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Supronowicz Ł, Rogalska M. Syphilitic hepatitis. Clin Exp Hepatol 2024; 10:9-13. [PMID: 38765910 PMCID: PMC11100338 DOI: 10.5114/ceh.2024.136235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 12/16/2023] [Indexed: 05/22/2024] Open
Abstract
Syphilis is a sexually transmitted multisystemic disease known as "the great imitator" due to its variable presentations. Despite being preventable and curable, it still constitutes a major health problem. Hepatic manifestation of syphilis is usually mild cholestatic liver injury but in very rare cases can become fulminant. Moreover, syphilitic hepatitis, known for several decades, is considered rare but is probably under-diagnosed. Given the significant morbidity associated with a missed diagnosis, syphilitic hepatitis should be taken into account as an element of differential diagnosis in patients with unexplained elevation of liver enzymes.
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Affiliation(s)
- Łukasz Supronowicz
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Poland
| | - Magdalena Rogalska
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Poland
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Guan Y, Qi T, Liao Q, Zhang R, Chen J, Liu L, Shen Y, Zhu H, Tang Q, Lu H. Multi-dimensional mismatch and barriers for promoting PrEP among men who have sex with men in China: a cross sectional survey from the Demand-side. AIDS Res Ther 2023; 20:11. [PMID: 36782323 PMCID: PMC9926770 DOI: 10.1186/s12981-022-00497-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 12/19/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Men who have sex with men (MSM) is a key population for preventing HIV in China, yet pre-exposure prophylaxis (PrEP) is not widely accepted in this population. The objective of this manuscript was to assessed the barriers in the acknowledgement and uptake focusing the demand side. METHODS An online questionnaire survey was conducted from December 2018 to January 2019. All participants were required to scan two-dimensional code which was the online crowdsourcing survey platform to complete the electronic questionnaire anonymously. RESULTS Among 1915 MSM from thirty-four cities of China, 512 (26.7%) versus 1617 (84.4%) had an objective or subjective need of PrEP, respectively. One hundred and six (5.5%) reported affordability and only 23 (1.2%) had ever taken it. Age, living alone and occupation were associated with the objective needs. Age, income, sexual behavior were associated with actual usage. The participants who they had objective need to use PrEP are the population which we should focus on. CONCLUSION A wide disconnect exists among the objective need, willingness, affordability and uptake of PrEP. Cost was the most prevalent barrier, accounting for 78.22% of individuals who needed and wished for PrEP but finally failed to receive it. The findings might facilitate optimizing future allocation of resources to better promote PrEP in Chinese MSM.
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Affiliation(s)
- Yuan Guan
- grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, Shanghai, China ,grid.263817.90000 0004 1773 1790National Clinical Research Center for Infectious Disease Shenzhen Third Peoples Hospital The Second Affiliated Hospital School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong China
| | - Tangkai Qi
- grid.8547.e0000 0001 0125 2443Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Qibin Liao
- grid.263817.90000 0004 1773 1790National Clinical Research Center for Infectious Disease Shenzhen Third Peoples Hospital The Second Affiliated Hospital School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong China
| | - Renfang Zhang
- grid.8547.e0000 0001 0125 2443Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jun Chen
- grid.8547.e0000 0001 0125 2443Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Li Liu
- grid.8547.e0000 0001 0125 2443Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yinzhong Shen
- grid.8547.e0000 0001 0125 2443Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Han Zhu
- grid.8547.e0000 0001 0125 2443Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Qi Tang
- School of Public Health, Fudan University, Shanghai, China.
| | - Hongzhou Lu
- National Clinical Research Center for Infectious Disease Shenzhen Third Peoples Hospital The Second Affiliated Hospital School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, China.
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Yun K, Yu J, Liu C, Zhang X. A Cost-effectiveness Analysis of a Mobile Phone-Based Integrated HIV-Prevention Intervention Among Men Who Have Sex With Men in China: Economic Evaluation. J Med Internet Res 2022; 24:e38855. [PMID: 36322123 PMCID: PMC9669883 DOI: 10.2196/38855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/27/2022] [Accepted: 10/01/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Mobile phone-based digital interventions have been shown to be a promising strategy for HIV prevention among men who have sex with men (MSM). OBJECTIVE This study aimed to evaluate the cost-effectiveness of a mobile phone-based digital intervention for HIV prevention among MSM in China from the perspective of a public health provider. METHODS The cost-effectiveness of the mobile phone-based digital intervention was estimated for a hypothetical cohort of 10,000 HIV-negative MSM who were followed for 1 year. A model was developed with China-specific data to project the clinical impact and cost-effectiveness of two mobile phone-based digital strategies for HIV prevention among MSM. The intervention group received an integrated behavioral intervention that included 1) individualized HIV infection risk assessment, 2) recommendation of centers testing for HIV and other STIs, 3) free online order of condoms and HIV and syphilis self-test kits and 4) educational materials about HIV/AIDS. The control group was only given educational materials about HIV/AIDS. Outcomes of interest were the number of HIV infections among MSM averted by the intervention, intervention costs, cost per HIV infection averted by the mobile phone-based digital intervention, and quality-adjusted life-years (QALYs). Univariate and multivariate sensitivity analyses were also conducted to examine the robustness of the results. RESULTS It is estimated that the intervention can prevent 48 MSM from becoming infected with HIV and can save 480 QALYs. The cost of preventing 1 case of HIV infection was US $2599.87, and the cost-utility ratio was less than 0. Sensitivity analysis showed that the cost-effectiveness of the mobile phone-based digital intervention was mainly impacted by the average number of sexual behaviors with each sexual partner. Additionally, the higher the HIV prevalence among MSM, the greater the benefit of the intervention. CONCLUSIONS Mobile phone-based digital interventions are a cost-effective HIV-prevention strategy for MSM and could be considered for promotion and application among high-risk MSM subgroups.
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Affiliation(s)
- Ke Yun
- Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jiaming Yu
- Department of Hospital Infection Management, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Changyang Liu
- Department of Ophthalmology Laboratory, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Xinxin Zhang
- Department of Ophthalmology Laboratory, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
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Liu S, Xia D, Wang Y, Xu H, Xu L, Yuan D, Liang A, Chang R, Wang R, Liu Y, Chen H, Hu F, Cai Y, Wang Y. Predicting the risk of HIV infection among internal migrant MSM in China: An optimal model based on three variable selection methods. Front Public Health 2022; 10:1015699. [PMID: 36388367 PMCID: PMC9641070 DOI: 10.3389/fpubh.2022.1015699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/04/2022] [Indexed: 01/27/2023] Open
Abstract
Introduction Internal migrant Men who have sex with men (IMMSM), which has the dual identity of MSM and floating population, should be more concerned among the vulnerable groups for HIV in society. Establishing appropriate prediction models to assess the risk of HIV infection among IMMSM is of great significance to against HIV infection and transmission. Methods HIV and syphilis infection were detected using rapid test kits, and other 30 variables were collected among IMMSM through questionnaire. Taking HIV infection status as the dependent variable, three methods were used to screen predictors and three prediction models were developed respectively. The Hosmer-Lemeshow test was performed to verify the fit of the models, and the net classification improvement and integrated discrimination improvement were used to compare these models to determine the optimal model. Based on the optimal model, a prediction nomogram was developed as an instrument to assess the risk of HIV infection among IMMSM. To quantify the predictive ability of the nomogram, the C-index measurement was performed, and internal validation was performed using bootstrap method. The receiver operating characteristic (ROC) curve, calibration plot and dynamic component analysis (DCA) were respectively performed to assess the efficacy, accuracy and clinical utility of the prediction nomogram. Results In this study, 12.52% IMMSMs were tested HIV-positive and 8.0% IMMSMs were tested syphilis-positive. Model A, model B, and model C fitted well, and model B was the optimal model. A nomogram was developed based on the model B. The C-index of the nomogram was 0.757 (95% CI: 0.701-0.812), and the C-index of internal verification was 0.705. Conclusions The model established by stepwise selection methods incorporating 11 risk factors (age, education, marriage, monthly income, verbal violence, syphilis, score of CUSS, score of RSES, score of ULS, score of ES and score of DS) was the optimal model that achieved the best predictive power. The risk nomogram based on the optimal model had relatively good efficacy, accuracy and clinical utility in identifying internal migrant MSM at high-risk for HIV infection, which is helpful for developing targeted intervention for them.
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Affiliation(s)
- Shangbin Liu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Danni Xia
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuxuan Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huifang Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lulu Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong Yuan
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ajuan Liang
- Renji Hospital, Affiliated With the School of Medicine Shanghai Jiao Tong University, Shanghai, China
| | - Ruijie Chang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rongxi Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yujie Liu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Hu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China,*Correspondence: Fan Hu
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Yong Cai
| | - Ying Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Ying Wang
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Zhang H, Wang M, Zhang Y, Tan S, Huang H, Zhu J, Tian W, Mo J, Mo J, Cen P, Ning C. Usability of dual HIV/syphilis self-testing among men who have sex with men in China: study protocol for a three-arm randomised controlled trial. BMJ Open 2022; 12:e059034. [PMID: 36216414 PMCID: PMC9558798 DOI: 10.1136/bmjopen-2021-059034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION HIV self-testing (HIVST) provides a key measure for the early detection of HIV infection in men who have sex with men (MSM). However, dual HIV/syphilis self-testing in the MSM population has not been studied. We describe a randomised controlled trial to evaluate the effect of dual HIV/syphilis self-testing on the testing frequency among MSM in China. METHODS AND ANALYSIS This randomised controlled trial will be implemented in Guangxi, China. 330 MSM, including 255 frequent testers and 75 less frequent testers, will be recruited and randomly assigned in a 1:1:1 ratio into one of three arms: a site-based testing arm, a single HIVST arm and a dual HIV/syphilis self-testing arm. Participants in the single HIVST arm and dual HIV/syphilis self-testing arm will receive two free finger-prick-based HIVST or HIV/syphilis self-testing kits at enrolment. The data will be collected at five separate times: baseline, 3 months, 6 months, 9 months and 12 months. The primary outcome is the mean frequency of HIV testing used by MSM after intervention comparing each group during the study period. The secondary outcome includes changes in sex behaviours (eg, number of male sex partners and the proportion of consistent condom use) and the mean number of HIV tests used by the social network members over the study period. ETHICS AND DISSEMINATION The study protocol was reviewed and approved by the Medical Ethics Committee of Guangxi Medical University, China (20210173). The study results will be disseminated through conferences and academic journals. TRIAL REGISTRATION NUMBER ChiCTR2100050898.
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Affiliation(s)
- Hong Zhang
- Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Min Wang
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Yun Zhang
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Sumin Tan
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Haimei Huang
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Jiawen Zhu
- The Second Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Weiyi Tian
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Jinli Mo
- The Second Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Jieling Mo
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Ping Cen
- AIDS/STD Control and Prevention, Nanning Municipal Center for Disease Prevention and Control, Nanning, Guangxi, China
| | - Chuanyi Ning
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
- Key Lab of AIDS Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
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Systematic Review of Hepatitis C Virus Prevalence in the WHO Western Pacific Region. Viruses 2022; 14:v14071548. [PMID: 35891529 PMCID: PMC9320901 DOI: 10.3390/v14071548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This review aimed to identify hepatitis C virus (HCV) prevalence estimates among the general population and six key populations (people who inject drugs, men who have sex with men, sex workers, prisoners/detainees, Indigenous people, and migrants) in the World Health Organization Western Pacific Region (WHO WPR). METHODS Original research articles published between 2016 and 2020 were identified from bibliographic databases. Publications were retrieved, replicas removed, and abstracts screened. Retained full texts were assessed and excluded if inclusion criteria were not met. Methodological quality was assessed using the Johanna Briggs Institute critical appraisal checklist for prevalence data. Data on HCV exposure and active infection were extracted and aggregated and forest plots generated for each population by country. RESULTS There were no HCV prevalence estimates in any population for more than half of WPR countries and territories. Among the 76 estimates, 97% presented prevalence of exposure and 33% prevalence of active infection. General population viraemic prevalence was 1% or less, except in Mongolia. Results confirm the endemic nature of HCV among people who inject drugs, with estimates of exposure ranging from 30% in Cambodia to 76% in Hong Kong. CONCLUSIONS Countries require detailed knowledge of HCV prevalence in diverse populations to evaluate the impact of efforts to support WHO HCV elimination goals. Results provide baseline estimates from which to monitor and evaluate progress and by which to benchmark future elimination efforts.
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Chan PSF, Fang Y, Chidgey A, Fong F, Ip M, Wang Z. Would Chinese Men Who Have Sex With Men Take Up Human Papillomavirus (HPV) Screening as an Alternative Prevention Strategy to HPV Vaccination? Front Med (Lausanne) 2022; 9:904873. [PMID: 35721088 PMCID: PMC9205561 DOI: 10.3389/fmed.2022.904873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background Men who have sex with men (MSM) are at high risk for human papillomavirus (HPV) infection. A community-based organization (CBO)-private clinic service model promoting HPV vaccination among MSM was implemented in Hong Kong. The aim of this study was to evaluate the effectiveness of this service model in increasing HPV screening among MSM. Methods This was a secondary analysis of the CBO-private clinic service model in increasing HPV screening among MSM. Participants were Hong Kong Chinese-speaking MSM aged 18–45 years who had never received HPV vaccination. All participants completed a telephone survey at baseline before receiving online intervention promoting HPV vaccination and completed another telephone survey 12 months afterward. Results A total of 350 participants completed a baseline telephone survey and received interventions promoting HPV vaccination. Among 274 participants being followed up at Month 12, 33 (12.0%) received any type of HPV screening during the study period. Such uptake rate was similar to the prevalence of HPV screening in the past year measured at baseline (12.0 vs. 9.9%, p = 0.43). More MSM preferred HPV vaccination or HPV vaccination plus HPV screening, and very few preferred HPV screening alone. After adjusting for significant baseline characteristics, higher perceived susceptibility to HPV (adjusted odds ratio (AOR): 1.16, 95% confidence interval (CI): 1.00–1.34) and receiving HPV vaccination during the study period (AOR: 7.03, 95% CI: 3.07–16.13) were significantly associated with higher HPV screening uptake. Conclusions The CBO-private clinic service model promoting HPV vaccination had limited impact in increasing HPV screening among MSM in Hong Kong. MSM in Hong Kong may not use HPV screening as an alternative prevention strategy to HPV vaccination. Future programs preventing HPV-related diseases among MSM in Hong Kong should focus on HPV vaccination promotion.
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Affiliation(s)
- Paul Shing-fong Chan
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | | | | | - Mary Ip
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Zixin Wang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- *Correspondence: Zixin Wang
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Xu Y, Wu S, Fu X, Ding J, Xu W, Li X, Shi H, Qiao M, Zhu Z. Trends in HIV Prevalence and HIV-Related Risk Behaviors Among Male Students Who Have Sex With Men From 2016 to 2020 in Nanjing, China: Consecutive Cross-Sectional Surveys. Front Public Health 2022; 10:806600. [PMID: 35570976 PMCID: PMC9091556 DOI: 10.3389/fpubh.2022.806600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/24/2022] [Indexed: 11/29/2022] Open
Abstract
Background The growing HIV epidemic among student men who have sex with men (MSM) necessitates immediate attention from public health. In China, male students who have sex with men (SMSM) were also at an increasing risk of HIV transmission. The aim of this study was to investigate the trends in HIV prevalence, HIV-related risk behaviors, and HIV testing, as well as analyze the factors associated with HIV infection among SMSM in Nanjing. Methods Data were collected through face-to-face questionnaire interviews and laboratory testing in Nanjing. The participants were recruited among SMSM by snowball sampling and internet-recruited convenience sampling annually from 2016 to 2020. The self-report data primarily included demographics, HIV knowledge, HIV-related behaviors, and HIV testing, while the laboratory test results of HIV and syphilis were collected. Linear-by-linear chi-square test was used to analyze the trends of HIV/syphilis prevalence and its risk behaviors. The binary logistic regression model was used to explore the factors associated with HIV infection. Results During the 5 years from 2016 to 2020, a total of 775 SMSM were recruited in our survey (220, 112, 171, 142, and 120, respectively). The HIV prevalence was 5.2, 6.3, 5.3, 7.0, and 8.3%, without a significant increasing trend (P = 0.277). Syphilis prevalence fluctuated from 5.7% in 2016 to 4.2% in 2020, without a significant decreasing trend (P = 0.318). The proportion of consistent condom use in anal intercourse (48.5 to 56.2%, P < 0.05), and HIV testing in the past 12 months (51.0 to 59.2%, P < 0.05) were increasing. A remarkable growing trend has been reported in the percentage of MSM with more than one male sex partner (46.2 to 59.2%, P < 0.05). Multivariate analysis showed that HIV testing in the past 12 months was a protective factor against HIV infection. MSM who had unprotected anal intercourse (UAI) in the past 6 months, recreational drug use, and currently syphilis infection were risk factors for HIV infection. Conclusions We observed stable HIV/ syphilis prevalence, increasing consistent condom use, increasing HIV testing rate, and increasing multiple male sex partners dramatically among SMSM in China. The original comprehensive intervention measures should be continuously strengthened for the subgroup. To satisfy the current HIV prevention requirements, new biological interventions should be introduced and carried out as major components of combination prevention programs.
