HIV/STD pattern and its associated risk factors among male STD clinic attendees in China: a foci for HIV intervention.
BACKGROUND
Previous studies suggested a high prevalence of STDs including HIV among female sex workers and men who have sex with men in China, but little was known about the prevalence in male patients attending public STD clinics. The aim of this study was to investigate STD patterns and HIV prevalence among male STD clinic attendees in different areas in China and the associated risk factors. The feasibility of Provider-initiated HIV testing and counseling (PITC) was evaluated as well.


METHODS
A cross-sectional study was conducted at 46 public STD clinics in 4 provinces in China. Between July 2009 and September 2009, a total of 3243 eligible subjects were invited to participate in an interview with a structured-questionnaire for collecting socio-demographic characteristics and sexual behavioral information. They also were asked to provide venous blood samples for serological determinations of HIV and syphilis infection, and first void urine specimens for detecting Chlamydia trachomatis and Neisseria gonorrhoeae infections,


RESULTS
Out of the 3243 eligible patients, 2951(91%) men agreed to take part in the HIV and syphilis testing. The overall prevalence rate of HIV infection was 0.7% while the rates of syphilis, N. gonorrhoeae, C. trachomatis infections were 10.7%, 4.3% and 6.9%, respectively, with the highest syphilis and N. gonorrhoeae rates in Jiangsu Province. Patients from Guangxi province, homosexual/bisexual practices and intravenous drug use were significantly associated with HIV infection in multivariate logistic regression analyses. Provider-initiated HIV testing and counseling (PITC) was well accepted by attendees, with 91% of eligible attendees agreeing to undergo HIV testing and counseling. All HIV positive patients were properly managed accordingly.


CONCLUSIONS
A modest prevalence of HIV infection and substantial prevalence of other STD infections were found among male patients attending public STD clinics in China. The findings further support the introduction of HIV and syphilis PITC strategy into this important setting.
National Center for STD Control and Prevention, China Centers for Diseases Control and Prevention, Nanjing 210042, China. wangqianqiu@sina.com
Qian-Qiu
QQ
Wang
Xiang-Sheng
XS
Chen
Yue-Ping
YP
Yin
Guo-Jun
GJ
Liang
Ning
N
Jiang
Ting
T
Dai
Xi-Ping
XP
Huan
Bing
B
Yang
Qiao
Q
Liu
Yu-Jiao
YJ
Zhou
Bao-Xi
BX
Wang
D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D002690:Chlamydia Infections / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008403:Mass Screening / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D016485:Needle Sharing; D015995:Prevalence; D011322:Primary Prevention; D012309:Risk-Taking; D012725:Sexual Behavior / Q000208:ethnology; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous; D013587:Syphilis / Q000453:epidemiology