title: Syphilis and HIV seroconversion among a 12-month prospective cohort of men who have sex with men in Shenyang, China.
abstract: BACKGROUND
  Cross-sectional studies have found a high prevalence of syphilis and HIV infection among men who have sex with men (MSM) in China.
  
  
  METHODS
  A total of 218 HIV-negative MSM participated in this prospective cohort study. Interviewer-administered questionnaires were completed, and blood samples were obtained for HIV and syphilis testing, both upon enrollment and at 12-month follow-up.
  
  
  RESULTS
  Of enrolled participants, 56% (122) were retained for the full 12-month follow-up period. The cohort had an HIV incidence density of 5.4 (95% CI: 2.0-11.3)/100 person-year (PY) and a syphilis incidence density of 38.5(95% CI: 27.7-50.2)/100 PY. Having syphilis (odds ratio [OR]: 11.4, 95% CI: 1.2-104.7) and more than 5 male sexual partners within the past 12 months (OR: 6.5, 95% CI: 1.1-39.8) were independent risk factors for HIV seroconversion (each P < 0.05). Being married (OR: 3.5, 95% CI: 1.4-8.2) and having more than 5 male sexual partners within the past 12 months (OR: 4.7, 95% CI: 2.0-6.2) were risk factors for syphilis seroconversion, while age > or =30 (OR 2.1, 95% CI 0.7-9.5) and having recently engaged in unprotected receptive anal sex (OR: 2.4, 95% CI: 0.7-13.1) were marginally associated with syphilis seroconversion.
  
  
  CONCLUSIONS
  The high incidence rates of HIV and syphilis in the Shenyang MSM community are significant cause for concern. The seroconversion rate for syphilis, in particular, indicates the high prevalence of high-risk sexual behaviors and the potential for increased HIV transmission. Appropriate interventions that address MSM-specific issues, including stigma, pressures from traditional society, and bisexual behavior, need to be tailored to inform and empower MSM in order to prevent HIV and syphilis in this community.
authors.affiliation: Hospital of China Medical University, Shenyang, China.
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Xu
authors.forename: Min
authors.initials: M
authors.lastname: Zhang
authors.forename: Katherine
authors.initials: K
authors.lastname: Brown
authors.forename: Kathleen
authors.initials: K
authors.lastname: Reilly
authors.forename: Hailong
authors.initials: H
authors.lastname: Wang
authors.forename: Qinghai
authors.initials: Q
authors.lastname: Hu
authors.forename: Haibo
authors.initials: H
authors.lastname: Ding
authors.forename: Zhenxing
authors.initials: Z
authors.lastname: Chu
authors.forename: Tristan
authors.initials: T
authors.lastname: Bice
authors.forename: Hong
authors.initials: H
authors.lastname: Shang
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission; D006679:HIV Seropositivity / Q000453:epidemiology*; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000453:epidemiology* / Q000635:transmission; D055815:Young Adult