title: Effectiveness of integrated HIV prevention interventions among Chinese men who have sex with men: evaluation of a 16-city public health program.
abstract: To examine the impacts of a multi-city HIV prevention public health program (China Global Fund Round 5 Project) on condom use and HIV infection, we analyzed four yearly cross-sectional surveys from 2006 through 2009 among 20,843 men who have sex with men (MSM) in 16 Chinese cities. Self-reported condom use at last sex with a male partner increased from 58% in 2006 to 81% in 2009 (trend test, P<0.001). HIV prevalence increased from 2.3% in 2006 to 5.3% in 2009 (P<0.001). Multivariable logistic regression analysis showed that self-reported receipt of interventions was an independent predictor of increased condom use at last sex with a male partner over time (adjusted odds ratio [aOR], 1.63 in 2006 to 2.33 in 2009; P<0.001), and lower HIV prevalence (aOR, 1.08 in 2006 to 0.45 in 2009; P<0.001). HIV prevalence increased from 2006-2009 for participants with no self-reported receipt of interventions (2.1% in 2006 to 10.3% in 2009) and less so for those with interventions (2.4% to 4.7%). This Chinese public health program had positive impacts on both behaviors and disease rate among MSM population. Escalation of the coverage and intensity of effective interventions is needed for further increasing condom use and for reversing the rising trend of HIV epidemic.
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN, USA.
authors.forename: Shaodong
authors.initials: S
authors.lastname: Ye
authors.forename: Yan
authors.initials: Y
authors.lastname: Xiao
authors.forename: Canrui
authors.initials: C
authors.lastname: Jin
authors.forename: Holly
authors.initials: H
authors.lastname: Cassell
authors.forename: Meridith
authors.initials: M
authors.lastname: Blevins
authors.forename: Jiangping
authors.initials: J
authors.lastname: Sun
authors.forename: Sten H
authors.initials: SH
authors.lastname: Vermund
authors.forename: Han-Zhu
authors.initials: HZ
authors.lastname: Qian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D002947:Cities; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D012307:Risk Factors; D040242:Risk Reduction Behavior; D021841:Safe Sex; D012725:Sexual Behavior; D055815:Young Adult