Sexual Behaviors Linked to Drug and Alcohol Use Among Men Who Have Sex With Men in China.
High-risk sexual behaviors drive the HIV epidemic among men who have sex with men (MSM). Alcohol consumption and use of club drugs may increase sexual risk behaviors. We evaluated effects of drug and alcohol use on sexual behaviors with both their male and female partners as well as on HIV and syphilis infections among MSM in China.



As the part of a community randomized clinical trial that conducted among MSM in Beijing from 2013 to 2015, we recruited a total of 3,680 participants cross-sectionally. A self-administered questionnaire was employed to collect information regarding demographics, sexual behaviors, and a history of alcohol and drug use. Blood sample was collected for HIV and syphilis testing.



A total of 3,588 MSM completed the survey and were included in the data analysis. The mean age was 29.9 with 97.3% of Han-ethnicity and 85.0% unmarried. The HIV and syphilis prevalence was 12.7% and 7.4%, respectively. Drug use was significantly associated with higher odds of HIV infection (aOR = 1.3, 95% Confidence Interval [CI] = 1.0,1.6), but not associated with syphilis. A higher level of alcohol consumption was similarly associated with higher odds of HIV risks with both male (e.g., condomless sex acts) and female partners (e.g., numbers of sexual partners).



The association between drug and alcohol use and high-risk behaviors is notable among MSM in China. Integrated HIV interventions that target substance use among MSM may be more effective than programs that only target HIV alone.
a Vanderbilt Institute for Global Health , Vanderbilt University School of Medicine , Nashville , Tennessee , USA.
Chen
C
Zhang
a Vanderbilt Institute for Global Health , Vanderbilt University School of Medicine , Nashville , Tennessee , USA.|b Division of Epidemiology , Vanderbilt University School of Medicine , Nashville , Tennessee , USA.
Han-Zhu
HZ
Qian
a Vanderbilt Institute for Global Health , Vanderbilt University School of Medicine , Nashville , Tennessee , USA.
Lu
L
Yin
a Vanderbilt Institute for Global Health , Vanderbilt University School of Medicine , Nashville , Tennessee , USA.
Yu
Y
Liu
c College of Nursing , New York University , New York , New York , USA.
Shiela M
SM
Strauss
d State Key Laboratory of Infectious Disease Prevention and Control (SKLID) , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Beijing , China.
Yuhua
Y
Ruan
d State Key Laboratory of Infectious Disease Prevention and Control (SKLID) , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Beijing , China.
Yiming
Y
Shao
e Beijing Center for Disease Control and Prevention , Beijing , China.
Hongyan
H
Lu
a Vanderbilt Institute for Global Health , Vanderbilt University School of Medicine , Nashville , Tennessee , USA.|f Department of Pediatrics , Vanderbilt University School of Medicine , Nashville , Tennessee , USA.
Sten H
SH
Vermund
D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D000072339:Sexual and Gender Minorities; D013587:Syphilis
Alcohol use; China; HIV; drug use; sexual behavior; men who have sex with men