title: Commercial sex and risk of HIV, syphilis, and herpes simplex virus-2 among men who have sex with men in six Chinese cities.
abstract: BACKGROUND
  Men who have sex with men (MSM) are at high risk of HIV and sexually transmitted infections (STIs) in China and globally. Engaging in commercial sex put them at even greater risk. This study estimated the prevalence of HIV/STIs among three subgroups of MSM: MSM who sold sex (MSM-selling), MSM who bought sex (MSM-buying), and non-commercial MSM (NC-MSM) and evaluated the relationship between commercial sex and HIV/STIs.
  
  
  METHODS
  We conducted a cross-sectional survey among MSM in six Chinese cities (Shenyang, Ji'nan, Changsha, Zhengzhou, Nanjing, and Kunming) from 2012 to 2013. Data on socio-demographics and sexual behaviors were collected. Serological tests were conducted to detect HIV, syphilis, and human simplex virus type 2 (HSV-2).
  
  
  RESULTS
  Of 3717 MSM, 6.8% were engaged in commercial sex. The overall prevalence of HIV, syphilis and HSV-2 infections was 11.1, 8.8 and 12.1%, respectively. MSM-selling had higher prevalence of HIV (13.4%), syphilis (12.1%) and HSV-2 (17.9%) than NC-MSM (10.9, 8.7 and 11.9% for HIV, syphilis and HSV-2, respectively), though the differences are not statistically significant. Among MSM-selling, HIV prevalence was significantly higher for those who found sex partners via Internet than those did not (19.4% vs. 8.1%, P = 0.04). Compared to NC-MSM, MSM-selling were more likely to use recreation drugs (59.3% vs. 26.3%), have unprotected anal intercourse (77.9% vs. 61.7%), and have ≥10 male sex partners (46.2% vs. 6.2%) in the past 6 months (each P < 0.05).
  
  
  CONCLUSIONS
  All three subgroups of MSM in six large Chinese cities have high prevalence of HIV/STIs. Those who sell sex only have a particularly high risk of acquiring and transmitting disease, and therefore, they should be considered as a priority group in HIV/STIs surveillance and intervention programs.
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Cunge
authors.initials: C
authors.lastname: Zheng
authors.affiliation: Department of Laboratory Medicine, Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, The First Affiliated Hospital, China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Xu
authors.affiliation: Department of Laboratory Medicine, Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, The First Affiliated Hospital, China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.
authors.forename: Qing-Hai
authors.initials: QH
authors.lastname: Hu
authors.affiliation: Department of Laboratory Medicine, Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, The First Affiliated Hospital, China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.
authors.forename: Yan-Qiu
authors.initials: YQ
authors.lastname: Yu
authors.affiliation: Department of Laboratory Medicine, Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, The First Affiliated Hospital, China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.
authors.forename: Zhen-Xing
authors.initials: ZX
authors.lastname: Chu
authors.affiliation: Department of Laboratory Medicine, Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, The First Affiliated Hospital, China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Laboratory Medicine, Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, The First Affiliated Hospital, China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.
authors.forename: Xiao-Xu
authors.initials: XX
authors.lastname: Han
authors.affiliation: Yunnan Provincial Centers for Disease Control and Prevention, Kunming, Yunnan, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Lu
authors.affiliation: Henan Provincial Centers for Disease Control and Prevention, Zhengzhou, Henan, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Shandong Provincial Centers for Disease Control and Prevention, Ji'nan, Shandong, China.
authors.forename: Ji-Hua
authors.initials: JH
authors.lastname: Fu
authors.affiliation: Hunan Provincial Centers for Disease Control and Prevention, Changsha, Hunan, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.affiliation: Jiangsu Provincial Centers for Disease Control and Prevention, Nanjing, Jiangsu, China.
authors.forename: Hong-Jing
authors.initials: HJ
authors.lastname: Yan
authors.affiliation: Department of Laboratory Medicine, Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, The First Affiliated Hospital, China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.
authors.forename: Yong-Jun
authors.initials: YJ
authors.lastname: Jiang
authors.affiliation: Department of Laboratory Medicine, Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, The First Affiliated Hospital, China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.
authors.forename: Wen-Qing
authors.initials: WQ
authors.lastname: Geng
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA.|Departments of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Sten H
authors.initials: SH
authors.lastname: Vermund
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA. han-zhu.qian@vanderbilt.edu.|Department of Laboratory Medicine, Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, The First Affiliated Hospital, China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China. han-zhu.qian@vanderbilt.edu.|Division of Epidemiology, Departments of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. han-zhu.qian@vanderbilt.edu.
authors.forename: Han-Zhu
authors.initials: HZ
authors.lastname: Qian
authors.affiliation: Department of Laboratory Medicine, Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, The First Affiliated Hospital, China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China. hongshang100@hotmail.com.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China. hongshang100@hotmail.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Shang
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D002947:Cities / Q000453:epidemiology; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000453:epidemiology*; D006558:Herpes Genitalis / Q000453:epidemiology*; D018258:Herpesvirus 2, Human / Q000472:pathogenicity; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012307:Risk Factors; D011477:Sex Work / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D013587:Syphilis / Q000453:epidemiology*; D055815:Young Adult
keywords: Commercial sex; HIV; Men who have sex with men; Sexually transmitted infection China