title: Risk factors for HIV/syphilis infection and male circumcision practices and preferences among men who have sex with men in China.
abstract: OBJECTIVE
  To investigate factors associated with HIV infection and the frequency and willingness of male circumcision among men who have sex with men (MSM) in Chengdu city, China.
  
  
  METHODS
  A cross-sectional survey provided information on participants' demographics, risk behaviors, circumcision, and uptake of HIV prevention services.
  
  
  RESULTS
  Of 570 participants, 13.3% were infected with HIV and 15.9% with syphilis. An estimated 43.0% of respondents reported having unprotected receptive anal intercourse, and 58.9% reported having ≥2 male sexual partners in the past 6 months. Multivariable logistic regression revealed that syphilis, more male sex partners, predominantly receptive anal intercourse, and exclusively receptive male sex were associated with HIV infection. Higher level of education and peer education service were inversely associated with HIV infection. Nearly a fifth (18.0%) of participants were circumcised. More than half of uncircumcised participants expressed willingness to be circumcised.
  
  
  CONCLUSIONS
  This study reveals a high prevalence of HIV and syphilis among MSM in Chengdu province of China. The frequency of unprotected receptive anal intercourse and multiple male sexual partnerships highlight the urgency for an effective comprehensive HIV prevention strategy. Although the willingness to accept male circumcision (MC) is high, further research is needed to assess the protective effective of MC among MSM.
authors.affiliation: Sichuan Provincial Center of Disease Control and Prevention, Chengdu 610041, China.
authors.forename: Yali
authors.identifier: 0000-0001-9501-3047
authors.initials: Y
authors.lastname: Zeng
authors.affiliation: Sichuan Provincial Center of Disease Control and Prevention, Chengdu 610041, China.
authors.forename: Linglin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Sichuan Provincial Center of Disease Control and Prevention, Chengdu 610041, China.
authors.forename: Tian
authors.initials: T
authors.lastname: Li
authors.affiliation: Sichuan Provincial Center of Disease Control and Prevention, Chengdu 610041, China.
authors.forename: Wenhong
authors.initials: W
authors.lastname: Lai
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN 37027, USA.
authors.forename: Yujiang
authors.initials: Y
authors.lastname: Jia
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN 37027, USA.
authors.forename: Muktar H
authors.initials: MH
authors.lastname: Aliyu
authors.affiliation: School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
authors.forename: Mai
authors.initials: M
authors.lastname: Do
authors.affiliation: Chengdu Gay Community Care Organization, Chengdu 610021, China.
authors.forename: Xiaodong
authors.identifier: 0000-0002-4739-0347
authors.initials: X
authors.lastname: Wang
authors.affiliation: Chengdu Center of Disease Control and Prevention, Chengdu 610041, China.
authors.forename: Delin
authors.identifier: 0000-0002-1068-1829
authors.initials: D
authors.lastname: Han
authors.affiliation: Sichuan Provincial Center of Disease Control and Prevention, Chengdu 610041, China.
authors.forename: Wanli
authors.initials: W
authors.lastname: Huang
authors.affiliation: Sichuan Construction Workers Hospital, Chengdu 610081, China.
authors.forename: Shuping
authors.initials: S
authors.lastname: Du
authors.affiliation: National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Xu
authors.affiliation: Sichuan Provincial Center of Disease Control and Prevention, Chengdu 610041, China.
authors.forename: Jiushun
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Sichuan Provincial Center of Disease Control and Prevention, Chengdu 610041, China.
authors.forename: Shu
authors.initials: S
authors.lastname: Liang
authors.affiliation: Chengdu Gay Community Care Organization, Chengdu 610021, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.affiliation: Medical School, Tulane University, New Orleans, LA 70112, USA.
authors.forename: Yanqing
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002681:China / Q000453:epidemiology; D002944:Circumcision, Male / Q000706:statistics & numerical data*; D015897:Comorbidity; D004522:Educational Status; D015658:HIV Infections / Q000453:epidemiology*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D057240:Patient Preference / Q000706:statistics & numerical data*; D012307:Risk Factors; D012747:Sexual Partners / Q000145:classification; D013587:Syphilis / Q000453:epidemiology*; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D055815:Young Adult