Impact of HIV/sexually transmitted infection testing on risky sexual behaviors among men who have sex with men in Langfang, China / 中华医学杂志(英文版)

ABSTRACT

<p><b>BACKGROUND</b>Men who have sex with men (MSM) in China remain at high risk for HIV infection, the proportion of reported HIV/AIDS cases that occurred among MSM rose greatly from 2005 to 2011. HIV testing and counseling is a critical HIV prevention strategy among HIV related high-risk population, including MSM in China. This article aimed to assess the association between receiving HIV testing and high-risk sexual behaviors among MSM in Langfang, Hebei Province, China.</p><p><b>METHODS</b>Between September and November 2007, 233 MSM were recruited to receive an HIV testing intervention. Face-to-face interviews were conducted before HIV testing and 3 months later HIV-related risk behaviors were assessed. Serological testing for HIV and other sexually transmitted infections (STIs) was performed.</p><p><b>RESULTS</b>Of the recruited 233 MSM, 200 completed follow-up. Baseline prevalence was 7.8% for HIV, 21.0% for syphilis, 15.8% for gonorrhea, and 5.0% for chlamydia. Multivariate analysis indicated that inconsistent condom use (OR = 7.9, 95%CI 0.9 - 66.7, P = 0.059) and bleeding during anal sex (OR = 5.9, 95%CI 1.3 - 26.2, P = 0.019) were risk factors for HIV infection, and group sex (OR = 6.6, 95%CI 2.2 - 19.7, P = 0.001) was a risk factor for syphilis infection at baseline. At 3 months follow-up, among STI-positive MSM, self-reported anal sex fell from 73.1% to 38.5% (P < 0.001); group sex fell from 19.2% to 5.8% (P < 0.001); and bleeding during anal sex fell from 23.1% to 5.8% (P < 0.001). Among STI-negative MSM, the frequency of one-night stands fell from 32.5% to 17.2% (P < 0.001), and oral sex rose from 57% to 78.5% (P < 0.001). STI-positive MSM were less likely to engage in anal sex compared to STI-negative MSM (χ(2) = 5.189, P = 0.023).</p><p><b>CONCLUSIONS</b>HIV testing is an important intervention strategy among MSM. HIV testing services among MSM need to be scaled up, along with comprehensive, tailored interventions including condom promotion and STI treatment.</p>