title: Disparities and risks of sexually transmissible infections among men who have sex with men in China: a meta-analysis and data synthesis.
abstract: BACKGROUND
  Sexually transmitted infections (STIs), including Hepatitis B and C virus, are emerging public health risks in China, especially among men who have sex with men (MSM). This study aims to assess the magnitude and risks of STIs among Chinese MSM.
  
  
  METHODS
  Chinese and English peer-reviewed articles were searched in five electronic databases from January 2000 to February 2013. Pooled prevalence estimates for each STI infection were calculated using meta-analysis. Infection risks of STIs in MSM, HIV-positive MSM and male sex workers (MSW) were obtained. This review followed the PRISMA guidelines and was registered in PROSPERO.
  
  
  RESULTS
  Eighty-eight articles (11 in English and 77 in Chinese) investigating 35,203 MSM in 28 provinces were included in this review. The prevalence levels of STIs among MSM were 6.3% (95% CI: 3.5-11.0%) for chlamydia, 1.5% (0.7-2.9%) for genital wart, 1.9% (1.3-2.7%) for gonorrhoea, 8.9% (7.8-10.2%) for hepatitis B (HBV), 1.2% (1.0-1.6%) for hepatitis C (HCV), 66.3% (57.4-74.1%) for human papillomavirus (HPV), 10.6% (6.2-17.6%) for herpes simplex virus (HSV-2) and 4.3% (3.2-5.8%) for Ureaplasma urealyticum. HIV-positive MSM have consistently higher odds of all these infections than the broader MSM population. As a subgroup of MSM, MSW were 2.5 (1.4-4.7), 5.7 (2.7-12.3), and 2.2 (1.4-3.7) times more likely to be infected with chlamydia, gonorrhoea and HCV than the broader MSM population, respectively.
  
  
  CONCLUSIONS
  Prevalence levels of STIs among MSW were significantly higher than the broader MSM population. Co-infection of HIV and STIs were prevalent among Chinese MSM. Integration of HIV and STIs healthcare and surveillance systems is essential in providing effective HIV/STIs preventive measures and treatments.
  
  
  BACKGROUND
  PROSPERO NO: CRD42013003721.
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, NSW, Australia ; Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia ; Melbourne Sexual Health Centre, Alfred Hospital, Melbourne, VIC, Australia ; Comprehensive AIDS Research Center, School of Medicine, Tsinghua University, Beijing, China.
authors.forename: Eric P F
authors.initials: EP
authors.lastname: Chow
authors.affiliation: University of North Carolina Project-China, Guangzhou, China ; London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tucker
authors.affiliation: Department of Behavioral Sciences and Health Education, Emory University, Atlanta, Georgia, United States of America.
authors.forename: Frank Y
authors.initials: FY
authors.lastname: Wong
authors.affiliation: Department of Behavioral Sciences and Health Education, Emory University, Atlanta, Georgia, United States of America.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Nehl
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Yanjie
authors.initials: Y
authors.lastname: Wang
authors.affiliation: School of Public Health, Nantong University, Nantong, Jiangsu Province, China.
authors.forename: Xun
authors.initials: X
authors.lastname: Zhuang
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, NSW, Australia ; Comprehensive AIDS Research Center, School of Medicine, Tsinghua University, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
mesh_terms: D002681:China / Q000453:epidemiology; D060085:Coinfection / Q000453:epidemiology*; D015658:HIV Infections / Q000453:epidemiology*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment; D060386:Sex Workers / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology