Prevalence and associated risk characteristics of HIV infection based on anal sexual role among men who have sex with men: a multi-city cross-sectional study in Western China.
BACKGROUND
The HIV prevalence among men who have sex with men (MSM) in Western China is substantial and increasing at an alarming rate. The current HIV infection prevalence among MSM in Western China and its associated risk characteristics were explored by looking at different anal sexual roles separately.


METHODS
A total 1245 MSM recruited by convenience sampling from multiple sources and areas in the Chongqing and Sichuan region were interviewed using an anonymous self-administered questionnaire with the assistance of investigators and then underwent HIV testing. Multivariate logistic regression was used to identify factors independently associated with HIV infection.


RESULTS
Of the 1235 respondents who reported their sexual roles during anal sex with men, the overall HIV antibody positive rate was 21.21% (262/1235). With regard to the different anal sex roles, HIV-positive rates were significantly higher among men who played the '0.5' role (versatile, equal) and '0' role (only bottom or versatile, but mostly bottom) during anal sex with men than among those who played the '1' role (only top or versatile, but mostly top) (26.41% for '0.5' role, 26.20% for '0' role, and 15.19% for '1' role; Chi-square=22.66, p<0.0001). Statistically significant differences were not found between the '0.5' role and '0' role groups (p > 0.05). The '1' role MSM who had an education level lower than senior high school, a rural household registration, and low self-perceived severity status of AIDS, the '0.5' role MSM who had an education level lower than senior high school and had not undergone HIV testing in the recent 1 year, and the '0' role MSM who were retired or unemployed and had been diagnosed with a sexually transmitted disease by a doctor in the recent 6 months were more likely to be HIV-infected.


CONCLUSIONS
In this study, the HIV prevalence among MSM was alarmingly high. Moreover, the '0.5' and '0' role MSM were found to have a higher risk of infection compared to the '1' role MSM, while respective risk characteristics were not completely the same across the three groups. Along with routine preventive intervention services, more focused and specific interventions are needed to target anal sex role classes separately.
Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China; Research Center for Medicine and Social Development, Chongqing, China; Innovation Center for Social Risk Governance in Health, Chongqing, China.
Xin
X
Zeng
Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China; Research Center for Medicine and Social Development, Chongqing, China; Innovation Center for Social Risk Governance in Health, Chongqing, China. Electronic address: zxn133cq@sina.com.
Xiaoni
X
Zhong
Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China; Research Center for Medicine and Social Development, Chongqing, China; Innovation Center for Social Risk Governance in Health, Chongqing, China.
Bin
B
Peng
Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China; Research Center for Medicine and Social Development, Chongqing, China; Innovation Center for Social Risk Governance in Health, Chongqing, China.
Yan
Y
Zhang
Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China; Research Center for Medicine and Social Development, Chongqing, China; Innovation Center for Social Risk Governance in Health, Chongqing, China.
Cuie
C
Kong
First Clinical Institute, Chongqing Medical University, Chongqing, China.
Xiyao
X
Liu
Key Laboratory of Molecular Biology for Infectious Diseases of the Ministry of Education, Chongqing Medical University, Chongqing, China.
Ailong
A
Huang
D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000453:epidemiology* / Q000209:etiology; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior
Anal sexual roles; HIV; Men who have sex with men (MSM); Risk factors; Western China