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Affiliation(s)
- Yuanyuan Xu
- Department of AIDS/STD Control and Prevention, Nanjing Center for Disease Control and Prevention, Nanjing, China
| | - Sushu Wu
- Department of AIDS/STD Control and Prevention, Nanjing Center for Disease Control and Prevention, Nanjing, China
| | - Xuezhen Fu
- International Department of Nanjing No.13 Middle School, Nanjing, China
| | - Jie Ding
- Department of Office, Nanjing Center for Disease Control and Prevention, Nanjing, China
| | - Wenjiong Xu
- Department of Microbiology Laboratory, Nanjing Center for Disease Control and Prevention, Nanjing, China
| | - Xin Li
- Department of AIDS/STD Control and Prevention, Nanjing Center for Disease Control and Prevention, Nanjing, China
| | - Hongjie Shi
- Department of AIDS/STD Control and Prevention, Nanjing Center for Disease Control and Prevention, Nanjing, China
| | - Mengkai Qiao
- Department of Microbiology Laboratory, Nanjing Center for Disease Control and Prevention, Nanjing, China
| | - Zhengping Zhu
- Department of AIDS/STD Control and Prevention, Nanjing Center for Disease Control and Prevention, Nanjing, China
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Mi T, Lan G, Yang X, Li X, Qiao S, Shen Z, Zhou Y. HIV-Related Stigma, Sexual Identity, and Depressive Symptoms Among MSM Living With HIV in China: A Moderated Mediation Modeling Analysis. Am J Mens Health 2022; 16:15579883221087531. [PMID: 35343811 PMCID: PMC8966094 DOI: 10.1177/15579883221087531] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Depression is one of the biggest health issues among men who have sex with men (MSM) living with HIV, where sexual identity might play an intricate role. Yet, findings of the relationship between sexual identity and depression were mixed and few studies explored its underlying mechanisms. This study aimed to examine the association between sexual identity and depression, and the potential mediating role of HIV-related stigma and moderating role of age. A cross-sectional survey was conducted among 203 MSM living with HIV in Guangxi, China. Participants provided information on sexual identity, depression, HIV-related stigma, and background information. Descriptive statistics, bivariate analysis, and path analysis were applied to examine our hypotheses. Bivariate analysis demonstrated that participants who self-identified as gay reported a lower level of HIV-related stigma and depression. Path analysis revealed an insignificant direct effect of identifying as gay on depression. Yet, the indirect pathway was significant, with identifying as gay being associated with a lower level of HIV stigma and thus a lower level of depression. This indirect effect was moderated by age. The conditional indirect effect was significant in the younger group yet ceased in the older group. The study provided information to better understand the effect of sexual identity on mental health among stigmatized sexual and gender minorities by highlighting the mediating effect of HIV-related stigma and the protective effect of age. Interventions targeting mental health of MSM living with HIV might consider placing greater emphasis on addressing HIV-related stigma among younger MSM.
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Affiliation(s)
- Tianyue Mi
- Department of Health Promotion, Education, and Behavior & South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Guanghua Lan
- Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Xueying Yang
- Department of Health Promotion, Education, and Behavior & South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior & South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shan Qiao
- Department of Health Promotion, Education, and Behavior & South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Zhiyong Shen
- Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Yuejiao Zhou
- Guangxi Center for Disease Control and Prevention, Nanning, China
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Jiang TT, Cao NX, Chen XS. Estimating burden of syphilis among men who have sex with men. Lancet Glob Health 2021; 9:e1648. [DOI: 10.1016/s2214-109x(21)00452-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/23/2021] [Indexed: 10/19/2022]
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Lu X, Gao P, Wang X, Wang X, Zhao X, He Q, Zhang H, Wang J, Sun Y, Liu T, Sun S, Yang C, Zaller N, Zhang Z, Operario D. User Preferences for an mHealth Approach to Support HIV Self-Testing and Linkage to HIV Prevention or Care Services for MSM in China. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:534-550. [PMID: 34874759 DOI: 10.1521/aeap.2021.33.6.534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This research qualitatively explored user preferences for an app-based mHealth approach to support HIV self-testing and linkage to HIV prevention or care services developed for men who have sex with men (MSM) in China. We conducted 12 online focus group discussions with MSM participants (N = 48) about their preferences for using an app to meet their HIV self-testing and service linkage needs. Data were examined using thematic analysis. Participants specified four domains to align program delivery with their preferences for app-based intervention: (1) expanding HIV prevention/antiretroviral therapy concepts beyond basic knowledge; (2) enhancing the style and presentation of app-based messages; (3) incorporating interactive and dynamic app-engagement features; and (4) creating a "one station" app that covers the continuum of HIV services. Given the changing landscapes of HIV knowledge and community/user preferences for app-based interaction, findings underscore how engagement with end-user participants is essential to optimize mHealth interventions for HIV.
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Affiliation(s)
- Xiaoyan Lu
- School of Public Health at Anhui Medical University, University of Hefei, China
| | - Pan Gao
- Hefei Youth Social Organization, Hefei, China
| | - Xiaodong Wang
- Chengdu Tongle Health Counseling Service Center, Chengdu, China
| | - Xia Wang
- Center for Disease Control and Prevention in Wuhan, China
| | - Xiuping Zhao
- Center for Disease Control and Prevention in Suzhou, China
| | - Qinying He
- Center for Disease Control and Prevention in Chengdu, China
| | - Hongbo Zhang
- School of Public Health at Anhui Medical University, University of Hefei, China
| | - Jun Wang
- School of Public Health at Anhui Medical University, University of Hefei, China
| | - Yehuan Sun
- School of Public Health at Anhui Medical University, University of Hefei, China
| | - Tao Liu
- School of Public Health, Brown University, Providence, Rhode Island
| | - Shufang Sun
- School of Public Health, Brown University, Providence, Rhode Island
| | - Cui Yang
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Nickolas Zaller
- Fay W. Boozman College of Public Health University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Zhihua Zhang
- School of Public Health at Anhui Medical University, University of Hefei, China
| | - Don Operario
- School of Public Health, Brown University, Providence, Rhode Island
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12
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Zhao P, Yang Z, Li B, Xiong M, Zhang Y, Zhou J, Wang C. Simple-to-use nomogram for predicting the risk of syphilis among MSM in Guangdong Province: results from a serial cross-sectional study. BMC Infect Dis 2021; 21:1199. [PMID: 34844553 PMCID: PMC8628378 DOI: 10.1186/s12879-021-06912-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 11/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to develop and validate a simple-to-use nomogram for the prediction of syphilis infection among men who have sex with men (MSM) in Guangdong Province. Methods A serial cross-sectional data of 2184 MSM from 2017 to 2019 was used to develop and validate the nomogram risk assessment model. The eligible MSM were randomly assigned to the training and validation dataset. Factors included in the nomogram were determined by multivariate logistic regression analysis based on the training dataset. The receiver operating characteristic (ROC) curves was used to assess its predictive accuracy and discriminative ability. Results A total of 2184 MSM were recruited in this study. The prevalence of syphilis was 18.1% (396/2184). Multivariate logistic analysis found that age, the main venue used to find sexual partners, condom use in the past 6 months, commercial sex in the past 6 months, infection with sexually transmitted diseases (STD) in the past year were associated with syphilis infection using the training dataset. All these factors were included in the nomogram model that was well calibrated. The C-index was 0.80 (95% CI 0.76–0.84) in the training dataset, and 0.79 (95% CI 0.75–0.84) in the validation dataset. Conclusions A simple-to-use nomogram for predicting the risk of syphilis has been developed and validated among MSM in Guangdong Province. The proposed nomogram shows good assessment performance. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06912-z.
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Affiliation(s)
- Peizhen Zhao
- Department of Biostatistics, State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China.,Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Ziying Yang
- Department of Biostatistics, State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Baohui Li
- Department of Biostatistics, State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Mingzhou Xiong
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Ye Zhang
- Kirby Institute, New South Wales University, Sydney, Australia
| | - Jiyuan Zhou
- Department of Biostatistics, State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China. .,Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Guangzhou, China.
| | - Cheng Wang
- Dermatology Hospital, Southern Medical University, Guangzhou, China.
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13
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Wang Z, Fang Y, Chan PSF, Chidgey A, Fong F, Ip M, Lau JTF. Effectiveness of a Community-Based Organization-Private Clinic Service Model in Promoting Human Papillomavirus Vaccination among Chinese Men Who Have Sex with Men. Vaccines (Basel) 2021; 9:vaccines9111218. [PMID: 34835149 PMCID: PMC8620588 DOI: 10.3390/vaccines9111218] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/15/2021] [Accepted: 10/15/2021] [Indexed: 01/21/2023] Open
Abstract
This study evaluated the effectiveness of the community-based organization (CBO)-private clinic service model in increasing human papillomavirus (HPV) vaccination uptake among unvaccinated men who have sex with men (MSM) in Hong Kong during a 12-month follow-up period. A CBO-private clinic model was implemented to promote HPV vaccination among Chinese MSM. A CBO with good access to MSM approached MSM aged 18–45 years who had never received an HPV vaccination, invited them to receive an online health promotion, and referred them to receive HPV vaccination at gay-friendly private clinics. A baseline survey and a follow-up evaluation at Month 12 were conducted. A total of 350 participants completed the baseline survey. Among 274 participants who were followed up at Month 12, 46 (16.8%) had taken up at least one dose of HPV vaccination. After adjusting for significant baseline characteristics, the perceived susceptibility (AOR:1.25, p = 0.002) and perceived severity (AOR:1.21, p = 0.003) of HPV and HPV-related diseases, perceived benefits (AOR:1.16, p = 0.03), self-efficacy to receive HPV vaccination (AOR:1.37, p = 0.001), and behavioral intention to take up HPV vaccination at baseline (AOR:6.99, p < 0.001) significantly predicted HPV vaccination uptake. The process evaluation of the program was positive. The CBO-private clinic service model was helpful in increasing HPV vaccination uptake among MSM.
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Affiliation(s)
- Zixin Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (M.I.)
- Correspondence: (Z.W.); (J.T.F.L.)
| | - Yuan Fang
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, China;
| | - Paul Shing-fong Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (M.I.)
| | | | | | - Mary Ip
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (M.I.)
| | - Joseph T. F. Lau
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.S.-f.C.); (M.I.)
- Correspondence: (Z.W.); (J.T.F.L.)
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14
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Lu Y, Ni Y, Wang Q, Jing F, Zhou Y, He X, Huang S, Dai W, Wu D, Tucker JD, Jiang H, Huang L, Tang W. Effectiveness of sexual health influencers identified by an ensemble machine learning model in promoting secondary distribution of HIV self-testing among men who have sex with men in China: study protocol for a quasi-experimental trial. BMC Public Health 2021; 21:1772. [PMID: 34583667 PMCID: PMC8480079 DOI: 10.1186/s12889-021-11817-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HIV self-testing (HIVST), especially the secondary distribution of HIVST (SD-HIVST) initiated by sexual health influencers (SHIs), has been recognized as an effective strategy in promoting HIV testing, especially among men who have sex with men (MSM). This quasi-experimental study aimed to evaluate whether SHIs identified through the ensemble machine learning approach can distribute more HIVST than those who identified by the empiricalscale. METHODS We will recruit eligible adults (≥18 years old) who were assigned male gender at birth, and willing to participate in potential SD-HIVST online. Participants will be assigned randomly to two groups (scale group or machine learning group), followed by a separate process of SHI identification based on the group assignment. After identification, all index participants (defined as identified SHIs who are verbally consented to participate in SD-HIVST or who directly order HIVST kits) will follow the same procedure for SD-HIVST acquisition and distribution. Index participants can order HIVST online and distribute them to members within their social networks (defined as alters) in-person or virtually through a personalized peer referral link. Once a unique alter uploads a photographed test result to the platform, both the alter and the corresponding index participant will receive a fixed incentive of 3 USD. The index MSM can order up to five HIVST in the first three months and ten HIVST in the following three months. Each index participant will need to complete a baseline survey at the first-time ordering and one to two follow-upbased on the times of ordering,, three months after ordering. This trial will be comparing 1) the mean number of alters motivated by each index participant in each group and 2) the mean number of newly-tested alters motivated by each index participant in each group. DISCUSSION In promoting the efficacy of identifying SHIs for SD-HIVST, our study has the potential to enhance testing coverage, particularly among marginalized individuals and those who are reluctant to for HIV and other sexually transmitted infections. TRIAL REGISTRATION We registered the study on the Chinese Clinical Trial Registry website on 4th November 2021, with registration number ChiCTR2000039632 .
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Affiliation(s)
- Ying Lu
- Dermatology Hospital of South Medical University, Guangzhou, China.,University of North Carolina Project-China, Guangzhou, China
| | - Yuxin Ni
- Dermatology Hospital of South Medical University, Guangzhou, China.,University of North Carolina Project-China, Guangzhou, China
| | - Qianyun Wang
- Dermatology Hospital of South Medical University, Guangzhou, China.,University of North Carolina Project-China, Guangzhou, China
| | - Fengshi Jing
- Institute for Healthcare Artificial Intelligence, Guangdong Second Provincial General Hospital, Guangzhou, China.,School of Data Science, City University of Hong Kong, Hong Kong, SAR, China
| | - Yi Zhou
- Zhuhai Center for Diseases Control and Prevention, Zhuhai, China.,Faculty of Medicine, Macau University of Science and Technology, SAR, Macau, China
| | - Xi He
- Zhuhai Xutong Voluntary Services Center, Zhuhai, China
| | - Shanzi Huang
- Zhuhai Center for Diseases Control and Prevention, Zhuhai, China
| | - Wencan Dai
- Zhuhai Center for Diseases Control and Prevention, Zhuhai, China
| | - Dan Wu
- University of North Carolina Project-China, Guangzhou, China.,London School of Hygiene and Tropical Medicine, London, UK
| | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China.,London School of Hygiene and Tropical Medicine, London, UK
| | - Hongbo Jiang
- Guangdong Pharmaceutical University, Guangzhou, China
| | - Liqun Huang
- Zhuhai Center for Diseases Control and Prevention, Zhuhai, China
| | - Weiming Tang
- Dermatology Hospital of South Medical University, Guangzhou, China. .,University of North Carolina Project-China, Guangzhou, China.
