and the National Major Science and Technology Project on Infectious Diseases including AIDS, Tuberculosis and Hepatitis (2012ZX10001007-006). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.