High HIV incidence epidemic among men who have sex with men in china: results from a multi-site cross-sectional study.
BACKGROUND
Recent upsurge of new HIV infections among men who have sex with men (MSM) is a major concern in China. Paucity of national-level information regarding the burden and predictors of this progressive epidemic of new infections called for a multi-centric, timely and comprehensive investigation.


METHODS
Mixed methods were used to recruit MSM from seven cities in China between 2012 and 2013. Recent and established HIV infections were estimated by Western Blot and BED HIV-1 capture enzyme immunoassay. Syphilis and herpes simplex virus-2 (HSV-2) were also tested.


RESULTS
A total of 4496 eligible MSM were recruited. The majority was aged ≤35 years (77.5 %), migrants (60.3 %), never married (69.8 %), and played receptive role in anal sex (70.5 %). The HIV prevalence was 9.9 %, and 41.9 % were recently infected, with sensitivity/specificity adjusted HIV incidence of 8.9 (95 % CI: 7.6-10.2)/100 Person-Years. The prevalence of history HSV-2 and syphilis were 12.5 % and 8.5 %, respectively. Recent HIV infection was associated with having multiple male partners (aOR = 1.4, 95 % CI 1.1-1.9), recreational drug use (aOR = 2.2, 95 % CI 1.6-3.0), anal bleeding (aOR = 2.1, 95 % CI 1.4-3.0), syphilis infection (aOR = 2.8, 95 % CI 1.9-4.3) and history HSV-2 infection (aOR = 2.3, 95 % CI 1.5-3.3).


CONCLUSIONS
High rate of recent HIV infection is potentially resulting in progressive deterioration of the overall HIV epidemic among MSM in China. Targeted interventions to address high-risk MSM including those having multiple partners, history of recreational drug use and syphilis or HSV-2 infection seemed to be the need of the hour.
Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, 110001, People's Republic of China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China.
Jun-Jie
JJ
Xu
University of North Carolina at Chapel Hill, Project-China, No. 2 Lujing Road, Guangzhou, 510085, People's Republic of China.|Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, 510085, People's Republic of China.
Wei-Ming
WM
Tang
Kirby Institute, the University of New South Wales, Sydney, NSW, 2052, Australia.
Hua-Chun
HC
Zou
Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 90095, USA.
Tanmay
T
Mahapatra
Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, 110001, People's Republic of China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China.
Qing-Hai
QH
Hu
Jiangsu Provincial Centers for Disease Control and Prevention, Nanjing, China.
Geng-Feng
GF
Fu
He'nan Provincial Centers for Disease Control and Prevention, Zhengzhou, China.
Zhe
Z
Wang
Yunnan Provincial Centers for Disease Control and Prevention, Kunming, China.
Lin
L
Lu
Shanghai Municipal Centers for Disease Control and Prevention, Shanghai, China.
Ming-Hua
MH
Zhuang
Hu'nan Provincial Centers for Disease Control and Prevention, Changsha, China.
Xi
X
Chen
Shandong Provincial Centers for Disease Control and Prevention, Jinan, China.
Ji-Hua
JH
Fu
Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, 110001, People's Republic of China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China.
Yan-Qiu
YQ
Yu
Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, 110001, People's Republic of China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China.
Jin-Xin
JX
Lu
Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, 110001, People's Republic of China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China.
Yong-Jun
YJ
Jiang
Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, 110001, People's Republic of China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China.
Wen-Qing
WQ
Geng
Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, 110001, People's Republic of China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China.
Xiao-Xu
XX
Han
Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, 110001, People's Republic of China. hongshang100@hotmail.com.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China. hongshang100@hotmail.com.
Hong
http://orcid.org/0000-0003-4303-7295
H
Shang
D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D058872:Epidemics; D015658:HIV Infections / Q000453:epidemiology*; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
BED HIV-1 capture enzyme immunoassay (BED-CEIA); HIV; Incidence; Men who have sex with men (MSM)