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15
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Lu R, Zhang X, Zhou C, Zhang W, Ouyang L, Xing H, Shao Y, Ruan Y, Wu G. Trends of Human Immunodeficiency Virus, Syphilis, and Hepatitis C Infections Among Men Who Have Sex With Men in Chongqing, China: A Serial Cross-sectional Survey From 2011 to 2018. Sex Transm Dis 2021; 47:491-498. [PMID: 32541307 PMCID: PMC7294744 DOI: 10.1097/olq.0000000000001173] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Human immunodeficiency virus (HIV) prevalence and incidence rates have expeditiously increased among Chongqing men who have sex with men (MSM) over the past decade. This study investigated the trends of HIV, syphilis, and hepatitis C virus (HCV) infections and behavioral attributes of Chongqing MSM. METHODS Chongqing MSM who were 18 years or older were recruited annually from 2011 to 2018. Interviewer-administered paper-pencil interviews were used to collect demographics, behavioral information, and sexually transmitted diseases history. Blood samples were collected for the tests of HIV, syphilis, and HCV. A stepwise regression model was conducted to assess the associations of demographics, behaviors, and syphilis and HCV infections with HIV infection. RESULTS A total of 4900 MSM participated in the study. The average HIV, syphilis, and HCV prevalence over 8 years were 15.4%, 4.0%, and 0.3%, respectively. The HIV prevalence ranged from 13.5% to 16.4%. Syphilis and HCV were generally low and stable across years. An increased proportion of participants received HIV counseling, testing, and condoms. Multivariable regression indicated that HIV-positive MSM were more likely to be older, married, and less educated, and they were more likely to perform unprotected anal intercourse with male partners in the past 6 months, have syphilis, and less likely to receive HIV counseling, testing, condoms, and peer education in the past year. CONCLUSIONS The HIV counseling, testing, and peer education programs showed a negative association with HIV-positive status among Chongqing MSM. The HIV prevalence is still high. More programs must be implemented to effectively curb the HIV epidemic.
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Affiliation(s)
- Rongrong Lu
- From the Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Xiangjun Zhang
- School of Community Health Sciences, University of Nevada, Reno, NV
| | - Chao Zhou
- From the Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Wei Zhang
- From the Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Lin Ouyang
- From the Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Hui Xing
- State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Yiming Shao
- State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Yuhua Ruan
- State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Guohui Wu
- From the Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
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16
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Wang Z, Fang Y, Wong NS, Ip M, Guo X, Wong SYS. Facilitators and Barriers to Take Up Clinician-Collected and Self-Collected HPV Tests among Chinese Men Who Have Sex with Men. Viruses 2021; 13:v13040705. [PMID: 33921752 PMCID: PMC8073020 DOI: 10.3390/v13040705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/30/2021] [Accepted: 04/12/2021] [Indexed: 12/17/2022] Open
Abstract
Regular tests for human papillomavirus (HPV) and early treatment could represent an important strategy for preventing anal cancers among men who have sex with men (MSM). This study investigated facilitators and barriers to take up clinician-collected and self-collected HPV tests among Chinese MSM. This study was based on the baseline sample of a longitudinal study promoting HPV vaccination among 350 Chinese MSM who had never received an HPV vaccination. The baseline survey was conducted from August 2019 to April 2020. The prevalence of any HPV tests uptake in lifetime was 19.1%; 4.9% had HPV infection in anus, genital, oral cavity, and other places. Among the participants, 20% and 76.8% intended to take up self-financed and free clinician-collected HPV tests, and 76.8% intended to use free self-collected HPV tests. After adjusting for significant background characteristics, perceived risk of HPV infection, and perceived benefits, barriers, cue to action, and self-efficacy related to HPV tests in general and/or specific to self-collected HPV tests were associated with behavioral intention to take up free clinician-collected and/or self-collected HPV tests. Less than 20% of Chinese MSM reported HPV tests uptake. Modifying perceptions related to HPV tests may be useful to increase HPV tests coverage in this group.
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Affiliation(s)
- Zixin Wang
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (N.S.W.); (M.I.); (X.G.)
- Correspondence: (Z.W.); (S.Y.S.W.); Tel.: +852-22528740 (Z.W.); +852-22528774 (S.Y.S.W.)
| | - Yuan Fang
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, China;
| | - Ngai Sze Wong
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (N.S.W.); (M.I.); (X.G.)
| | - Mary Ip
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (N.S.W.); (M.I.); (X.G.)
| | - Xin Guo
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (N.S.W.); (M.I.); (X.G.)
| | - Samuel Yeung Shan Wong
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (N.S.W.); (M.I.); (X.G.)
- Correspondence: (Z.W.); (S.Y.S.W.); Tel.: +852-22528740 (Z.W.); +852-22528774 (S.Y.S.W.)
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17
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Hu L, Luo Y, Zhong X, Lu R, Wang Y, Sharma M, Ye M. Condom Use and Related Factors among Rural and Urban Men Who Have Sex With Men in Western China: Based on Information-Motivation-Behavioral Skills Model. Am J Mens Health 2021; 14:1557988319899799. [PMID: 32028826 PMCID: PMC7008563 DOI: 10.1177/1557988319899799] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
This study aimed to determine the differences in condom use and related factors among rural–urban men who have sex with men (MSM) in Western China. A cross-sectional survey was conducted in Chongqing, Sichuan, and Guangxi, which recruited MSM by non-probability sampling. Data were collected through an anonymous, standardized, and self-reported questionnaire guided by an information–motivation–behavioral skills model. Structural equation model was applied to analyze the related factors. Out of the 1141 MSM included in this analysis, 856 (75%) and 285 (25%) were from urban and rural areas, respectively. The median age was 27 years for both groups. Self-reported consistent condom use for anal sex in the past 6 months was 57.58%. The rate of consistent condom use was lower in rural MSM than in urban MSM (50.88% vs. 59.81%, p = .008). Behavioral skills, HIV/AIDS intervention services, and response costs had direct positive and negative influences on condom use, respectively. By contrast, motivation and information exhibited indirect influence. All the factors were mediated by behavioral skills in rural and urban MSM, except for the information that had no effect among urban MSM but had an indirect effect among rural MSM. These findings suggest that service providers should pay attention to substantial rural–urban differences and design different AIDS prevention and intervention strategies targeting rural and urban MSM.
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Affiliation(s)
- Ling Hu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Yetao Luo
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Xiaoni Zhong
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Rongrong Lu
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Yang Wang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Manoj Sharma
- Department of Behavioral and Environmental Health, Jackson State University, Jackson, MS, USA.,School of Health Sciences, Walden University, Minneapolis, MN, USA
| | - Mengliang Ye
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
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18
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Wang Z, Lau JTF, Ip TKM, Yu Y, Fong F, Fang Y, Mo PKH. Two Web-Based and Theory-Based Interventions With and Without Brief Motivational Interviewing in the Promotion of Human Papillomavirus Vaccination Among Chinese Men Who Have Sex With Men: Randomized Controlled Trial. J Med Internet Res 2021; 23:e21465. [PMID: 33528372 PMCID: PMC7886619 DOI: 10.2196/21465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/30/2020] [Accepted: 12/24/2020] [Indexed: 01/09/2023] Open
Abstract
Background Human papillomavirus (HPV) vaccination is effective in the prevention of vaccine-type genital warts and cancers among men who have sex with men (MSM). Objective The primary objective of this randomized controlled trial (RCT) is to evaluate the efficacies of 2 web- and theory–based interventions with and without brief motivational interviewing (MI) over the phone to increase the completion of HPV vaccination among unvaccinated participants within a 24-month follow-up period compared with the control group. Methods A 3-arm parallel-group RCT was conducted between July 2017 and December 2019. Five telephone surveys were conducted at baseline and at 3, 6, 9, and 24 months by blinded interviewers. Participants were Hong Kong Chinese–speaking MSM aged between 18 and 45 years with regular internet access who were recruited from outreaching at venues, web-based recruitment, and peer referral. Those who had ever received HPV vaccination were excluded. A total of 624 participants were randomized into either the online tutorial (OT) only group (n=208), the OT plus MI group (OT-MI; n=208), or the control group (n=208). In total, 459 (459/624, 73.6%) completed the follow-up evaluation at 24 months. Participants in the OT group received a fully automated OT developed based on the health belief model. On top of the same OT, the OT-MI group received brief MI over the phone. Reminders were sent to the participants of the OT and OT-MI groups after 1, 2, 4, 6, and 8 months. Participants in the control group received web-based health communication messages unrelated to HPV or HPV vaccination. The research team validated the self-reported HPV vaccination uptake. Intention-to-treat analysis was used for outcome analyses. Logistic regression models and multivariable linear regression models were used to test the between-group differences in primary and secondary outcomes. Baron and Kenny’s methods were used to test the mediation hypothesis. Results The participants in the OT-MI group reported a significantly higher validated completion of HPV vaccination at 24 months than the control group (36/208, 17.3% vs 15/208, 7.2%; P=.006). However, the difference in HPV vaccination completion between the OT and the control groups (24/208, 11.5% vs 15/208, 7.2%; P=.17), or between OT-MI and OT groups (P=.13), was not statistically significant. The association between randomization status (OT-MI group vs control group) and HPV vaccination completion became statistically nonsignificant after controlling for changes in the perceived susceptibility to HPV (24 months vs baseline), whereas perceived susceptibility remained strongly associated with HPV vaccination uptake in the model (P<.001). Changes in perceived susceptibility fully mediated the intervention effect. Conclusions Theory-based OT with brief MI over the phone was effective in increasing HPV vaccination completion among Chinese MSM. Perceived susceptibility is an active theoretical component that causes behavioral changes. Trial Registration ClinicalTrials.gov NCT03286907; https://clinicaltrials.gov/ct2/show/NCT03286907
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Affiliation(s)
- Zixin Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Joseph T F Lau
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Tsun Kwan Mary Ip
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yebo Yu
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Yuan Fang
- Department of Early Childhood Education, Faculty of Education and Human Development, The Education University of Hong Kong, Hong Kong, China
| | - Phoenix K H Mo
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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19
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Lu T, Mao X, Peng E, Gao Y, Chu Z, Dong W, Zhang W, Jiang YJ, Xu J. Association between rectal douching and HIV acquisition: the mediating role of condom use and rectal bleeding in a national online sample of Chinese men who have sex with men. Sex Transm Infect 2021; 97:69-74. [PMID: 32371429 PMCID: PMC7841489 DOI: 10.1136/sextrans-2019-054415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 03/30/2020] [Accepted: 04/14/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Previous studies have demonstrated that rectal douching (RD) is associated with HIV acquisition among men who have sex with men (MSM). However, the precise mechanism underlying the association between RD and HIV remains unclear. METHODS We recruited participants over WeChat from October 2017 to October 2018. Respondents received mailed HIV self-testing kits, uploaded images of HIV self-test results and completed an online electronic questionnaire simultaneously. The questionnaire assessed sociodemographic characteristics, RD practices and sexual risk behaviours. HIV status was measured as the result of the HIV self-testing. The Baron and Kenny statistical method was used to assess the association between RD and HIV, controlling for condomless anal intercourse (CAI) and rectal bleeding. RESULTS Of 1365 participants, 39.93% (545/1365) reported RD in the past 6 months, 60.07% had multiple male sexual partners and 43.08% had CAI in the past 6 months. The prevalence of HIV, based on self-testing, was 3.37% (46/1365). Multivariable logistic analysis showed RD was significantly associated with bottom sexual role (adjusted OR (aOR) 14.0; 95% CI 9.8 to 20.2), having multiple male sexual partners (aOR 1.8; 95% CI 1.4 to 2.2), CAI (aOR 1.3; 95% CI 1.0 to 1.6), rectal bleeding (aOR 2.0; 95% CI 1.6 to 2.6) and HIV infection (aOR 1.9; 95% CI 1.0 to 3.4). Baron and Kenny analysis found both CAI (aOR 2.2; 95% CI 1.2 to 4.1) and rectal bleeding (aOR 1.9; 95% CI 1.0 to 3.4) play a mediating role in the association between RD and HIV. CONCLUSIONS Our study results confirmed the relationship between RD and HIV, and found CAI and rectal bleeding mediated HIV infection in Chinese MSM who douched. Strategies should be encouraged to strengthen health education and reduce high-risk sexual behaviour in order to reduce the risk of HIV in MSM who use enemas. Rectal microbicides may represent an efficient means of providing HIV prophylaxis among MSM.
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Affiliation(s)
- Tianyi Lu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiang Mao
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Erlei Peng
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yangyang Gao
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhenxing Chu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Willa Dong
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Wenran Zhang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yong-Jun Jiang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Junjie Xu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
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20
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Jin F, Dore GJ, Matthews G, Luhmann N, Macdonald V, Bajis S, Baggaley R, Mathers B, Verster A, Grulich AE. Prevalence and incidence of hepatitis C virus infection in men who have sex with men: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2020; 6:39-56. [PMID: 33217341 DOI: 10.1016/s2468-1253(20)30303-4] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND WHO has set targets for hepatitis C virus (HCV) elimination by 2030. We did a global systematic review of HCV prevalence and incidence in men who have sex with men (MSM) to provide updated estimates that can guide community education and public health policy. METHODS We did a systematic review and meta-analysis of studies published and listed on MEDLINE or Embase between Jan 1, 2000, and Oct 31, 2019, including conference proceedings. Studies were eligible if they reported measures of HCV prevalence or HCV incidence (or both) among MSM. Studies that relied on participants' self-reported HCV status with no laboratory confirmation were excluded. Pooled HCV estimates in MSM were stratified by HIV status and by injecting drug use, then by WHO region and by income level. Random-effects meta-analysis was done to account for between-study heterogeneity and examined using the I2 statistic. Pooled HCV prevalence was also compared with HCV estimates in the general population and presented as prevalence ratios (PRs). In HIV-negative MSM, incidence estimates were stratified by use of HIV pre-exposure prophylaxis (PrEP). The systematic review was registered with PROSPERO, number CRD42020156262. FINDINGS Of 1221 publications identified, 194 were deemed to be eligible and included in the systematic review and meta-analysis. Overall, the pooled HCV prevalence in MSM was 3·4% (95% CI 2·8-4·0; I2=98·0%) and was highest in Africa (5·8%, 2·5-10·4) and South-East Asia (5·0%, 0·0-16·6). Globally, HCV prevalence was 1·5% (1·0-2·1) in HIV-negative MSM and 6·3% (5·3-7·5) in HIV-positive MSM. Compared with the general population, HCV prevalence was slightly higher in HIV-negative MSM (PR 1·58, 95% CI 1·14-2·01) and markedly higher (6·22, 5·14-7·29) in HIV-positive MSM. Pooled HCV prevalence was substantially higher in MSM who had ever injected drugs (30·2%, 22·0-39·0) or currently injected drugs (45·6%, 21·6-70·7) than in those who never injected drugs (2·7%, 2·0-3·6). In HIV-negative MSM, the pooled HCV incidence was 0·12 per 1000 person-years (95% CI 0·00-0·72) in individuals not on PrEP and 14·80 per 1000 person-years (9·65-20·95) in individuals on PrEP. HCV incidence in HIV-positive MSM was 8·46 per 1000 person-years (6·78-10·32). INTERPRETATION HIV-positive MSM are at substantially increased risk of HCV. Overall, HIV-negative MSM had a slightly higher prevalence of HCV than the general population but had a lower prevalence than HIV-positive MSM. High HCV incidence in more recent PrEP studies suggests that as PrEP use increases, greater HCV transmission might occur. HCV burden in MSM varies considerably by region, which is likely to be associated with variation in the prevalence of injecting drug use and HIV. FUNDING World Health Organization.
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Affiliation(s)
- Fengyi Jin
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
| | - Gregory J Dore
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Gail Matthews
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Niklas Luhmann
- Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Virginia Macdonald
- Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Sahar Bajis
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Rachel Baggaley
- Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Bradley Mathers
- Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Annette Verster
- Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Andrew E Grulich
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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Understanding the Role of Voluntary Counseling and Testing (VCT) in HIV Prevention in Nantong, China. BIOMED RESEARCH INTERNATIONAL 2020; 2020:5740654. [PMID: 33083474 PMCID: PMC7556064 DOI: 10.1155/2020/5740654] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/15/2020] [Accepted: 09/19/2020] [Indexed: 12/15/2022]
Abstract
Voluntary counseling and testing (VCT) service plays an essential part in the prevention of human immunodeficiency virus (HIV) infection. The purpose of this study was to investigate the characteristics of participants and analyze the major factors of HIV infection in VCT in Nantong, China. This study was conducted between January 2010 and December 2015, based on the responses to questionnaires and blood test results retrieved from the Chinese National HIV/AIDS Comprehensive Control Information System (CNHCCIS). Multivariate logistic regression analyses were used to identify factors related to HIV infection. Differences between first-time testers and repeat testers were assessed using the chi-squared or Fisher test. Over six years, a total of 11,560 VCT participants were included, and 420 cases were confirmed to be HIV-positive. Overall, the annual number of participants was relatively stable with a mean of 1927, while there was a rapid increase in the HIV detection rate (from 1.03% in 2010 to 7.52% in 2015). In multivariate analysis, referral counseling and having a HIV-positive spouse/fixed sex partners were found to be significantly associated with HIV infection among all participants, while being unmarried or divorced, having commercial heterosexual behaviors, and male-male sexual behaviors are additional HIV-related factors for males. Compared to first-time testers, repeat testers were more willing to engage in high-risk sexual behaviors and had higher HIV detection rates (P < 0.001). In conclusion, the HIV epidemic in Nantong is still not controlled. Therefore, in the future, it is critical to expand VCT services to increase the detection rate of HIV, which can prevent the transmission of HIV effectively.
