title: HIV and syphilis prevalence among men who have sex with men: a cross-sectional survey of 61 cities in China.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV) has rapidly spread among men who have sex with men (MSM) in China in recent years; the magnitude of the epidemic is unclear. We sought to test 3 hypotheses: (1) The prevalence of both HIV and syphilis among MSM in China is high, (2) the 2 epidemics each have unique geographical distributions, and (3) demographic and sexual behavior characteristics are different among segments of the MSM population in China.
  
  
  METHODS
  A total of 47 231 MSM from 61 cities in China participated in a cross-sectional survey conducted from February 2008 to September 2009. Demographic and behavioral data were collected and analyzed and blood samples tested for HIV and syphilis. Three subgroups among the broader MSM sample were described. Main outcome measures were HIV and syphilis prevalence.
  
  
  RESULTS
  An overall prevalence of 4.9% (2314/47 231; 95% confidence interval [CI], 4.7%-5.1%) for HIV and 11.8% (5552/47 231; 95% CI, 11.5%-12.0%) for syphilis was found. Syphilis-positive MSM had the highest HIV prevalence, 12.5% (693/5552; 95% CI, 11.6%-13.4%). However, correlations between HIV and syphilis prevalence were found in only 3 of 6 geographical regions (Northwest: r = 0.82, P = .0253; East: r = 0.78, P = .0004; and South-central: r = 0.63, P = .0276). Three subgroups-nonlocal MSM, Internet-using MSM, and female-partnering MSM-were found to have different profiles of characteristics and behaviors.
  
  
  CONCLUSIONS
  HIV and syphilis prevalences among MSM in China are high and the 2 epidemics are largely separate geographically. Three segments of the Chinese MSM population each have different demographic and sexual risk "profiles" that suggest high potential for bridging infection across geographies, generations, and sexes.
authors.affiliation: National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention.
authors.forename: Zunyou
authors.initials: Z
authors.lastname: Wu
authors.forename: Jie
authors.initials: J
authors.lastname: Xu
authors.forename: Enwu
authors.initials: E
authors.lastname: Liu
authors.forename: Yurong
authors.initials: Y
authors.lastname: Mao
authors.forename: Yan
authors.initials: Y
authors.lastname: Xiao
authors.forename: Xinhua
authors.initials: X
authors.lastname: Sun
authors.forename: Yufen
authors.initials: Y
authors.lastname: Liu
authors.forename: Yan
authors.initials: Y
authors.lastname: Jiang
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: McGoogan
authors.forename: Zhi
authors.initials: Z
authors.lastname: Dou
authors.forename: Guodong
authors.initials: G
authors.lastname: Mi
authors.forename: Ning
authors.initials: N
authors.lastname: Wang
authors.forename: Jiangping
authors.initials: J
authors.lastname: Sun
authors.forename: Zhongfu
authors.initials: Z
authors.lastname: Liu
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.forename: Keming
authors.initials: K
authors.lastname: Rou
authors.forename: Lin
authors.initials: L
authors.lastname: Pang
authors.forename: Wenge
authors.initials: W
authors.lastname: Xing
authors.forename: Juan
authors.initials: J
authors.lastname: Xu
authors.forename: Shuo
authors.initials: S
authors.lastname: Wang
authors.forename: Yan
authors.initials: Y
authors.lastname: Cui
authors.forename: Zhijun
authors.initials: Z
authors.lastname: Li
authors.forename: Marc
authors.initials: M
authors.lastname: Bulterys
authors.forename: Wen
authors.initials: W
authors.lastname: Lin
authors.forename: Jinkou
authors.initials: J
authors.lastname: Zhao
authors.forename: Ray
authors.initials: R
authors.lastname: Yip
authors.forename: You
authors.initials: Y
authors.lastname: Wu
authors.forename: Yang
authors.initials: Y
authors.lastname: Hao
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D060085:Coinfection / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013587:Syphilis / Q000150:complications* / Q000453:epidemiology*; D019371:Topography, Medical; D055815:Young Adult
keywords: China; HIV; MSM; syphilis