title: Predictors of HIV and syphilis among men who have sex with men in a Chinese metropolitan city: comparison of risks among students and non-students.
abstract: BACKGROUND
  Men who have sex with men (MSM) are at a substantial risk of HIV, given rising HIV prevalence in urban China. Adolescent and adult students often take HIV-related risk as part of sexual exploration. We compared the risks of HIV and syphilis infections and risky sexual behaviors between student and non-student among urban MSM.
  
  
  METHODS
  Respondent driven sampling approach was used to recruit men who were self-identified as MSM in Chongqing Metropolitan City in southwestern China in 2009. Each participant completed a computer-assisted self-interview which collected demographic and behavioral data, and provided blood specimens for HIV and syphilis testing. Multivariable logistic regression analyses identified predictors for HIV and syphilis infections while comparing student and non-student MSM.
  
  
  RESULTS
  Among 503 MSM participants, 36.4% were students, of whom 84.2% were in college. The adjusted prevalence of HIV infection was 5.5% (95% confidence interval [CI]: 2.1%-10.2%) in students and 20.9% (95% CI: 13.7%-27.5%) in non-students; the adjusted prevalence of syphilis was 4.4% (95% CI: 0.7%-9.0%) in students and 7.9% (95% CI: 3.6%-12.9%) in non-students (P = 0.12). Two groups had similar risky sexual behaviors such as number of sexual partners and exchanging sex for money. Multivariate analysis showed that students had lower HIV prevalence than non-students (adjusted odds ratio [AOR]: 0.3; 95% CI: 0.1-0.8) adjusting for age, ethnicity and other variables.
  
  
  CONCLUSIONS
  Student MSM have lower HIV and similar syphilis prevalence compared with non-student MSM. However, due to a shorter duration of sexual experience and high prevalence of at-risk sexual behaviors among student MSM, HIV risk might be quite high in students as in non-students.
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America.
authors.forename: Lan
authors.initials: L
authors.lastname: Zhang
authors.forename: Xianbin
authors.initials: X
authors.lastname: Ding
authors.forename: Rongrong
authors.initials: R
authors.lastname: Lu
authors.forename: Liangui
authors.initials: L
authors.lastname: Feng
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Li
authors.forename: Yan
authors.initials: Y
authors.lastname: Xiao
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Ruan
authors.forename: Sten H
authors.initials: SH
authors.lastname: Vermund
authors.forename: Yiming
authors.initials: Y
authors.lastname: Shao
authors.forename: Han-Zhu
authors.initials: HZ
authors.lastname: Qian
mesh_terms: D002681:China / Q000453:epidemiology; D002947:Cities; D015658:HIV Infections / Q000453:epidemiology*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D018570:Risk Assessment; D012309:Risk-Taking; D013334:Students; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000453:epidemiology*