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Lu T, Li H, Mao X, Peng E, Gao Y, Chu Z, Zhang J, Dong W, Jiang Y, Xu J. HIV Self-Testing to Promote Serostatus Disclosure Among Men Who Have Sex With Men in China: Protocol for a Stepped Wedge Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e17788. [PMID: 32673264 PMCID: PMC7380896 DOI: 10.2196/17788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/09/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Disclosure of HIV serostatus is important for the prevention of HIV infection among men who have sex with men (MSM). However, knowledge of sexual partners' HIV status among MSM in China is low. As a complement to HIV testing services, HIV self-testing (HIVST) has considerable potential to promote serostatus disclosure. OBJECTIVE The primary objective of our trial is to evaluate the effect of HIVST on improving serostatus disclosure to sexual partners. We hypothesize that MSM in an intervention condition will have a higher awareness of the HIV status of their sexual partners compared with MSM in the control condition. The secondary aims are to evaluate (i) changes in sexual behaviors after disclosure of HIV status by sexual partners, (ii) promotion of the frequency of HIV and syphilis testing on participants and their sexual partners, and (iii) factors that restrict the disclosure of HIV infection to sexual partners. We hypothesize that MSM in the intervention condition will exhibit safer sexual decision making and a higher rate of HIV testing uptake compared with MSM in the control condition. METHODS A stepped wedge randomized controlled trial will be conducted throughout China. Study recruitment of 800 MSM will be promoted through advertisements released on WeChat public accounts. Individuals who are born biologically male, aged ≥18 years, HIV negative, and who have not undergone HIV testing in the past 3 months will be recruited. Eligible men will be randomly divided (1:1:1:1) into four groups and randomized. The group cluster will initiate the intervention so that participants will be provided with 2-4 free finger prick-based HIVST kits until trial completion. The intervention period for participants in each of the four groups will be initiated at 3-month intervals. Men in both groups will be required to complete a baseline and four follow-up surveys every 3 months. The primary intervention outcome will evaluate the effect of the distribution of HIVST kits on improvement in the disclosure of sexual partners' HIV status. The secondary outcomes will be changes in sexual behaviors after disclosure of HIV status from sexual partners, the promotion of the frequency of HIVST on participants and their sexual partners, and the factors that restrict disclosure of HIV status to sexual partners. RESULTS Subject recruitment began in August 2018. The first round of follow-up surveys post intervention is complete, with three rounds remaining to be done. Data analysis was scheduled for April 2020 and the results will be disseminated through conferences and peer-reviewed publications. CONCLUSIONS Few studies have evaluated interventions to increase knowledge of sexual partners' HIV status among MSM. Our trial will provide information on the link between HIVST and HIV serostatus disclosure. The findings of this trial will facilitate the implementation of HIVST services to help control the spread of HIV among MSM in China. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1800019453; http://www.chictr.org.cn/showproj.aspx?proj=30158. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/17788.
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Affiliation(s)
- Tianyi Lu
- NHC Key Laboratory of AIDS Immunology, Department of Laboratory Medicine, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Hang Li
- NHC Key Laboratory of AIDS Immunology, Department of Laboratory Medicine, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiang Mao
- NHC Key Laboratory of AIDS Immunology, Department of Laboratory Medicine, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Erlei Peng
- NHC Key Laboratory of AIDS Immunology, Department of Laboratory Medicine, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yangyang Gao
- NHC Key Laboratory of AIDS Immunology, Department of Laboratory Medicine, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhenxing Chu
- NHC Key Laboratory of AIDS Immunology, Department of Laboratory Medicine, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jing Zhang
- NHC Key Laboratory of AIDS Immunology, Department of Laboratory Medicine, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Willa Dong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Yongjun Jiang
- NHC Key Laboratory of AIDS Immunology, Department of Laboratory Medicine, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Junjie Xu
- NHC Key Laboratory of AIDS Immunology, Department of Laboratory Medicine, First Affiliated Hospital of China Medical University, Shenyang, China
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23
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Ding Y, Ma Z, He J, Xu X, Qiao S, Xu L, Shi R, Xu X, Zhu B, Li J, Wong FY, He N. Evolving HIV Epidemiology in Mainland China: 2009-2018. Curr HIV/AIDS Rep 2020; 16:423-430. [PMID: 31773403 DOI: 10.1007/s11904-019-00468-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE OF REVIEW This review is intended to provide an overview of the evolution of HIV epidemiology over the past decade in China. RECENT FINDINGS We provided a succinct overall view of the epidemic, followed by surveillance data, profiles of key populations, HIV molecular epidemiology, and drug resistance, as well as survival in the age of antiretroviral therapy usage. For each topical issue, we first reviewed the latest empirical evidence, followed by a brief summary assessment. We briefly addressed the challenges and opportunities of the next generation of HIV control and prevention efforts in China. Notably, macro-social factors need to be integrated into the next generation of clinical and/or behavioral HIV research to inform disease progression and management, as well as control and prevention.
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Affiliation(s)
- Yingying Ding
- Department of Epidemiology, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Zhonghui Ma
- Department of Epidemiology, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Jiayu He
- Department of Epidemiology, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Xiaoyi Xu
- Department of Epidemiology, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Shijie Qiao
- Department of Epidemiology, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Lulu Xu
- Department of Epidemiology, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Ruizi Shi
- Department of Epidemiology, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Xiaohui Xu
- Department of Epidemiology, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Bowen Zhu
- Department of Epidemiology, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Jing Li
- Department of Epidemiology, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Frank Y Wong
- Center for Indigenous Nursing Research for Health Equity, Florida State University, Tallahassee, FL, USA.,Department of Psychology, University of Hawai`i at Mānoa, Honolulu, HI, USA
| | - Na He
- Department of Epidemiology, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China. .,Key Laboratory of Health Technology Assessment of Ministry of Health, Fudan University, P. O. Box 289, 138 Yi Xue Yuan Road, Shanghai, 200032, China.
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24
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Wang Z, Mo PKH, Ip M, Fang Y, Lau JTF. Uptake and willingness to use PrEP among Chinese gay, bisexual and other men who have sex with men with experience of sexualized drug use in the past year. BMC Infect Dis 2020; 20:299. [PMID: 32321442 PMCID: PMC7178573 DOI: 10.1186/s12879-020-05024-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/12/2020] [Indexed: 01/03/2023] Open
Abstract
Background Sexualized drug use (SDU) refers to use of any psychoactive substance before/during sexual intercourse. Chemsex is a subset of SDU, which is defined as the use of some specific psychoactive substances (methamphetamine, mephedrone, γ-hydroxybutyrate, ketamine and cocaine) before/during sexual intercourse. SDU and chemsex are prevalent among gay, bisexual and other men who have sex with men (GBMSM). This study investigated uptake and willingness to use pre-exposure prophylaxis (PrEP) among a sample of GBMSM in Hong Kong with experience of SDU in the past year. Methods A total of 600 GBMSM were recruited by convenient sampling through outreaching in gay venues, online recruitment and peer referral. Participants completed a cross-sectional anonymous telephone interview. This study was based on a subsample of 580 GBMSM self-reported as HIV negative/unknown sero-status. Results Of the participants, 82 (14.1%) and 37 (6.4%) had experience of SDU and chemsex in the past year. The prevalence of PrEP uptake was 4.0% among all participants and 14.6% among those with experience of SDU in the past year. Among GBMSM with experience of SDU in the past year who were not on PrEP (n = 70), 67.1% were willing to use daily oral PrEP in the next 6 months. Multivariate logistic regression models showed that positive attitudes toward PrEP (AOR: 2.37, 95%CI: 1.47, 3.82), perceived support from significant others to use PrEP (AOR: 9.67, 95%CI: 2.95, 31.71), and perceived behavioral control of using PrEP (AOR: 19.68, 95%CI: 5.44, 71.26) were significantly associated with higher willingness to use PrEP. Conclusion GBMSM with experience of recent SDU are potentially good candidates of PrEP implementation. This group of GBMSM reported high prevalence of uptake and willingness to use PrEP. Perceptions related to PrEP based on the Theory of Planned Behavior were significantly associated with willingness to use PrEP.
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Affiliation(s)
- Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China. .,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China.
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Mary Ip
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yuan Fang
- Department of Early Childhood Education, Faculty of Education and Human Development, The Education University of Hong Kong, Hong Kong SAR, China
| | - Joseph T F Lau
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
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25
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Yang X, Wang Z, Wang X, Ma T, Xue H, He Y, Lau JTF. Behavioral Intention to Initiate Antiretroviral Therapy (ART) Among Chinese HIV-Infected Men Who Have Sex With Men Having High CD4 Count in the Era of "Treatment for All". Am J Mens Health 2020; 13:1557988319828615. [PMID: 30819066 PMCID: PMC6775561 DOI: 10.1177/1557988319828615] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
China has updated its national guideline recommending antiretroviral therapy (ART) to all people living with HIV (PLWH) since 2016. This study was to investigate the prevalence of behavioral intention to initiate ART among HIV-infected men who have sex with men (MSM) with CD4 levels >350 cells/mm3, who had just become eligible to receive free ART in China. A cross-sectional survey was conducted among 262 eligible HIV-infected MSM who had never received ART. The theory of planned behavior (TPB) was used to guide the variable selection. The prevalence of behavioral intention to initiate ART was 69.9%. After adjusting for significant background variables, all five constructs of TPB were significantly associated with behavioral intention to initiate ART. These significant constructs were: positive attitudes (adjusted odds ratios, AOR: 1.14; 95% CI [1.06, 1.24]) and negative attitudes (AOR: 0.89; 95% CI [0.82, 0.97]) toward immediate ART initiation; perceived their significant others would support them to initiate ART immediately (perceived subjective norm; AOR: 1.14; 95% CI [1.03, 1.25]); perceived high proportion of PLWH having similar CD4 cell levels were on ART (perceived descriptive norm; AOR: 2.22, 95% CI [1.16, 4.24]); and being confident in initiating ART immediately (perceived behavioral control; AOR: 1.21; 95% CI [1.04, 1.39]). Prevalence of behavioral intention to initiate ART was high among this group of MSM. Effective health promotion is needed to translate behavioral intention into related action. TPB may be a useful framework for developing future health promotion increasing ART coverage in this group.
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Affiliation(s)
- Xueying Yang
- 1 Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.,2 Beijing Chaoyang Centre for Disease Control and Prevention, China
| | - Zixin Wang
- 1 Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.,3 Shenzhen Research Institute, The Chinese University of Hong Kong, China
| | - Xiaodong Wang
- 4 Chengdu Tongle Health Counselling Service Centre, China
| | - Tiecheng Ma
- 5 Consultation Center of AIDS Aid and Health Service, Shenyang, China
| | - Honghong Xue
- 6 Fujian Volunteers Association of STD&AIDS Prevention and Control, Fuzhou, China
| | | | - Joseph Tak Fai Lau
- 1 Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.,3 Shenzhen Research Institute, The Chinese University of Hong Kong, China
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Yang X, Li X, Qiao S, Li L, Parker C, Shen Z, Zhou Y. Intersectional stigma and psychosocial well-being among MSM living with HIV in Guangxi, China. AIDS Care 2020; 32:5-13. [PMID: 32156159 DOI: 10.1080/09540121.2020.1739205] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The existing literature suggests a negative impact of intersectional stigma on multiple aspects of psychosocial well-being among individuals with multiple stigmatized identities. However, such impact remains poorly understood. This study aims to investigate the association between intersectional stigma and psychosocial well-being among 193 men who have sex with men (MSM) living with HIV. Based on their responses to measures of HIV-related stigma and sexual and gender minority (SGM) stigma, the participants were grouped into "high" vs "low" on each type of stigma. The General Linear Model (GLM) was used to analyze the main and interaction effect of two types of stigma on multiple psychosocial measures. Our results indicated a significant interaction effect of two types of stigma on depression, anxiety, quality of life, and psychological resilience after controlling for key socio-demographic covariates. The findings suggest that experiencing both HIV-related stigma and SGM stigma may synergistically lead to poor psychosocial well-being among MSM in a more profound manner than experiencing only one type of stigma. It is critical for researchers and clinicians to consider the patients' multiple stigmatized identities, develop effective intervention strategies, and improve the psychosocial well-being of MSM living with HIV in China and other cultural settings.
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Affiliation(s)
- Xueying Yang
- Department of Health Promotion, Education, and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), University of South Carolina Arnold School of Public Health, Columbia, SC, USA
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), University of South Carolina Arnold School of Public Health, Columbia, SC, USA
| | - Shan Qiao
- Department of Health Promotion, Education, and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), University of South Carolina Arnold School of Public Health, Columbia, SC, USA
| | - Linda Li
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Casey Parker
- School of Public Health, Brown University, Providence, RI, USA
| | - Zhiyong Shen
- Guangxi Center for Disease Control and Prevention, Nanning, People's Republic of China
| | - Yuejiao Zhou
- Guangxi Center for Disease Control and Prevention, Nanning, People's Republic of China
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Sun S, Hoyt WT, Pachankis JE. Sexual risk behaviors in the internet age: the case of Chinese men who have sex with men. AIDS Care 2020; 32:302-309. [PMID: 31533450 PMCID: PMC6980990 DOI: 10.1080/09540121.2019.1668525] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 09/11/2019] [Indexed: 10/26/2022]
Abstract
This cross-sectional study examined a sample of sexually active Chinese MSM recruited online (N = 403) to determine the associations of MSM social life (both online and in-person) and sexual identity stigma with three types of sexual risk behaviors in the past 12 months, including condom use %, number of anal intercourse partners, and number of partners engaged in condomless anal intercourse (CAI). Hierarchical regression analyses were conducted. More frequent use of social media was associated with higher numbers of anal intercourse partners as well as more condom use in past 12 months, but not number of CAI partners. More active in-person MSM social life was associated with higher numbers of partners in anal intercourse as well as CAI. Both perceived and enacted sexual identity stigma associated with higher numbers of CAI partners; perceived stigma was also linked to less condom use. In conclusion, social life and minority stress are relevant factors of sexual risk among MSM in China in the uptrend of internet use. The internet may be an important and promising platform for HIV prevention, and intervention efforts should consider online-based designs to promote safe sex and reduce sexual minority stigma.
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Affiliation(s)
- Shufang Sun
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University
| | - William T. Hoyt
- Department of Counseling Psychology, University of Wisconsin-Madison
| | - John E. Pachankis
- Department of Chronic Disease Epidemiology, Social and Behavioral Sciences Division, Yale School of Public Health, Yale University
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Li H, Tucker JD, Ma W, Kim ES, Marley G, Kang D, Liao M, Tang W, Jiang B. Growth Trajectories of Peer Norms, Self-efficacy and Condom Use Behavior Among Sexually Active Chinese Men Who Have Sex with Men: Latent Class Analysis and Growth Mixture Modeling. AIDS Behav 2020; 24:854-865. [PMID: 31016503 DOI: 10.1007/s10461-019-02515-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Data from a randomized controlled trial in 2015 were used to estimate the growth trajectories of peer norms, self-efficacy, and condom use behavior, and to identify associated sociodemographic and behavioral factors among a sample of 804 Chinese men who have sex with men (MSM). Latent class analysis and growth mixture modeling were conducted using Mplus. Two growth trajectories were estimated for each outcome variable with good model fit. The growth trajectories of peer norms were related to age (β = - 0.066, p < 0.05). The growth trajectories of self-efficacy were related to age (β = 0.057, p < 0.01) and using a condom during first sexual encounter with another man (β = 0.777, p < 0.001). The growth trajectories of condom use behavior were related to income (β = 0.366, p < 0.01) and having casual male partners (β = - 1.016, p < 0.001). Predictors for the growth factors within each latent class were also estimated. For subsets of MSM who are older, richer, used a condom during their first sexual encounter with another man, and do not have a casual male partner, condom videos may not have sufficient efficacy and other interventions may be necessary.
