title: Prevalence of condomless anal intercourse and recent HIV testing and their associated factors among men who have sex with men in Hangzhou, China: A respondent-driven sampling survey.
abstract: Men who have sex with men (MSM) are a large high-risk population for HIV infection in recent years in China. A cross-sectional survey was conducted in Hangzhou, China, to determine rates of condomless anal intercourse (CAI), recent HIV testing (in the recent year) and associated factors using respondent-driven sampling. Questionnaires using face-to-face interviews were employed to collect data on sexual risk behaviors and HIV testing. Five hundred eleven MSM were recruited, of which 459 (89.8%) had anal intercourse in the past 6 months. Of these 459 participants, 457 (99.6%) answered whether they had taken an HIV test in the recent year, so only their data were analyzed. Weighted data were analyzed using bivariate and multivariate logistic regression analysis. The CAI rate with male partners in the past 6 months was 43.7% (95% confidence interval [CI], 34.0-51.5%), while the rate of condomless vaginal intercourse (CVI) was 21.6% (95% CI, 15.6-32.3%). The prevalence of recent HIV testing was 56.8% (95% CI, 48.7-66.5%), while the prevalence of HIV and syphilis were 8.8% and 6.5%, respectively. Multivariate analysis indicated that CAI was associated with earlier homosexual debut, suicidal inclinations, childhood sexual abuse, HIV testing in the recent year, and lower estimate of HIV prevalence. Recent HIV testing was associated with homosexual debut age, engaging in CAI with male partners in the past 6 months, having oral sex in the past 6 months, self-perceived higher likelihood of HIV infection, knowing about antiretroviral therapy for HIV/AIDS, receiving AIDS/sexually transmitted infection (STI) interventions in the past year, and syphilis infection. Given high prevalence of HIV and syphilis, high levels of CAI and CVI, and low HIV testing rate, the results indicated high risk of HIV infection and transmission among MSM. HIV prevention interventions should target MSM with early homosexual debut and psychosocial health problems, while HIV/AIDS education among MSM should focus on increasing knowledge of HIV risk, estimated HIV prevalence and antiretroviral therapy, and improving risk perception of HIV acquisition.
authors.affiliation: Department of HIV/AIDS and STDs Control & Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.|Department of Epidemiology and Health Statistics, School of Medicine, Ningbo University, Ningbo, Zhejiang Province, People's Republic of China.
authors.forename: Runhua
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of HIV/AIDS and STDs Control & Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of HIV/AIDS and STDs Control & Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Pan
authors.affiliation: Department of HIV/AIDS and STDs Control & Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
authors.forename: Qiaoqin
authors.initials: Q
authors.lastname: Ma
authors.affiliation: Department of HIV/AIDS and STDs Control & Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
authors.forename: Lin
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of HIV/AIDS and STDs Control & Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of HIV/AIDS and STDs Control & Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
authors.forename: Tingting
authors.initials: T
authors.lastname: Jiang
authors.affiliation: Department of HIV/AIDS and STDs Control & Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
authors.forename: Lin
authors.initials: L
authors.lastname: He
authors.affiliation: Center for Disease Control and Prevention of Hangzhou City, Hangzhou, Zhejiang Province, People's Republic of China.
authors.forename: Junfang
authors.initials: J
authors.lastname: Chen
authors.affiliation: Center for Disease Control and Prevention of Hangzhou City, Hangzhou, Zhejiang Province, People's Republic of China.
authors.forename: Xingliang
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Center for Disease Control and Prevention of Hangzhou City, Hangzhou, Zhejiang Province, People's Republic of China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Center for Disease Control and Prevention of Xiacheng District, Hangzhou, Zhejiang Province, People's Republic of China.
authors.forename: Shengjun
authors.initials: S
authors.lastname: Xi
authors.affiliation: Center for Disease Control and Prevention of Xiacheng District, Hangzhou, Zhejiang Province, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Lv
authors.affiliation: Department of HIV/AIDS and STDs Control & Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
authors.forename: Shichang
authors.initials: S
authors.lastname: Xia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D002681:China / Q000453:epidemiology; D017280:Condoms; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010465:Perception; D015995:Prevalence; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents