title: HIV prevalence, incidence and risk behaviours among men who have sex with men in Yangzhou and Guangzhou, China: a cohort study.
abstract: BACKGROUND
  In China, the prevalence and incidence of HIV among men who have sex with men (MSM) in large-sized cities have drawn much attention. In contrast, there has been a paucity of research focussing on the sexual health of MSM of medium-sized cities. This study fills this important gap in the knowledge by investigating the sexual health of MSM in a medium-sized city (Yangzhou) and a large-sized city (Guangzhou).
  
  
  METHODS
  A baseline survey and a prospective cohort study were conducted among MSM in Yangzhou and Guangzhou from July 2009 to September 2010. A total of 622 MSM (317 from Yangzhou and 305 from Guangzhou) were screened for eligibility. Prevalence and incidence of HIV infection, as well as its risk factors, were investigated.
  
  
  RESULTS
  Baseline HIV prevalence was 14.5%, and overall HIV incidence density was 6.78 per 100 person-years (PY) among Yangzhou MSM. Risk factors for HIV prevalence that were significant in multivariate models were older age, married status, unprotected sex with female partners, sexually transmitted disease (STD)-associated symptoms and syphilis positivity. Risk factors for HIV incidence that were significant in multivariate models were STD-associated symptom and syphilis positivity. Compared to Yangzhou MSM, Guangzhou MSM had a lower HIV prevalence (6.2%; p<0.05) and lower overall HIV incidence density (5.77 per 100 PY). Risk factors for HIV prevalence that were significant in multivariate models were married status, unprotected anal sex with men and syphilis positivity. The single risk factor for HIV incidence that was significant in multivariate models was unprotected anal sex with men.
  
  
  CONCLUSIONS
  This study showed a high prevalence and incidence of HIV among Yangzhou MSM, which suggest a more serious HIV epidemic than that in large-sized cities. Further investigation targeting MSM in medium-sized cites is urgently needed to prevent the spread of the HIV epidemic in China.
authors.affiliation: National Center for STD Control and Prevention, China Centers for Diseases Control and Prevention, Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing, China; doctorwqq@163.com.
authors.forename: Qian-Qiu
authors.initials: QQ
authors.lastname: Wang
authors.affiliation: National Center for STD Control and Prevention, China Centers for Diseases Control and Prevention, Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing, China.
authors.forename: Xiang-Sheng
authors.initials: XS
authors.lastname: Chen
authors.affiliation: National Center for STD Control and Prevention, China Centers for Diseases Control and Prevention, Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing, China.
authors.forename: Yue-Ping
authors.initials: YP
authors.lastname: Yin
authors.affiliation: National Center for STD Control and Prevention, China Centers for Diseases Control and Prevention, Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing, China.
authors.forename: Guo-Jun
authors.initials: GJ
authors.lastname: Liang
authors.affiliation: National Center for STD Control and Prevention, China Centers for Diseases Control and Prevention, Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing, China.
authors.forename: Rui-Li
authors.initials: RL
authors.lastname: Zhang
authors.affiliation: National Center for STD Control and Prevention, China Centers for Diseases Control and Prevention, Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Jiang
authors.affiliation: Jiangsu Provincial Centers for Disease Control and Prevention, Nanjing, China.
authors.forename: Xi-Ping
authors.initials: XP
authors.lastname: Huan
authors.affiliation: Guangdong Provincial Center for Skin Diseases and STD Control, Guangzhou, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Yang
authors.affiliation: Hainan Provincial Center for Skin Diseases and STD Control, Haikou, China.
authors.forename: Qiao
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Guangxi Centers for Disease Control and Prevention, Nanning, China.
authors.forename: Yu-Jiao
authors.initials: YJ
authors.lastname: Zhou
authors.affiliation: National Center for STD Control and Prevention, China Centers for Diseases Control and Prevention, Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing, China.
authors.forename: Bao-Xi
authors.initials: BX
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012309:Risk-Taking; D014505:Urban Population; D055815:Young Adult
keywords: Guangzhou; HIV; Yangzhou; incidence; men who have sex with men; prevalence; risk behaviours
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