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Wang Y, Lu R, Wu G, Lan R, Ou R, Zhang Y, Ye M. Changing Trends of HIV, Syphilis, and Hepatitis C among Male Migrant Workers in Chongqing, China: Nine Consecutive Cross-Sectional Surveys, 2010-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030875. [PMID: 32019250 PMCID: PMC7036957 DOI: 10.3390/ijerph17030875] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 11/23/2022]
Abstract
Background: Male migrant workers (MMWs) have been reported to be vulnerable to human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). Chongqing, China is one of the major migration destinations and hotspots of HIV. This study aims to explore the prevalence of HIV, syphilis, and hepatitis C virus (HCV), as well as HIV-related knowledge and behaviors, among MMWs in Chongqing. Methods: Questionnaire surveys were conducted, and blood samples were collected and examined among MMWs selected by two-stage stratified sampling in Chongqing from 2010 to 2018. The Cochran–Armitage trend test was conducted to observe the trends in the prevalence of HIV, syphilis, and HCV, as well as HIV-related knowledge and behaviors. The Chi-square test and Binary Logistic Regression were conducted to observe the distinctions between different groups. Results: The overall HIV prevalence was 0.6% with an increasing trend (0.2% to 0.9%, p < 0.001), whereas the overall HCV prevalence was 0.5% with a decreasing trend (0.5% to 0.4%, p < 0.001). The overall syphilis prevalence was 1.3% in the ≥50 age group, 1.0% in the 30–49 age group, and higher than 0.3% in the 16–29 group (X2 = 19.527, p < 0.001). An uptrend (80.2%–80.6%, p < 0.001) was observed in correct HIV-related knowledge. The 16–29 ((Odds Ratio) OR: 1.575; 95%CI (Confidence Interval): 1.380–1.798; p < 0.001) and 30–49 (OR: 1.697; 95%CI: 1.495–1.926; p < 0.001) age groups had 1.575 and 1.697 times correct HIV-related knowledge more than the ≥50 age group. The proportion of subjects engaged in commercial sex in the past year (7.7%–13.3%, p < 0.001), consistent condom use during this activity (20.5%–54.0%, p < 0.001), and condom use in the last commercial sex (48.6%–72.1%, p = 0.020) were increasing. The risk of engaging in commercial sex in the past year in the 16–29 age group was 0.768 times (OR: 0.768; 95%CI: 0.643–0.917; p = 0.003) less than that in the ≥50 age group. The risk of engaging in non-regular sex in the past year in the 16–29 (OR: 2.819; 95%CI: 2.317–3.431; p < 0.001) and 30–49 (OR: 1.432; 95%CI: 1.184–1.733; p < 0.001) age groups were 2.819 and 1.432 times more than that in the ≥50 age group. The risk of engaging in anal sex in the past year in the 16–29 age group was 6.333 times (OR: 6.333; 95%CI: 1.468–27.327; p < 0.013) more than that in the ≥50 age group. The proportion of consistent condom use during non-regular sex in the past year (10.9%–47.3%, p < 0.001) and condom use in the last non-regular sex (40.8%–71.1%, p < 0.001) increased remarkably. The possibilities of consistent condom use during commercial sex in the past year in the 16–29 (OR: 2.606; 95%CI: 1.847–3.677; p < 0.001) and 30–49 (OR: 1.632; 95%CI: 1.214–2.195; p = 0.001) age groups were 2.606 and 1.632 times more than that in the ≥50 age group. The possibilities of condom use in the last commercial sex in the 16–29 (OR: 1.805; 95%CI: 1.258–2.589; p = 0.001) and 30–49 (OR: 1.360; 95%CI: 1.016–1.821; p = 0.039) age groups were 1.805 and 1.360 times more than that in the ≥50 age group. The possibilities of consistent condom use during non-regular sex in the past year (OR: 1.628; 95%CI: 1.066–2.484; p = 0.024) and condom use in the last non-regular sex (OR: 1.671; 95%CI: 1.148–2.433; p = 0.007) in the 16–29 age group were 1.628 and 1.671 times more than those in the ≥50 age group, respectively. Conclusion: An upward trend of HIV and a downward trend of HCV were observed among MMWs in Chongqing from 2010 to 2018. We also found an increase in commercial sex and inadequate condom use during high-risk behaviors among this population. The overall syphilis prevalence in the middle-aged and elderly groups was higher than in the young group, and elderly MMWs were more likely to engage in unprotected high-risk behaviors. Thus, targeted STI prevention for MMWs in Chongqing, especially those aged 50 years and above, is urgently needed.
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Affiliation(s)
- Yujun Wang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China; (Y.W.); (R.L.); (Y.Z.)
| | - Rongrong Lu
- Institute for AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing 400042, China; (R.L.); (G.W.)
| | - Guohui Wu
- Institute for AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing 400042, China; (R.L.); (G.W.)
| | - Rong Lan
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China; (Y.W.); (R.L.); (Y.Z.)
| | - Rong Ou
- Library of Chongqing Medical University, Chongqing 400016, China;
| | - Yangchang Zhang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China; (Y.W.); (R.L.); (Y.Z.)
| | - Mengliang Ye
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China; (Y.W.); (R.L.); (Y.Z.)
- Correspondence: ; Tel.: +86-153-1093-9053
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Yang X, Wang Z, Harrison S, Lau JTF. Coverage and adherence of antiretroviral therapy among Chinese HIV-positive men who have sex with men with high CD4 counts in the era of 'Treat all'. Trop Med Int Health 2019; 25:308-318. [PMID: 31758830 DOI: 10.1111/tmi.13353] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES HIV-positive men who have sex with men (MSM) with CD4 cell counts> 350 cells/mm3 in China recently became eligible for free antiretroviral therapy (ART) due to updated national guidelines. This study aimed to investigate ART coverage and adherence among a large sample of HIV-positive MSM in China. METHODS A cross-sectional survey was conducted in Chengdu and Hangzhou, China, from February to November 2016. Participants were 277 MSM who had received a confirmatory HIV diagnosis and had CD4 levels of> 350 cells/mm3 . Trained staff of collaborating non-governmental organizations contacted all HIV-positive MSM listed in their service records and invited them to join the study. The ART initiation, ART adherence and interactions between healthcare professionals and the patients were assessed. RESULTS ART coverage was 60.3%. Among those who were on ART (n = 167), no participants reported missing any doses in the last four days, but 25.7% reported non-compliance to either ART dosing schedule or dosage instructions. After adjusting for background variables and perceived eligibility for ART, two variables were significant factors of higher ART coverage: (i) receiving a recommendation from healthcare professionals for immediate ART initiation and (ii) perceiving having received an adequate explanation of potential harms of ART. Being prescribed> 3 pills per dose and not having a temporary resident permit were associated with non-compliance. CONCLUSIONS Significant efforts are needed to increase ART coverage among HIV-positive MSM with high CD4 counts in China. Although prevalence of missing doses was low, non-compliance to dosing schedule/instructions should not be neglected. Interactions between healthcare professionals and MSMs play an important role in facilitating ART initiation.
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Affiliation(s)
- Xueying Yang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Department of Health Promotion, Education, and Behavior, South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Sayward Harrison
- Department of Health Promotion, Education, and Behavior, South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Joseph T F Lau
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
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Wang C, Tang W, Zhao P, Tucker J, Chen L, Smith MK, Wong NS, Dong W, Yang B, Zheng H. Rapid increase of gonorrhoea cases in Guangdong Province, China, 2014-2017: a review of surveillance data. BMJ Open 2019; 9:e031578. [PMID: 31712340 PMCID: PMC6858213 DOI: 10.1136/bmjopen-2019-031578] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES An increased trend in the number of reported gonorrhoea cases has been observed between 2014 and 2017 in China. This study aims to describe the reported epidemic of gonorrhoea and potential driving forces in Guangdong Province, China. DESIGN A review of surveillance data. PARTICIPANTS Three different sources of data from Guangdong Province were analysed: gonorrhoea cases reported to the Chinese sexually transmitted infections (STI) case report system (CRS); a clinic-based retrospective study conducted to collect information on annual gonorrhoea screening coverage and data from the Guangdong governmental sentinel surveillance network (SSN) to examine the gonorrhoea prevalence among males attending STI clinics. OUTCOME MEASURES Reported incidence of gonorrhoea, number of reported gonorrhoea cases, number of screening tests for gonorrhoea and gonorrhoea prevalence. RESULTS The STI CRS data showed that the reported incidence of gonorrhoea has increased rapidly from 15.7 cases per 100 000 population in 2014 to 27.3 cases per 100 000 in 2017 in Guangdong (p<0.001). Regions with a reported incidence of gonorrhoea cases of more than 10 cases per 100 000 expanded from 7 cities in 2014 to 13 cities in 2017. The SSN data showed that the gonorrhoea prevalence among males attending STI clinics increased from 2.7% in 2015 to 3.6% in 2017 (p=0.14). The retrospective study showed that the increased rate of screening for gonorrhoea between 2014 and 2017 was 35.0%, which was much lower than the increased rate of the number of reported gonorrhoea cases (123.3%). CONCLUSIONS The number of gonococcal infections is rapidly rising in Guangdong, China. Expanded screening coverage, use of more sensitive diagnostics and increase of gonorrhoea prevalence are three potential contributors to the epidemic. Additional targeted intervention strategies are necessary in the future to control the epidemic.
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Affiliation(s)
- Cheng Wang
- STD Control, Dermatology Hospital of Southern Medical University, Guangzhou, China
- STD Control, Guangdong Provincial Center for Skin Diseases and STIs control, Guangzhou, China
| | - Weiming Tang
- STD Control, Guangdong Provincial Center for Skin Diseases and STIs control, Guangzhou, China
- Project-China, University of North Carolina, Guangzhou, China
| | - Peizhen Zhao
- STD Control, Dermatology Hospital of Southern Medical University, Guangzhou, China
- STD Control, Guangdong Provincial Center for Skin Diseases and STIs control, Guangzhou, China
| | - Joseph Tucker
- Project-China, University of North Carolina, Guangzhou, China
| | - Lei Chen
- STD Control, Dermatology Hospital of Southern Medical University, Guangzhou, China
- STD Control, Guangdong Provincial Center for Skin Diseases and STIs control, Guangzhou, China
| | - M Kumi Smith
- School of Public Health, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Ngai Sze Wong
- Stanley Ho Center for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Willa Dong
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Bin Yang
- STD Control, Dermatology Hospital of Southern Medical University, Guangzhou, China
- STD Control, Guangdong Provincial Center for Skin Diseases and STIs control, Guangzhou, China
| | - Heping Zheng
- STD Control, Dermatology Hospital of Southern Medical University, Guangzhou, China
- STD Control, Guangdong Provincial Center for Skin Diseases and STIs control, Guangzhou, China
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Zhang Y, Wu G, Lu R, Xia W, Hu L, Xiong Y, Xie J, Yu Q, Ye M. What has changed HIV and syphilis infection among men who have sex with men (MSM) in Southwest China: a comparison of prevalence and behavioural characteristics (2013-2017). BMC Public Health 2019; 19:1314. [PMID: 31638943 PMCID: PMC6805434 DOI: 10.1186/s12889-019-7730-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 10/09/2019] [Indexed: 12/13/2022] Open
Abstract
Background Chongqing reportedly has a large MSM population and a high STI prevalence in previous studies. However, most studies are attributed to independent cross-sectional studies, few studies have investigated trends in the prevalence of syphilis and HIV, as well as behavioural characteristics among MSM using serial surveillance surveys. Methods Data were collected in Chongqing through face-to-face questionnaire interview and laboratory testing in Chongqing. The respondents were recruited among MSM by snowball sampling from May 2013 to December 2017. The self-report questionnaire primarily included socio-demographics, HIV knowledge, and HIV-related behaviour characteristics over the year. Blood specimens were tested to diagnose HIV and syphilis infection by Chongqing CDC. Cochran-Armitage trend test and multivariate logistic regression were conducted to compare the changes in STI prevalence and independent behavioural factors among MSM. Results There were 6568 eligible participants (98.4%). The overall HIV prevalence was 20.5% among MSM in Chongqing, with a decrease from 23.0% in 2013 to 19.2% in 2017. The overall syphilis prevalence was 5.8%, with an increase from 3.2% in 2013 to 6.7% in 2017. The proportion of consistent condom use (CCU) during anal intercourse (46.3 to 57.7%, P<0.001),CCU with regular male partners(47.7 to 59.7%, P<0.001), CCU with casual male partners (51.5 to 62.3%, P<0.001) and drug use during anal intercourse (0.3 to 1.4%, P<0.05) were increasing. By contrast, a significant decrease was reported in the percentage of MSM with more than two regular male partners (66.0 to 21.4%, P<0.001) and more than two casual male partners (38.3 to 20.7%, P<0.001). A significant difference was observed in syphilis infection, testing for HIV antibodies and drug use during anal intercourse in the past years between the HIV-positive and HIV-negative respondents. Conclusion A decreasing trend of HIV prevalence was showed during among MSM from 2013 to 2017 in Chongqing. While gradual reduction of high-risk behaviors along with HIV prevalence supported development of STI counselling and testing, increasing syphilis infection and drug use during anal intercourse warrants further understanding.
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Affiliation(s)
- Yangchang Zhang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China
| | - Guohui Wu
- Institute for AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Rongrong Lu
- Institute for AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Wanyuan Xia
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China
| | - Ling Hu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China
| | - Yang Xiong
- Department of the First Clinical Medicine, Chongqing Medical University, Chongqing, 400016, China
| | - Junhao Xie
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China
| | - Qiuhua Yu
- Department of Nursing, Chongqing Medical University, Chongqing, 400016, China
| | - Mengliang Ye
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China.
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Huang W, Wu D, Pan SW, Li K, Ong JJ, Fu H, Liu C, Mao J, Tucker JD, Tang W. Driving force of condomless sex after online intervention among Chinese men who have sex with men. BMC Public Health 2019; 19:978. [PMID: 31331300 PMCID: PMC6647144 DOI: 10.1186/s12889-019-7307-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 07/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Condom use remains consistently low among Chinese men who have sex with men (MSM). This study aims to identify factors associated with condom use after online video intervention. METHODS This is a secondary data analysis of data collected from an online non-inferiority trial comparing the effectiveness of two condom use promotion video interventions among Chinese MSM. Participants from the two groups were combined since the effectiveness of two video interventions were shown to be non-inferior. Univariable and multivariable logistic regression were used to identify factors associated with condomless sex after the intervention during the follow-up interval. RESULTS Overall, 1173 participants were recruited at baseline and 791 (67.4%) completed the three-month follow-up survey. 57.3% (453/791) of the participants reported condomless sex after intervention in the three-month follow-up interval. MSM who have had sex under the influence of alcohol in the last 3 months (Odds Ratio(OR) = 1.90; 95% CI: 1.22, 2.97; Adjusted OR(AOR) = 1.79; 95% CI: 1.13, 2.83) and ever have had sex tourism (OR = 2.75; 95% CI: 1.34, 5.63; AOR = 2.40; 95% CI: 1.15, 5.07) at baseline were more likely to have condomless sex after intervention in the three-month follow-up period. MSM who had a higher level of community engagement in sexual health (OR = 0.54; 95% CI: 0.35, 0.82; AOR = 0.49; 95% CI: 0.32, 0.75 with substantial engagement) and who viewed additional condom promotion videos during the follow-up period by themselves (OR = 0.67; 95% CI = 0.50, 0.89; AOR = 0.67; 95% CI: 0.50, 0.91). were less likely to have condomless sex during the follow-up period. CONCLUSION The intervention appeared to be effective among MSM who reported viewing additional condom promotion videos by themselves and more community engagement after the intervention. In MSM who reported risky sexual behaviors at baseline, the intervention appeared less effective. Tailored intervention videos that target particular subgroups, active in-person community engagement, and optimized intervention frequency should be considered in future sexual health interventions.
