Objective To examine the
prevalence of and
risk factors for
syphilis among men who have sex with men (MSM) in 16 cities/districts, 6 provinces in
China.
Methods Based on a previous
survey on the entertainment place and
population size of MSM, a
cross-sectional study was conducted in 2007 using non-
probability sampling
method among MSM in 16 cities/districts in
China.Information about the
demography,
risk behavior and
syphilis infection was collected through
questionnaires from MSM. Univariate and multivariate stepwise
logistic regression model was constructed to evaluate independent factors associated with
syphilis. Results A total of 4211 participants were recruited. The mean age of these participants was 28 years. Among them, 66.7% were
self identified as
homosexual, 72.5% were
unmarried, and 76.4% had an
education beyond senior middle
school; in the past 6 months, 8.7% had sexual contact with more than 10
male sex partners, 5.6% had ever paid for
male sex service, 11.3% had provided
commercial sex service to
males, and 18.9% had sexual contact with
females, while
condom was consistently used in only 36.3% of
male-to-
male anal
sexual behavior.
Syphilis was diagnosed in 10.6% of these participants. The
risk factors independently associated with
syphilis included being older than 25 years (adjusted OR = 1.7; 95% CI1.3-2.0), local
residency (adjusted OR = 1.3; 95% CI 1.0-1.7), being recruited from a bar or a park (adjusted OR = 1.3; 95% CI 1.1-1.7), having ever paid for a
male sex service(adjusted OR = 1.5; 95% CI 1.0-2.1),inconsistent
condom use during
male-to-
male anal
sexual behavior(adjusted OR = 1.2; 95% CI 1.0-1.5 ),
self reported
sexually transmitted infection history (adjusted OR = 1.3; 95% CI 1.0-1.7). Conclusions There is a high
prevalence of
syphilis in MSM in the 16
Chinese cities where
male-to-
male commercial sex service and unsafe
sexual behavior are common. Further efforts are urgently needed to scale-up the prevention of and
treatment program for
syphilis among MSM, which should include
syphilis and
HIV screening as well as
education on the use of
condom.