title: Risk factors for HIV-1 seroconversion among Taiwanese men visiting gay saunas who have sex with men.
abstract: BACKGROUND
  Men having sex with men (MSM) accounts for 33.6% of all reported cases of HIV-1 infection in Taiwan. The aim of this study was to investigate the epidemiology of HIV-1 infection among MSM in gay saunas in Taiwan.
  
  
  METHODS
  Patrons of 5 gay saunas were recruited for a weekly volunteer counseling and testing program from 2001 to 2005. Questionnaires were collected for a risk factor analysis. HIV-1 subtypes were determined using DNA sequencing and phylogenetic analyses.
  
  
  RESULTS
  HIV-1 prevalence rates among MSM in gay saunas in 2001 through 2005 were 3.4%, 5.1%, 8.9%, 8.5%, and 8.3%, respectively. In total, 81 of 1, 093 (7.4%) MSM had HIV-1 infection. Fifty-two HIV-1 strains were genotyped, and all of them were subtype B. HIV-seropositive men were significantly younger than the seronegatives. Only 37.1% used condoms every time during sexual intercourse. A multivariate logistic regression analysis showed that the risk factors for HIV-1 were being uncircumcised (odds ratio (OR) = 2.19; 95% confidence interval (CI), 1.08~4.45); having sexual intercourse with at least 2 partners during each sauna visit (≥ 2 vs. ≤ 1, OR = 1.71; 95% CI, 1.02~2.89); and the role played during anal intercourse (versatile vs. an exclusively insertive role, OR = 2.76; 95% CI, 1.42~5.36).
  
  
  CONCLUSIONS
  Overall, 7.4% Taiwanese MSM participating in this study had HIV-1 subtype B infection. Uncircumcised, being versatile role during anal intercourse, and having sex with more than one person during each sauna visit were main risk factors for HIV-1 infection.
authors.affiliation: AIDS Prevention and Research Center, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Yen-Ju
authors.initials: YJ
authors.lastname: Chen
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Lin
authors.forename: Marcelo
authors.initials: M
authors.lastname: Chen
authors.forename: Szu-Wei
authors.initials: SW
authors.lastname: Huang
authors.forename: Su-Fen
authors.initials: SF
authors.lastname: Lai
authors.forename: Wing-Wai
authors.initials: WW
authors.lastname: Wong
authors.forename: Hung-Chin
authors.initials: HC
authors.lastname: Tsai
authors.forename: Yu-Huei
authors.initials: YH
authors.lastname: Lin
authors.forename: Hsin-Fu
authors.initials: HF
authors.lastname: Liu
authors.forename: Shu-Yu
authors.initials: SY
authors.lastname: Lyu
authors.forename: Yi-Ming A
authors.initials: YM
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017280:Condoms; D004279:DNA, Viral / Q000235:genetics; D006679:HIV Seropositivity / Q000453:epidemiology*; D015497:HIV-1 / Q000235:genetics; D018451:Homosexuality, Male; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010802:Phylogeny; D015995:Prevalence; D012307:Risk Factors; D017422:Sequence Analysis, DNA; D029002:Steam Bath; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004279:DNA, Viral