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Affiliation(s)
- Wenting Huang
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
| | - Dan Wu
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
| | - Stephen W. Pan
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
- Department of Public Health, Xi’an Jiaotong-Liverpool University, Suzhou, China
| | - Katherine Li
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
- Weill Cornell Medical College, New York, USA
| | - Jason J. Ong
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
- Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, UK
| | - Hongyun Fu
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
| | - Chuncheng Liu
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
- Department of Sociology, University of California, San Diego, La Jolla USA
| | - Jessica Mao
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
- Department of Internal Medicine, Johns Hopkins Hospital, Baltimore, USA
| | - Joseph D. Tucker
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
- Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, UK
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Weiming Tang
- Dermatology Hospital of Southern Medical University, Guangzhou, China
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Wu T, Qu S, Fang Y, Ip M, Wang Z. Behavioral intention to perform risk compensation behaviors after receiving HPV vaccination among men who have sex with men in China. Hum Vaccin Immunother 2019; 15:1737-1744. [PMID: 31157598 DOI: 10.1080/21645515.2019.1622975] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Men who have sex with men (MSM) are recommended to take up human papillomavirus (HPV) vaccination. There are concerns that MSM would increase sexual risk behaviors after taking up HPV vaccination, a phenomenon known as risk compensation. This study investigated the prevalence of and factors associated with behavioral intention to reduce the frequency of condom use with men after receiving the HPV vaccination. The study was based on the baseline sample of an ongoing randomized controlled trial promoting HPV vaccination among MSM in Hong Kong. Hong Kong Chinese-speaking MSM who have never vaccinated against HPV were recruited from multiple sources. A total of 624 participants completed the baseline survey during July to December 2017. The prevalence of behavior intention to reduce the frequency of condom use with regular and non-regular male sex partners after receiving HPV vaccination was 6.9% and 4.0%; 8.0% of them intended to reduce condom use with either type of male partners after receiving the HPV vaccination. Adjusting for significant background variables (education level and condomless anal intercourse with men in the last six months), two constructs of the pre-intentional phase of Health Action Process Approach model were significantly associated with the dependent variable in the expected direction. They were (1) positive outcome expectancies of condomless anal intercourse after receiving HPV vaccination (adjusted odds ratios [AOR]: 1.29, 95% confidence interval [CI]: 1.12, 1.48, p < 0.001) and (2) perceived self-efficacy of consistent condom use after receiving HPV vaccination (AOR: 0.83, 95% CI: 0.70, 0.92, p = 0.001). Risk compensation may not be a major concern when promoting HPV vaccination among MSM. The results should be assuring health-care providers and policymakers.
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Affiliation(s)
- Terence Wu
- a JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong , Hong Kong , China
| | - Shuyu Qu
- b School of Public Health, Shanghai University of Traditional Chinese Medicine , Shanghai , China
| | - Yuan Fang
- a JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong , Hong Kong , China
| | - Mary Ip
- a JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong , Hong Kong , China
| | - Zixin Wang
- a JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong , Hong Kong , China.,c CUHK Shenzhen Research Institute, The Chinese University of Hong Kong , Shenzhen , China
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Zhao N, Li KT, Gao YY, Xu JJ, Huang DS. Mycoplasma Genitalium and Mycoplasma Hominis are prevalent and correlated with HIV risk in MSM: a cross-sectional study in Shenyang, China. BMC Infect Dis 2019; 19:494. [PMID: 31164096 PMCID: PMC6549264 DOI: 10.1186/s12879-019-4138-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/28/2019] [Indexed: 11/10/2022] Open
Abstract
Background A high proportion of men who have sex with men (MSM) use geosocial networking apps (Apps) to seek partners. However, the relationship of app use with HIV risk is unknown. Further, the risks of some sexually transmitted infection (STIs), including Mycoplasma genitalium, have seldom been studied among MSM. Methods MSM were enrolled at a community-based HIV testing site in Shenyang, China. After completing a questionnaire survey, we collected rectal swabs and venous blood specimens. We then simultaneously tested for ten STIs (Chlamydia trachomatis [CT], Neisseria gonorrhea [NG], Ureaplasma urealyticum [Uu], Ureaplasma parvum species [Up1, Up3, Up6, Up14), Mycoplasma hominis [Mh], Mycoplasma genitalium [Mg], and Herpes Simplex Virus Type 2 (HSV-2) using multiple PCR. We also performed blood tests for HIV, Syphilis, Hepatitis C antibody (HCV-Ab), Hepatitis B Surface Antigen (HBsAg), and Hepatitis A-IgM (HAV-IgM), etc. Results One hundred and eighty-three MSM participated in this study, of which 51.4% reported seeking partners through apps in the past year. The prevalence of HIV was 19.7%, Syphilis 12.0%, HAV 1.1%, rectal Mg 15.3% and Mh 7.1%. Multivariable logistic regression showed that HIV infection was independently correlated with app-using behavior (adjusted odds ratio[aOR] = 2.6), Mg infection (aOR = 3.2), Mh infection (aOR = 4.1) and Syphilis infection (aOR = 3.1) (each P < 0.05). Conclusions App use, Mg, Mh and Syphilis infection were correlated with higher HIV Risk in MSM. Geosocial networking apps should be utilized for HIV interventions targeting MSM. There is a need for more expansive STIs screening, particularly for Mg, Mh and Syphilis in MSM.
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Affiliation(s)
- Ning Zhao
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China.,Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | | | - Yang-Yang Gao
- Key Laboratory of AIDS Immunology of National Health Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, China
| | - Jun-Jie Xu
- Key Laboratory of AIDS Immunology of National Health Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, China
| | - De-Sheng Huang
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China. .,Department of Mathematics, School of Fundamental Sciences, China Medical University, Shenyang, 110122, China.
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Sun HY, Uemura H, Wong NS, Chan DPC, Wong BCK, Lin PH, Su LH, Hung CC, Oka S, Chang SY, Lee SS. Molecular epidemiology of acute HCV infection in HIV-positive patients from Hong Kong, Taipei, Tokyo. Liver Int 2019; 39:1044-1051. [PMID: 30770636 DOI: 10.1111/liv.14073] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/02/2019] [Accepted: 02/11/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Acute hepatitis C virus (HCV) infections have been increasingly reported among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) in the Asia-Pacific region. It remains unknown whether international network of HCV transmission has occurred in this region. METHODS HIV-positive patients with acute HCV infection, defined as HCV seroconversion within a year or documented acute hepatitis with seroconversion, diagnosed in Hong Kong, Taipei and Tokyo during 2010-2016 were included in this molecular epidemiology study. The NS5B region of the HCV genome (365 bp) was amplified using nested polymerase chain reaction and sequenced. RESULTS Of 234 HIV-positive patients with acute HCV infection, all were male with 94% being MSM. At the diagnosis of acute HCV infection, 73.5% had concurrent sexually transmitted diseases and 88.0% were receiving combination antiretroviral therapy. The most prevalent HCV genotype was 3a, 2a and 1b in Hong Kong, Taipei and Tokyo respectively. Nine independent clusters belonging to five genotypes (1b, 2a, 2c, 3a and 6a) were identified, each of which occurred in one city without overlapping except for one 3a sequence from Taipei that was closely related genetically to the Hong Kong cluster. CONCLUSIONS No international network of HCV transmission was identified among HIV-positive patients in the three Asia-Pacific cities. The transmission dynamics of sexually acquired HCV differed by city, but the risk of intercity clustering should not be ignored.
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Affiliation(s)
- Hsin-Yun Sun
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Haruka Uemura
- National Center for Global Health and Medicine, AIDS Clinical Center, Tokyo, Japan
| | - Ngai-Sze Wong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Denise P-C Chan
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Bonnie C-K Wong
- Special Prevention Programme, Department of Health, Centre for Health Protection, Hong Kong Special Administrative Region Government, Hong Kong, China
| | - Pi-Han Lin
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Li-Hsin Su
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chien-Ching Hung
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shinichi Oka
- National Center for Global Health and Medicine, AIDS Clinical Center, Tokyo, Japan
| | - Sui-Yuan Chang
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shui-Shan Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
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Modelling the Epidemiological Impact and Cost-Effectiveness of PrEP for HIV Transmission in MSM in China. AIDS Behav 2019; 23:523-533. [PMID: 29971734 DOI: 10.1007/s10461-018-2205-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Risk of HIV infection is high in Chinese MSM, with an annual HIV incidence ranging from 3.41 to 13.7/100 person-years. Tenofovir-based PrEP is effective in preventing HIV transmission in MSM. This study evaluates the epidemiological impact and cost-effectiveness of implementing PrEP in Chinese MSM over the next two decades. A compartmental model for HIV was used to forecast the impact of PrEP on number of infections, deaths, and disability-adjusted life years (DALY) averted. We also provide an estimate of the incremental cost-effectiveness ratio (ICER) and the cost per DALY averted of the intervention. Without PrEP, there will be 1.1-3.0 million new infections and 0.7-2.3 million HIV-related deaths in the next two decades. Moderate PrEP coverage (50%) would prevent 0.17-0.32 million new HIV infections. At Truvada's current price in China, daily oral PrEP costs $46,813-52,008 per DALY averted and is not cost-effective; on-demand Truvada reduces ICER to $25,057-27,838 per DALY averted, marginally cost-effective; daily generic tenofovir-based regimens further reduce ICER to $3675-8963, wholly cost-effective. The cost of daily oral Truvada PrEP regimen would need to be reduced by half to achieve cost-effectiveness and realize the public health good of preventing hundreds of thousands of HIV infections among MSM in China.
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38
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Yang LG, Zhang XH, Zhao PZ, Chen ZY, Ke WJ, Ren XQ, Wang LY, Chen WY, Tucker JD. Gonorrhea and chlamydia prevalence in different anatomical sites among men who have sex with men: a cross-sectional study in Guangzhou, China. BMC Infect Dis 2018; 18:675. [PMID: 30563478 PMCID: PMC6299533 DOI: 10.1186/s12879-018-3579-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 12/03/2018] [Indexed: 12/02/2022] Open
Abstract
Background A high rectal and oropharyngeal sexually transmitted infection (STI) burden has been reported among men who have sex with men (MSM) in many regions, but little data exists on rectal and oropharyngeal STIs among MSM in China. The purpose of this study was to determine the prevalence of gonorrhea and chlamydia at different anatomic sites among MSM in Guangzhou, China. Methods We recruited a cross-sectional sample of MSM in one Chinese city and collected detailed information about socio-demographic characteristics and sexual behaviors. Men had urine, rectal, and pharyngeal swab samples tested for gonorrhea and chlamydia using nucleic acid amplification tests (NAAT). Univariate and multivariate logistic regressions were used to evaluate factors associated with gonorrhea and chlamydia. Among men without any STI symptoms, we also examined the prevalence of gonorrhea and chlamydia by anatomical site. Results We enrolled 463 men between January 2015 and March 2017. A total of 58/463 (12.5%) of men had gonorrhea and 84/463 (18.1%) had chlamydia. MSM with gonorrhea were more likely to have been recruited from the STI clinic (OR 3.41, 95% CI 1.94–5.99), living with HIV (OR 2.41, 95% CI 1.18–4.92), diagnosed had STI co-infection (OR 2.55, 95% CI 1.39–4.69). MSM with chlamydia were more likely to be students (OR 1.8, 95% CI 0.99–3.39). Most gonorrhea (34/58, 59%) and chlamydia (64/84, 76%) infections were not associated with STI symptoms. Conclusion Asymptomatic gonorrhea and chlamydia infection were common in this sample of Chinese MSM. Further research is necessary to determine optimal STI screening programs.
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Affiliation(s)
- Li-Gang Yang
- Department of Sexually Transmitted Diseases, Dermatology Hospital, Southern Medical University, Guangzhou, 510091, China. .,Guangdong Provincial Dermatology Hospital, Guangzhou, 510091, China.
| | - Xiao-Hui Zhang
- Department of Sexually Transmitted Diseases, Dermatology Hospital, Southern Medical University, Guangzhou, 510091, China.,Guangdong Provincial Dermatology Hospital, Guangzhou, 510091, China
| | - Pei-Zhen Zhao
- Department of Sexually Transmitted Diseases, Dermatology Hospital, Southern Medical University, Guangzhou, 510091, China.,Guangdong Provincial Dermatology Hospital, Guangzhou, 510091, China
| | - Zheng-Yu Chen
- Department of Sexually Transmitted Diseases, Dermatology Hospital, Southern Medical University, Guangzhou, 510091, China.,Guangdong Provincial Dermatology Hospital, Guangzhou, 510091, China
| | - Wu-Jian Ke
- Department of Sexually Transmitted Diseases, Dermatology Hospital, Southern Medical University, Guangzhou, 510091, China.,Guangdong Provincial Dermatology Hospital, Guangzhou, 510091, China
| | - Xu-Qi Ren
- Department of Sexually Transmitted Diseases, Dermatology Hospital, Southern Medical University, Guangzhou, 510091, China.,Guangdong Provincial Dermatology Hospital, Guangzhou, 510091, China
| | - Liu-Yuan Wang
- Department of Sexually Transmitted Diseases, Dermatology Hospital, Southern Medical University, Guangzhou, 510091, China.,Guangdong Provincial Dermatology Hospital, Guangzhou, 510091, China
| | - Wei-Ying Chen
- Department of Sexually Transmitted Diseases, Dermatology Hospital, Southern Medical University, Guangzhou, 510091, China.,Guangdong Provincial Dermatology Hospital, Guangzhou, 510091, China
| | - Joseph D Tucker
- Department of Sexually Transmitted Diseases, Dermatology Hospital, Southern Medical University, Guangzhou, 510091, China.,Guangdong Provincial Dermatology Hospital, Guangzhou, 510091, China.,Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Raleigh, USA.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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Zhang C, Li X, Koniak-Griffin D, Goldsamt LA, Zhou J. Effectiveness of self-testing kits availability on improving HIV testing frequency for chinese men who have sex with men and their sexual partners: a protocol for a multicenter randomised controlled trial. BMJ Open 2018; 8:e024423. [PMID: 30552280 PMCID: PMC6303590 DOI: 10.1136/bmjopen-2018-024423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 08/29/2018] [Accepted: 10/12/2018] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION HIV epidemic is increasing among men who have sex with men (MSM) in China, yet HIV testing uptake remains low. As an emerging approach, HIV self-testing (HIVST) has the potential to promote HIV testing coverage and frequency in this population. However, evidence of the effectiveness on implementation of HIVST among Chinese MSM and their sexual partners is scarce. METHODS AND ANALYSIS The randomised controlled trial will be performed in Changsha, Changde, Shaoyang and Yiyang, Hunan province, China, recruiting 184 recent testers (men who had at least one HIV test within the past 2 years) and 26 non-recent testers (men who did not have HIV tests within 2 years or never had an HIV test). Eligible men will be randomly divided 1:1 into two groups: intervention (with free HIVST kits plus site-based HIV testing services) and control (site-based HIV testing services only). Participants in the intervention group will be provided with two free finger-prick-based HIVST kits, and can apply for two to four kits every 3 months for 1 year.Participants in both groups will complete questionnaires via WeChat at five separate times: baseline, third, sixth, ninth and twelfth month. The primary outcome is the mean number of HIV tests for MSM over the 12-month study period. The secondary outcome is the mean number of HIV tests for sexual partners of MSM over the 12-month study period. The tertiary outcomes are the self-reported proportion of consistent condom usage for anal sex, and the numbers of sexual partners during the 12-month study period. ETHICS AND DISSEMINATION The study has been approved by the Institutional Review Board of Behavioural and Nursing Research in Xiangya School of Nursing of Central South University, China (2018002). Study results will be disseminated through conferences and academic journals. TRIAL REGISTRATION NUMBER ChiCTR1800015584; Pre-results.
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Affiliation(s)
- Ci Zhang
- Xiangya Nursing School of Central South University, Changsha, China
| | - Xianhong Li
- Xiangya Nursing School of Central South University, Changsha, China
| | - Deborah Koniak-Griffin
- School of Nursing of University of California at Los Angeles, Los Angeles, California, USA
| | - Lloyd A. Goldsamt
- New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Jing Zhou
- Xiangya Nursing School of Central South University, Changsha, China
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Fu R, Zhao J, Wu D, Zhang X, Tucker JD, Zhang M, Tang W. A spatiotemporal meta-analysis of HIV/syphilis epidemic among men who have sex with men living in mainland China. BMC Infect Dis 2018; 18:652. [PMID: 30541463 PMCID: PMC6292157 DOI: 10.1186/s12879-018-3532-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/20/2018] [Indexed: 11/25/2022] Open
Abstract
Background Geographic differences in HIV, syphilis and condomless sex among men who have sex with men in China remained unknown. We aimed to elucidate these spatiotemporal changing patterns in China. Methods We conducted a spatiotemporal meta-analysis. We searched four databases for studies conducted between 2001 and 2015. We included studies that reported original data of HIV/syphilis prevalence in China, the study’s area/province, and period of data collection. We grouped studies into six regions and four time periods. We examined the changing patterns of national and regional prevalence of HIV, syphilis and condomless sex. Results Search results yielded 2119 papers, and 272 were included in the meta-analysis. The sample sizes of the studies ranged from 19 to 47,231. National HIV prevalence increased from 3.8% (95% CI 3.0–4.8) in 2001–07 to 6.6% (5.6–7.7) in 2013–15. In most regions, the rise occurred before 2010 and the HIV prevalence remained relatively stable afterwards, except for the Northwest which showed a considerable increase since 2008. National syphilis prevalence decreased from 12.3% (10.2–14.9) in 2001–07 to 7.1% (5.6–8.9) in 2013–15. Conclusions The trends of HIV and syphilis infections have been effectively curbed in MSM in most regions of China. Continuous efforts, particularly promotion of condom use, are needed to further reduce these infections. Electronic supplementary material The online version of this article (10.1186/s12879-018-3532-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rong Fu
- Dermatology Hospital, Southern Medical University, Guangzhou, 510095, Guangdong, China.,University of North Carolina Project-China, Guangzhou, China.,SESH (Social Entrepreneurship to Spur Health) study group, Guangzhou, China
| | - Jinkou Zhao
- Technical Advice and Partnership Department, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
| | - Dan Wu
- Dermatology Hospital, Southern Medical University, Guangzhou, 510095, Guangdong, China.,University of North Carolina Project-China, Guangzhou, China.,SESH (Social Entrepreneurship to Spur Health) study group, Guangzhou, China
| | - Xiayan Zhang
- Shijingshan District Center for Disease Control and Prevention, Beijing, China
| | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China.,SESH (Social Entrepreneurship to Spur Health) study group, Guangzhou, China
| | - Meiwen Zhang
- Claremont Graduate University, Claremont, CA, USA
| | - Weiming Tang
- Dermatology Hospital, Southern Medical University, Guangzhou, 510095, Guangdong, China. .,University of North Carolina Project-China, Guangzhou, China. .,SESH (Social Entrepreneurship to Spur Health) study group, Guangzhou, China.
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Tang W, Liu C, Cao B, Pan SW, Zhang Y, Ong J, Fu H, Ma B, Fu R, Yang B, Ma W, Wei C, Tucker JD. Receiving HIV Serostatus Disclosure from Partners Before Sex: Results from an Online Survey of Chinese Men Who Have Sex with Men. AIDS Behav 2018; 22:3826-3835. [PMID: 29470809 PMCID: PMC6105569 DOI: 10.1007/s10461-018-2062-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
HIV serostatus disclosure before sex can facilitate serosorting, condom use and potentially decrease the risk of HIV acquisition. However, few studies have evaluated HIV serostatus disclosure from partners before sex. We examined the rate and correlates of receiving HIV serostatus disclosure from regular and casual male partners before sex among an online sample of men who have sex with men (MSM) in China. An online cross-sectional study was conducted among MSM in eight Chinese cities in July 2016. Participants completed questions covering sociodemographic information, sexual behaviors, HIV testing (including HIV self-testing) history, self-reported HIV status, and post-test violence. In addition, participants were asked whether they received HIV serostatus disclosure from their most recent partners before sex. Overall, 2105 men completed the survey. Among them, 85.9% were never married, and 35.4% had high school or less education. A minority (20.6%, 346/1678; 17.8%, 287/1608) of men received HIV serostatus disclosure from their most recent regular and casual male partners, respectively. Multivariate analysis indicated that participants who ever self-tested for HIV were more likely to have received HIV status disclosure from regular [adjusted OR (aOR) = 1.92, 95% CI 1.50-2.44] and casual (aOR = 2.34, 95% CI 1.80-3.04) male partners compared to never self-tested participants. Compared to participants who had not received HIV status disclosure from regular partners, participants who received disclosure from regular male partners had higher likelihood in experiencing post-test violence (aOR = 5.18, 95% CI 1.53-17.58). Similar results were also found for receiving HIV serostatus disclosure from casual partners. This study showed that HIV serostatus disclosure from partners was uncommon among Chinese MSM. Interventions and further implementation research to facilitate safe disclosure are urgently needed for MSM.
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Affiliation(s)
- Weiming Tang
- University of North Carolina at Chapel Hill Project-China, Guangzhou, 510095, China.
- SESH Study Group, Guangzhou, China.
- Dermatology Hospital of Southern Medical University (Guangdong Dermatology Hospital), Guangzhou, China.
- School of Medicine of University of North Carolina at Chapel Hill, Chapel Hill, USA.
| | - Chuncheng Liu
- University of North Carolina at Chapel Hill Project-China, Guangzhou, 510095, China
- SESH Study Group, Guangzhou, China
- Department of Sociology, University of California, San Diego, La Jolla, USA
| | - Bolin Cao
- University of North Carolina at Chapel Hill Project-China, Guangzhou, 510095, China
- SESH Study Group, Guangzhou, China
- College of Mass Communication, Shenzhen University, Shenzhen, China
| | - Stephen W Pan
- University of North Carolina at Chapel Hill Project-China, Guangzhou, 510095, China
- SESH Study Group, Guangzhou, China
| | - Ye Zhang
- University of North Carolina at Chapel Hill Project-China, Guangzhou, 510095, China
- SESH Study Group, Guangzhou, China
- Dermatology Hospital of Southern Medical University (Guangdong Dermatology Hospital), Guangzhou, China
| | - Jason Ong
- University of North Carolina at Chapel Hill Project-China, Guangzhou, 510095, China
| | - Hongyun Fu
- Division of Community Health and Research, Eastern Virginia Medical School, Norfolk, VA, USA
| | | | - Rong Fu
- University of North Carolina at Chapel Hill Project-China, Guangzhou, 510095, China
- SESH Study Group, Guangzhou, China
| | - Bin Yang
- Dermatology Hospital of Southern Medical University (Guangdong Dermatology Hospital), Guangzhou, China
| | - Wei Ma
- School of Public Health, Shandong University, Jinan, China
| | - Chongyi Wei
- School of Medicine, University of California, San Francisco, San Francisco, USA
| | - Joseph D Tucker
- University of North Carolina at Chapel Hill Project-China, Guangzhou, 510095, China
- SESH Study Group, Guangzhou, China
- School of Medicine of University of North Carolina at Chapel Hill, Chapel Hill, USA
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Cheng W, Xu H, Zhong F, Pan S, Tucker JD, Weir S, Zhao J, Tang W. Can HIV service data be used for surveillance purposes?: a case study in Guangzhou, China. BMC Public Health 2018; 18:1268. [PMID: 30453934 PMCID: PMC6245699 DOI: 10.1186/s12889-018-6128-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 10/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Timely monitoring HIV epidemic among key populations is a formidable challenge. This study aimed to evaluate the agreement between data collected from an enhanced HIV sentinel surveillance (HSS+) and an HIV service, and to discuss whether testing service data can be used for surveillance purposes. METHODS The HSS+ data were collected from HIV sentinel surveillance conducted annually among men who have sex with men (MSM) between 2009 and 2013 in Guangzhou, China. The HIV service data were obtained from the China-Bill & Melinda Gates Foundation Cooperation Program on HIV Prevention and Care (China-Gates HIV Program) in Guangzhou during the same period. The China-Gates HIV Program aimed to increase HIV counseling and testing among MSM. We compared demographic characteristics, condom use, HIV testing history, and the HIV status among individuals in these two datasets. The Armitage-trend test was used to evaluate the HIV epidemic and behaviors of the participants in the two datasets over the study period. RESULTS Overall, a total of 2224 and 5311 MSM were included in the surveillance and service datasets, respectively. The majority of participants in the two datasets were between 20 and 29 years old, at least attended college, and had never been married. However, socio-demographic characteristics varied slightly between the two datasets. Similar trends were observed for the HIV epidemic in these two datasets. The surveillance dataset indicated that HIV prevalence increased from 3.9% in 2009 to 11.4% in 2013 (P-value for trend < 0.001), while data from the HIV service dataset indicated that MSM HIV prevalence during this same period increased from 6.2 to 8.9% (P-value for trend = 0.025). The rates of condom use were similar between the two datasets and remained consistent throughout the study period. CONCLUSION HIV service data can complement existing HIV surveillance systems for MSM in China, though it may underestimate the HIV prevalence (HSS+ data contains people whose status is already know, while service data contains people who were initially negative or people of unknown status). HIV service data can be used for surveillance purposes, when prerequisite variables are collected from a large number people, if the quality assessment is conducted.
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Affiliation(s)
- Weibin Cheng
- Dermatology Hospital of Southern Medical University, Guangzhou, China.,Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Huifang Xu
- Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Fei Zhong
- Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Stephen Pan
- University of North Carolina Project-China, No. 2 Lujing Road, Guangzhou, China
| | - Joseph D Tucker
- University of North Carolina Project-China, No. 2 Lujing Road, Guangzhou, China
| | - Sharon Weir
- School of Medicine of University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jinkou Zhao
- Technical Advice and Partnership Department, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Chemin de Blandonnet 8, CH 1214, Geneva, Switzerland.
| | - Weiming Tang
- Dermatology Hospital of Southern Medical University, Guangzhou, China. .,University of North Carolina Project-China, No. 2 Lujing Road, Guangzhou, China.
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Wang C, Tucker JD, Liu C, Zheng H, Tang W, Ling L. Condom use social norms and self-efficacy with different kinds of male partners among Chinese men who have sex with men: results from an online survey. BMC Public Health 2018; 18:1175. [PMID: 30326880 PMCID: PMC6192108 DOI: 10.1186/s12889-018-6090-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 10/04/2018] [Indexed: 01/09/2023] Open
Abstract
Background Social norms and self-efficacy play important roles in promoting consistent condom use among men who have sex with men (MSM). Few studies have investigated the association between social norms, self-efficacy and consistent condom use with different kinds of male partners among MSM. We conducted an online survey of MSM to evaluate this in China. Methods A cross-sectional online survey was conducted in 2015. Participants completed a validated questionnaire covering socio-demographic information, consistent condom use, condom use social norms and self-efficacy. Eligible participants were 16 or older, born biologically as a male, engaged in anal sex with a man at least once during their lifetime, engaged in condomless anal or vaginal sex in the last three months. In this study, we further restricted to people who had sex with male partners in the last three months. Participants were classified into three groups: engaged in sex only with regular partners, engaged in sex only with casual partners and engaged in sex with both regular partners and casual partners. Results Participants were recruited from 32 provinces in China. Among 1057 participants, 451(42.7%), 217(20.5%), and 389(36.8%) engaged in sex with regular partners only, casual partners only and both types in the last three months, respectively. Men engaged in sex only with regular partners in the last three months had a higher condom use self-efficacy than with other two types of partners (P < 0.01). Both social norms (regular partners: adjusted OR:1.59, 95% CI: 0.97–2.60; casual partners: adjusted OR: 1.58, 95% CI: 1.19–2.09; both types: adjusted OR: 1.48, 95% CI: 1.13–1.95) and self-efficacy (regular partners: adjusted OR: 2.88, 95% CI: 1.59–5.22; casual partners: adjusted OR: 2.35, 95% CI: 1.69–3.26; both types: adjusted OR: 2.45, 95% CI: 1.81–3.32) were positively associated with consistent condom use. No interaction effect was detected between condom social norms and self-efficacy on consistent condom use among Chinese MSM (p > 0.05). Conclusions Both social norms and self-efficacy were positively correlated with consistent condom use with any types of partners among Chinese MSM. Tailored interventions that aimed to improve social norms and self-efficacy has the potential to improve overall condom use among Chinese MSM. Trial registration ClinicalTrials.gov: NCT02516930. August 6, 2015. Electronic supplementary material The online version of this article (10.1186/s12889-018-6090-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cheng Wang
- Dermatology Hospital, Southern Medical University, Guangzhou, China.,Guangdong Center for Skin Diseases and STI Control, Guangzhou, China
| | - Joseph D Tucker
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China.,SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China.,School of Medicine of University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Chuncheng Liu
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China.,SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China
| | - Heping Zheng
- Dermatology Hospital, Southern Medical University, Guangzhou, China.,Guangdong Center for Skin Diseases and STI Control, Guangzhou, China
| | - Weiming Tang
- Dermatology Hospital, Southern Medical University, Guangzhou, China. .,Guangdong Center for Skin Diseases and STI Control, Guangzhou, China. .,University of North Carolina at Chapel Hill Project-China, Guangzhou, China. .,SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China. .,School of Medicine of University of North Carolina at Chapel Hill, Chapel Hill, USA.
| | - Li Ling
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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Cao WW, Zhou RR, Ou X, Shi LX, Xiao CQ, Chen TY, Tan H, Fan XG, Li BJ, Li N. Prevalence of hepatitis B virus, hepatitis C virus, human immunodeficiency virus and Treponema pallidum infections in hospitalized patients before transfusion in Xiangya hospital Central South University, China from 2011 to 2016. BMC Infect Dis 2018; 18:145. [PMID: 29606088 PMCID: PMC5879580 DOI: 10.1186/s12879-018-3051-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 03/20/2018] [Indexed: 01/17/2023] Open
Abstract
Background Human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and Treponema pallidum (TP) infections are considered classic transfusion-transmissible infections (TTIs). Few data are available about the prevalence of TTIs in patients before blood transfusion in China. This study aimed to investigate the seroprevalence of four TTIs among patients before blood transfusion in Xiangya Hospital Central South University, China. Methods From 2011 to 2016, 442,121 hospitalized patients before possible blood transfusion were tested for hepatitis B surface antigen (HBsAg), anti-HCV, syphilis antibody (anti-TP) and anti-HIV. Results Of the 442,121 patients, the overall positivity of the four TTI serum markers was 15.35%. The positive rates of HBsAg, anti-HCV, anti-HIV and anti-TP were 10.98, 1.43, 0.16 and 2.78%, respectively. TTI serum markers showed a significant difference by gender, with positive rates of 17.98% for males and 12.79% for females. The prevalence of TTI serum markers varied significantly by age. The overall co-infection rate was 0.63%, and the top three multiple infections were HBV-TP, HBV-HCV, and HCV-TP. The co-infection rates of HBV-TP and HBV-HCV showed a significant decrease from 2011 to 2016, while the rates of other co-infections remained stable. Conclusions The prevalence of TTIs in patients before blood transfusion is much higher compared to that in blood donors in the region. The infection rates of HIV and TP increased, and the infection rate of HBsAg decreased in recent years. Electronic supplementary material The online version of this article (10.1186/s12879-018-3051-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wei-Wei Cao
- Department of Blood Transfusion of Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Rong-Rong Zhou
- Department of Infectious Diseases, Xiangya Hospital, Central South University, Changsha, China
| | - Xinghua Ou
- Center for Disease Prevention and Control of Changsha, Changsha, China
| | - Ling-Xi Shi
- Department of Blood Transfusion of Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Chao-Qi Xiao
- Department of Blood Transfusion of Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Ting-Yin Chen
- Department of Information of Xiangya Hospital, Central South University, Changsha, China
| | - Hua Tan
- Center for Disease Prevention and Control of Kaifu District, Changsha, China
| | - Xue-Gong Fan
- Department of Infectious Diseases, Xiangya Hospital, Central South University, Changsha, China
| | - Bi-Juan Li
- Department of Blood Transfusion of Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Ning Li
- Department of Blood Transfusion of Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China.
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Guanghua L, Yi C, Shuai T, Zhiyong S, Zhenzhu T, Yuhua R, Yousuf MA, Wensheng F. HIV, syphilis and behavioral risk factors among men who have sex with men in a drug-using area of southwestern China: Results of 3 cross-sectional surveys from 2013 to 2015. Medicine (Baltimore) 2018; 97:e0404. [PMID: 29668597 PMCID: PMC5916656 DOI: 10.1097/md.0000000000010404] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To assess human immunodeficiency virus (HIV), syphilis, and behavioral risk factors among men who have sex with men (MSM) in southwestern China, where HIV started as a drug-driven epidemic, and shifted to mainly heterosexual transmission.These cross-sectional studies were conducted yearly in 2013, 2014, and 2015 in Guangxi, China. A total of 1,996, 1,965, and 1,697 participants were recruited in 2013, 2014, and 2015, respectively. The data included demographic and sexual behavioral variables. Other variables included individuals who used illegal drugs, and who received HIV counseling, testing, and free condoms, and peer education. Participants were tested for HIV, syphilis, and hepatitis C virus (HCV) with whole blood specimens. Questionnaires and laboratory testing data were double entered, and validated with EpiData software. The data were then transferred into SPSS software (SPSS Inc, Chicago, IL) and Chi-square test performed.The prevalence of HIV was 6.6% in 2013, 8.4% in 2014, and 11.2% in 2015. The prevalence of syphilis was 9.3% in 2013, 9.8% in 2014, and 6.1% in 2015. And HCV prevalence was 0.5% in 2013 and remained stable at 0.4% in 2014, and 2015. HIV infection, and associated factors among MSM in these 3 annual cross-sectional survey showed that HIV-infected MSM were significantly, more likely, to perform unprotected anal intercourse with any commercial male partners in the past 6 months (adjusted odds ratio [AOR] = 1.81, 95% CI: 1.50-2.20), had sex with any female partners in the past 6 months (AOR = 1.31, 95% CI: 1.01-1.71), used drugs in the past (AOR = 2.73, 95% CI: 1.30-5.71), and are syphilis infected (AOR = 3.53, 95% CI: 2.77-4.49).There is an urgent need for intervention strategies like condom distribution, HIV counseling, free testing, and education regarding safe sex, HIV, and other sex-related diseases in Guangxi to curb, and prevent HIV among MSM.
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Affiliation(s)
- Lan Guanghua
- Guangxi Center for Disease Control and Prevention, Nanning
| | - Chen Yi
- Guangxi Center for Disease Control and Prevention, Nanning
| | - Tang Shuai
- Guangxi Center for Disease Control and Prevention, Nanning
| | - Shen Zhiyong
- Guangxi Center for Disease Control and Prevention, Nanning
| | - Tang Zhenzhu
- Guangxi Center for Disease Control and Prevention, Nanning
| | - Ruan Yuhua
- State Key Laboratory for Infectious Disease Prevention and Control (SKLID), Chinese Center for Disease Control and Prevention (China CDC), Beijing
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | | | - Fan Wensheng
- Department of Health Services Administration, Florida International University, Miami, FL
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Zhang J, Xu JJ, Song W, Pan S, Chu ZX, Hu QH, Yu H, Mao X, Jiang YJ, Geng WQ, Shang H, Wang N. HIV Incidence and Care Linkage among MSM First-Time-Testers in Shenyang, China 2012-2014. AIDS Behav 2018; 22:711-721. [PMID: 28660379 DOI: 10.1007/s10461-017-1840-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
HIV testing is the first step to the fulfillment of Treat as Prevention (TasP) and reaching the 90-90-90 goal in HIV control. However, there are still a large number of Men who have Sex with Men (MSM) have never been tested for HIV before, and little is known about the HIV incidence and care linkage among this population. A Mixed method was used to recruit MSM who had never tested for HIV before from January 2012 to December 2014 in Shenyang, China. Potential MSM participants were invited to attend the enrollment for HIV and syphilis testing at a general hospital-based voluntary counseling and test (VCT). HIV confirmed positive subjects were further tested by BED HIV-1 capture enzyme immunoassay (BED-CEIA) to determine the HIV incidence. Syphilis was screened by the rapid plasma reagent test (RPR) and confirmed by Treponema pallidum particle assay (TPPA). All the HIV positive subjects were referred to the local Center for Disease Control and Prevention (CDC) and clinics for HIV primary care and follow-ups. In total 646 HIV first-time-testers of MSM (FMSM) attended this study, 73.4% (474/646) were aged under 31-year-old and 57.3% (370/646) and used the Internet as their major cruising avenue for seeking male sexual partners. The average prevalence of HIV and current syphilis infection was 10.8% (70/646) and 11.0% (71/646), respectively. The HIV incidence was 10.3 (95% confidence interval [CI] 6.1-14.5)/100PY. Multivariate logistic analysis showed that factors such as use of the Internet as the major cruising avenue (adjusted OR [AOR] 2.7, 95% CI 0.9-7.6) and having a current syphilis infection (AOR 4.2, 95% CI 1.8-12.2) were independent correlates of a recent HIV infection. Of the 95 HIV screening test positive FMSM, 73.7% (70/95) returned and be confirmed positive, 92.9% (65/70) of confirmed patients were linked to care. Among those retained and underwent CD4+ T cell test, 76.3% (42/55) started HIV antiretroviral therapy. Among the unconfirmed, 84.0% (21/25) were non-local migrants. The HIV incidence of FMSM in Shenyang was high. Future HIV testing program needs to keep on expanding among the MSM who have never been tested for HIV yet. The Internet-based campaigns and syphilis testing and treatment could represent an opportunity to get access to this hard-to-reach population and link them to HIV care. Future linkage to HIV care of this population should underscore the usage of HIV rapid diagnostic tests to prevent lost at early steps of linkage.
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Affiliation(s)
- Jing Zhang
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, No 155, Nanjingbei Street, Heping District, Shenyang, 110001, Liaoning, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Jun-Jie Xu
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, No 155, Nanjingbei Street, Heping District, Shenyang, 110001, Liaoning, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Wei Song
- Shenyang Center for Disease Control and Prevention, No. 37, Qishanzhong Street, Heping District, Shenyang, Liaoning, China
| | - Shi Pan
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, No 155, Nanjingbei Street, Heping District, Shenyang, 110001, Liaoning, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Zhen-Xing Chu
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, No 155, Nanjingbei Street, Heping District, Shenyang, 110001, Liaoning, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Qing-Hai Hu
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, No 155, Nanjingbei Street, Heping District, Shenyang, 110001, Liaoning, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Huan Yu
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, No 155, Nanjingbei Street, Heping District, Shenyang, 110001, Liaoning, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Xiang Mao
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, No 155, Nanjingbei Street, Heping District, Shenyang, 110001, Liaoning, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Yong-Jun Jiang
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, No 155, Nanjingbei Street, Heping District, Shenyang, 110001, Liaoning, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Wen-Qing Geng
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, No 155, Nanjingbei Street, Heping District, Shenyang, 110001, Liaoning, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Hong Shang
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, No 155, Nanjingbei Street, Heping District, Shenyang, 110001, Liaoning, China.
| | - Ning Wang
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, No 155, Nanjingbei Street, Heping District, Shenyang, 110001, Liaoning, China.
- National Center for AIDS/STI Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing, China.
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Wang C, Mollan KR, Hudgens MG, Tucker JD, Zheng H, Tang W, Ling L. Generalisability of an online randomised controlled trial: an empirical analysis. J Epidemiol Community Health 2018; 72:173-178. [PMID: 29183956 PMCID: PMC5880638 DOI: 10.1136/jech-2017-209976] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/09/2017] [Accepted: 11/13/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND Investigators increasingly use online methods to recruit participants for randomised controlled trials (RCTs). However, the extent to which participants recruited online represent populations of interest is unknown. We evaluated how generalisable an online RCT sample is to men who have sex with men in China. METHODS Inverse probability of sampling weights (IPSW) and the G-formula were used to examine the generalisability of an online RCT using model-based approaches. Online RCT data and national cross-sectional study data from China were analysed to illustrate the process of quantitatively assessing generalisability. The RCT (identifier NCT02248558) randomly assigned participants to a crowdsourced or health marketing video for promotion of HIV testing. The primary outcome was self-reported HIV testing within 4 weeks, with a non-inferiority margin of -3%. RESULTS In the original online RCT analysis, the estimated difference in proportions of HIV tested between the two arms (crowdsourcing and health marketing) was 2.1% (95% CI, -5.4% to 9.7%). The hypothesis that the crowdsourced video was not inferior to the health marketing video to promote HIV testing was not demonstrated. The IPSW and G-formula estimated differences were -2.6% (95% CI, -14.2 to 8.9) and 2.7% (95% CI, -10.7 to 16.2), with both approaches also not establishing non-inferiority. CONCLUSIONS Conducting generalisability analysis of an online RCT is feasible. Examining the generalisability of online RCTs is an important step before an intervention is scaled up. TRIAL REGISTRATION NUMBER NCT02248558.
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Affiliation(s)
- Cheng Wang
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Guangdong Provincial Dermatology Hospital, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
| | - Katie R. Mollan
- Center for AIDS Research, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Michael G. Hudgens
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joseph D. Tucker
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Guangdong Provincial Dermatology Hospital, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
| | - Heping Zheng
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Guangdong Provincial Dermatology Hospital, Guangzhou, China
| | - Weiming Tang
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Guangdong Provincial Dermatology Hospital, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
| | - Li Ling
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Changing Epidemic of HIV and Syphilis Among Resident and Migrant Men Who Have Sex with Men in Jiangsu, China. Sci Rep 2017; 7:9478. [PMID: 28842553 PMCID: PMC5573352 DOI: 10.1038/s41598-017-08671-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 07/12/2017] [Indexed: 11/08/2022] Open
Abstract
Men who have sex with men (MSM) in China face high rates of HIV and syphilis infection exacerbated by internal migration. Studies on the differences of HIV and syphilis epidemics changing trends in high-risk behaviors and geographic distribution between resident and migrant MSM in Jiangsu, China were conducted. MSM were recruited from 14 surveillance sites in the serial cross-sectional study. Data on demographics, sexual behaviors, HIV and syphilis prevalence were collected. Participants were classified as residents or migrants based on household registration. During 2010–2014, 19,750 MSM were investigated. Engaged in anal sex (76.3% to 80.2%, P < 0.01) as well as received HIV-related services (72.1% to 79.2%, P < 0.01) were increasing. In contrast, engaged in commercial anal sex with males (7.4% to 5.0%, P < 0.01) and drug use (1.6% to 0.8%, P < 0.01) were decreasing. HIV prevalence ranged between 8.6% to 9.6%, while syphilis prevalence decreased over time (13.4–6.8%, P < 0.01). Further, we found that migrant MSM were more likely to engage in condomless anal sex, also had a higher HIV and syphilis prevalence than resident. During the study period, while syphilis prevalence decreased, higher rates of risk behaviors among migrant MSM called for targeted intervention strategies to reduce the HIV transmission.
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Hu J, Gu X, Tao X, Qian Y, Babu GR, Wang G, Liao M, Han L, Kang D, Tang W. Prevalence and Trends of HIV, Syphilis, and HCV in Migrant and Resident Men Who Have Sex with Men in Shandong, China: Results from a Serial Cross-Sectional Study. PLoS One 2017; 12:e0170443. [PMID: 28103295 PMCID: PMC5245858 DOI: 10.1371/journal.pone.0170443] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 01/04/2017] [Indexed: 11/18/2022] Open
Abstract
Background Migrant men who have sex with men (MSM) have a higher predisposition for HIV transmission. We aimed to determine and compare the prevalence and trends of HIV, Syphilis, and HCV between migrant and resident MSM in Shandong, China. Methods A serial cross-sectional study was conducted in eight cities in Shandong, China from 2010 to 2014. The surveys collected information on demographics, HIV-related knowledge, and HIV-related behaviors including the serologic status of HIV, syphilis, and HCV. Bivariate and multivariable logistic regressions were used to determine differences between migrant and resident MSM. Results The overall prevalence of HIV among the 15,705 MSM (14120 were resident, 1580 were migrant and 5 were missing) was 2.6%, with an increase of 1.0% in 2010 to 4.4% in 2014. Prevalence of HIV was higher among migrant MSMs (5.5%) compared to resident MSMs (2.3%). Compared to residents, migrants also had higher prevalence of syphilis (7.5% vs 4.9%) and HCV (1.1% vs 0.6%). We found that there was an increase in the proportion of migrant MSM engaging in anal sex [adjusted OR (AOR) = 1.41 in migrants vs 1.12 in residents], condom use during last anal sex (AOR = 1.14 in residents, P for trend = 0.32), consistent condom use (AOR = 1.04 residents, P for trend = 0.11) and drug use (AOR = 1.51 in migrants and 1.29 among residents). Except in the year 2011, receiving some health services in last year was significant for people who were HIV-positive compared to negative. (P for trend <0.05). Conclusions Prevalence of HIV increased in resident as well as migrant MSMs. The migrant MSMs had higher STIs compared to resident MSMs and therefore, should be targeted for effective interventions aimed at reducing their risk behaviors. Deeper understanding of the role of migration in health issues is required for combating the persistently high and gradually increasing HIV burden in MSM in China.
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Affiliation(s)
- Jun Hu
- Institute of HIV/AIDS Prevention and Control, Shandong Provincial Center for Diseases Control and Prevention, Shandong, China
| | - Xu Gu
- Department of Epidemiology, School of Public Health, Weifang Medical College, Shandong, China
| | - Xiaorun Tao
- Institute of HIV/AIDS Prevention and Control, Shandong Provincial Center for Diseases Control and Prevention, Shandong, China
| | - Yaosheng Qian
- Institute of HIV/AIDS Prevention and Control, Shandong Provincial Center for Diseases Control and Prevention, Shandong, China
| | | | - Guoyong Wang
- Institute of HIV/AIDS Prevention and Control, Shandong Provincial Center for Diseases Control and Prevention, Shandong, China
| | - Meizhen Liao
- Institute of HIV/AIDS Prevention and Control, Shandong Provincial Center for Diseases Control and Prevention, Shandong, China
| | - Larry Han
- Project-China, University of North Carolina, Guangzhou, China
| | - Dianmin Kang
- Institute of HIV/AIDS Prevention and Control, Shandong Provincial Center for Diseases Control and Prevention, Shandong, China
- * E-mail: (DK); (WT)
| | - Weiming Tang
- Project-China, University of North Carolina, Guangzhou, China
- * E-mail: (DK); (WT)
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HIV epidemiology and responses among men who have sex with men and transgender individuals in China: a scoping review. BMC Infect Dis 2016; 16:588. [PMID: 27765021 PMCID: PMC5073436 DOI: 10.1186/s12879-016-1904-5] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 10/06/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite global efforts to control HIV among key populations, new infections among men who have sex with men (MSM) and transgender (TG) individuals are still increasing. The increasing HIV epidemic among MSM/TG in China indicates that more effective services are urgently needed. However, policymakers and program managers must have a clear understanding of MSM/TG sexual health in China to improve service delivery. To meet this need, we undertook a scoping review to summarize HIV epidemiology and responses among MSM and TG individuals in China. METHODS We searched MEDLINE, EMBASE and the Cochrane Library for recent studies on MSM/TG HIV epidemiology and responses. We also included supplemental articles, grey literature, government reports, policy documents, and best practice guidelines. RESULTS Overall, HIV prevalence among Chinese MSM was approximately 8 % in 2015 with a higher prevalence observed in Southwest China. TG are not captured in national HIV, STD, or other sexual health surveillance systems. There is limited data sharing between the public health authorities and community-based organizations (CBOs). Like other low and middle income countries, China is challenged by low rates of HIV testing, linkage, and retention. Several pilot interventions have been shown to be effective to increase HIV testing among MSM and TG individuals, but have not been widely scaled up. Data from two randomized controlled trials suggests that crowdsourcing contests can increase HIV testing, creating demand for services while engaging communities. CONCLUSION Improving HIV surveillance and expanding HIV interventions for Chinese MSM and TG individuals are essential. Further implementation research is needed to ensure high-quality HIV services for MSM and TG individuals in China.
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