Risk factors for HIV and syphilis infection among male sex workers who have sex with men: a cross-sectional study in Hangzhou, China, 2011.
OBJECTIVE
To investigate the prevalence and risk factors of HIV and syphilis infection among men who have sex with men (MSM) in male sex workers (MSW).


METHODS
Cross-sectional survey.


METHODS
Hangzhou, China.


METHODS
259 MSW in MSM were recruited by respondent-driven sampling from May 2011 to December 2011.The inclusion criteria were: (1) age ≥18 years; (2) engaging in sex with men in the previous year and (3) willing to cooperate in the implementation of the study.


METHODS
HIV-related knowledge, high-risk behaviour and condom use.


RESULTS
Among these MSW in MSM, 23.2% were infected with HIV and/or syphilis, 8.9% were infected only with HIV, 12.7% only with syphilis and 1.5% with HIV/syphilis co-infection; 96.6% sold sex to males, 8.9% bought sex from males and 15.4% sold sex to females; 49.0% had non-commercial sex behaviours with males and 24.3% with females. The rate of condom use while having commercial sex with clients was 86.9% and 53.3% (selling anal and oral sex to males, respectively), 95.5% (buying sex from males) and 77.5% (selling sex to females), respectively. Regarding their non-commercial sex behaviour, the rate of condom use was 77.2% (with males) and 49.2% (with females), respectively. Multivariate analysis showed that age >30 years (OR 1.055; 95% CIs 1.015 to 1.095) and having ≥10 non-commercial male sex partners (OR, 1.573; 95% CI 1.018 to 2.452) were significantly associated with HIV/syphilis infection, while heterosexuality (OR, 0.238; 95% CI 0.066 to 0.855) was significantly associated with a low HIV/syphilis infection rate.


CONCLUSIONS
The MSW in MSM population in Hangzhou has a high prevalence of HIV/syphilis infection, poor perceived risks of HIV and more engagement in unsafe sex with its clients and partners, in addition to a low rate of condom use. These risk factors may account for their relatively high infection rate of HIV/syphilis.
Department of AIDS Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, China.
Yan
Y
Luo
Department of Prevention Medicine, School of Public Health, Guangzhou Medical University, Guangzhou China.
Chunyan
C
Zhu
Department of AIDS Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, China.
Shuchang
S
Chen
Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou, China.
Qingshan
Q
Geng
School of Public Health, Sun Yat-Sen University, Guangzhou, China.
Rong
R
Fu
Department of AIDS Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, China.
Xiting
X
Li
Department of AIDS Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, China.
Ke
K
Xu
Department of AIDS Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, China.
Jie
J
Cheng
Department of AIDS Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, China.
Jianming
J
Ding
D000328:Adult; D002681:China / Q000453:epidemiology; D060085:Coinfection; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000453:epidemiology*; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D011477:Sex Work / Q000706:statistics & numerical data*; D060386:Sex Workers / Q000706:statistics & numerical data*; D013587:Syphilis / Q000453:epidemiology*; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult
EPIDEMIOLOGY