title: A Comparison of the Number of Men Who Have Sex with Men among Rural-To-Urban Migrants with Non-Migrant Rural and Urban Residents in Wuhan, China: A GIS/GPS-Assisted Random Sample Survey Study.
abstract: BACKGROUND
  Mobile populations and men who have sex with men (MSM) play an increasing role in the current HIV epidemic in China and across the globe. While considerable research has addressed both of these at-risk populations, more effective HIV control requires accurate data on the number of MSM at the population level, particularly MSM among migrant populations.
  
  
  METHODS
  Survey data from a random sample of male rural-to-urban migrants (aged 18-45, n=572) in Wuhan, China were analyzed and compared with those of randomly selected non-migrant urban (n=566) and rural counterparts (580). The GIS/GPS technologies were used for sampling and the survey estimation method was used for data analysis.
  
  
  RESULTS
  HIV-related risk behaviors among rural-to-urban migrants were similar to those among the two comparison groups. The estimated proportion of MSM among migrants [95% CI] was 5.8% [4.7, 6.8], higher than 2.8% [1.2, 4.5] for rural residents and 1.0% [0.0, 2.4] for urban residents, respectively. Among these migrants, the MSM were more likely than non-MSM to be older in age, married, and migrated to more cities. They were also more likely to co-habit with others in rental properties located in new town and neighborhoods with fewer old acquaintances and more entertainment establishments. In addition, they were more likely to engage in commercial sex and less likely to consistently use condoms.
  
  
  CONCLUSIONS
  Findings of this study indicate that compared to rural and urban populations, the migrant population in Wuhan consists of a higher proportion of MSM who also exhibit higher levels of HIV-related risk behaviors. More effective interventions should target this population with a focus on neighborhood factors, social capital and collective efficacy for risk reduction.
authors.affiliation: Department of Epidemiology, University of Florida, Gainesville, Florida, United States of America; Wuhan Centers for Disease Prevention and Control, Wuhan, China; School of Public Health, Wuhan University, Wuhan, China; Pediatric Prevention Research Center, Wayne State University, Detroit, Michigan, United States of America.
authors.forename: Xinguang
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Epidemiology, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Bin
authors.initials: B
authors.lastname: Yu
authors.affiliation: Wuhan Centers for Disease Prevention and Control, Wuhan, China.
authors.forename: Dunjin
authors.initials: D
authors.lastname: Zhou
authors.affiliation: Wuhan Centers for Disease Prevention and Control, Wuhan, China.
authors.forename: Wang
authors.initials: W
authors.lastname: Zhou
authors.affiliation: Wuhan Centers for Disease Prevention and Control, Wuhan, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Gong
authors.affiliation: School of Public Health, Wuhan University, Wuhan, China.
authors.forename: Shiyue
authors.initials: S
authors.lastname: Li
authors.affiliation: Pediatric Prevention Research Center, Wayne State University, Detroit, Michigan, United States of America.
authors.forename: Bonita
authors.initials: B
authors.lastname: Stanton
mesh_terms: D000293:Adolescent; D000328:Adult; D001727:Bisexuality / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data; D040362:Geographic Information Systems; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics / Q000706:statistics & numerical data; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012424:Rural Population / Q000706:statistics & numerical data*; D012494:Sampling Studies; D011477:Sex Work / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014171:Transients and Migrants / Q000706:statistics & numerical data*; D047568:Unsafe Sex / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult