title: Consistently high unprotected anal intercourse (UAI) and factors correlated with UAI among men who have sex with men: implication of a serial cross-sectional study in Guangzhou, China.
abstract: BACKGROUND
  China experiencing an increasing HIV epidemic among men who have sex with men (MSM), and unprotected anal intercourse (UAI) has played a key role in this process. The aims of this study were to examine the trend of UAI and to explore the factors correlated with UAI among MSM in Guangzhou, China.
  
  
  METHODS
  Data from 2008 to 2013 were retrieved from the annual serological and behavioral surveys system. We collected information on demographic, HIV related sexual behavior with men and women, access to HIV prevention services, and symptoms of sexually transmitted infections. Chi-square test was used to examine the similarity of the participants during the study period. Univariate and multivariate logistic regression were conducted to test the factors associated with UAI. Trend test was used to check the change of UAI in different characteristic stratums during the study period.
  
  
  RESULTS
  In total, 58.4% (range from 54.5% to 62.0%) of the participants reported that they engaged in UAI in the past six months. Participants who aged less than 20 [Adjusted Odds Ratio (AOR): 2.22, 95% Confidential Interval (CI): 1.07-4.61], only attended elementary school (or less) (AOR: 1.41, 95% CI: 1.04-1.90), cohabiting with male partner (AOR: 2.15, 95% CI: 1.66-2.79), divorced or widowed (AOR: 2.80, 95% CI: 1.54-5.07), did not test for HIV in the past year (AOR: 1.36, 95% CI: 1.12-1.65), and had 10 or more partners in the past six months (AOR: 1.85, 95% CI: 1.18-2.91) had higher odds of UAI. However, the proportions of UAI were stable in different stratums during the study period.
  
  
  CONCLUSIONS
  The proportion of MSM engaged in UAI was consistently high during the study period. Effective intervention strategies, which include but not limit to risk reduction counseling and testing services, are urgently needed to bring down the risk behaviors of the MSM in Guangzhou, in order to control HIV/STIs epidemic in this specific population.
authors.affiliation: Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Jiahe, Baiyun District, Guangzhou, Guangdong Province, 510440, China. chwb817@gmail.com.
authors.forename: Weibin
authors.initials: W
authors.lastname: Cheng
authors.affiliation: University of North Carolina Project-China, No.2 Lujing Road, Yuexiu District, Guangzhou, Guangdong Province, 510095, China. Weimingtangscience@gmail.com.
authors.forename: Weiming
authors.initials: W
authors.lastname: Tang
authors.affiliation: Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Jiahe, Baiyun District, Guangzhou, Guangdong Province, 510440, China. zfzhongfeizf@163.com.|School of Public Health, Sun Yat-Sen University, No.74 2nd Yat-Sen Road, Yuexiu District, Guangzhou, Guangdong, Province, 510080, China. zfzhongfeizf@163.com.
authors.forename: Fei
authors.initials: F
authors.lastname: Zhong
authors.affiliation: Department of Epidemiology, Public Health Foundation of India, IIPH H, Bangalore Campus, SIHFW Premises, 1st cross, Magadi road, Bangalore, Karnataka, 560023, India. giridhar@iiphh.org.
authors.forename: Giridhar R
authors.initials: GR
authors.lastname: Babu
authors.affiliation: Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Jiahe, Baiyun District, Guangzhou, Guangdong Province, 510440, China. zhiganghan616@163.com.
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Han
authors.affiliation: Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Jiahe, Baiyun District, Guangzhou, Guangdong Province, 510440, China. huanxiang6815@163.com.
authors.forename: Faju
authors.initials: F
authors.lastname: Qin
authors.affiliation: Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Jiahe, Baiyun District, Guangzhou, Guangdong Province, 510440, China. 1344207297@qq.com.
authors.forename: Kai
authors.initials: K
authors.lastname: Gao
authors.affiliation: Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Jiahe, Baiyun District, Guangzhou, Guangdong Province, 510440, China. 346869019@qq.com.
authors.forename: Huixia
authors.initials: H
authors.lastname: Mai
authors.affiliation: Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Jiahe, Baiyun District, Guangzhou, Guangdong Province, 510440, China. hentleyzhao@163.com.
authors.forename: Yuteng
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Jiahe, Baiyun District, Guangzhou, Guangdong Province, 510440, China. liangcaiyun2011@21cn.com.
authors.forename: Caiyun
authors.initials: C
authors.lastname: Liang
authors.affiliation: Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Jiahe, Baiyun District, Guangzhou, Guangdong Province, 510440, China. fanli2003.student@sina.com.
authors.forename: Lirui
authors.initials: L
authors.lastname: Fan
authors.affiliation: Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Jiahe, Baiyun District, Guangzhou, Guangdong Province, 510440, China. wuhao1980dj@gmail.com.
authors.forename: Hao
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Jiahe, Baiyun District, Guangzhou, Guangdong Province, 510440, China. xuhuifang1027@21cn.com.
authors.forename: Huifang
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Jiahe, Baiyun District, Guangzhou, Guangdong Province, 510440, China. wangming@gzcdc.org.cn.
authors.forename: Ming
authors.initials: M
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China; D003430:Cross-Sectional Studies; D006306:Health Surveys; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult