1
|
He L, Jiang T, Chen W, Jiang S, Zheng J, Chen W, Wang H, Ma Q, Chai C. Examining HIV Testing Coverage and Factors Influencing First-Time Testing Among Men Who Have Sex With Men in Zhejiang Province, China: Cross-Sectional Study Based on a Large Internet Survey. JMIR Public Health Surveill 2024; 10:e56906. [PMID: 38875001 PMCID: PMC11214029 DOI: 10.2196/56906] [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: 01/30/2024] [Revised: 02/20/2024] [Accepted: 05/05/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Men who have sex with men (MSM) constitute a significant population of patients infected with HIV. In recent years, several efforts have been made to promote HIV testing among MSM in China. OBJECTIVE This study aimed to assess HIV testing coverage and factors associated with first-time HIV testing among MSM to provide a scientific basis for achieving the goal of diagnosing 95% of patients infected with HIV by 2030. METHODS This cross-sectional study was conducted between July 2023 and December 2023. MSM were recruited from the "Sunshine Test," an internet platform that uses location-based services to offer free HIV testing services to MSM by visiting the WeChat official account in Zhejiang Province, China. Participants were required to complete a questionnaire on their demographic characteristics, sexual behaviors, substance use, and HIV testing history. A logistic regression model was used to analyze first-time HIV testing and its associated factors. RESULTS A total of 7629 MSM participated in the study, with 87.1% (6647) having undergone HIV testing before and 12.9% (982) undergoing HIV testing for the first time. Multivariate logistic regression analysis revealed that first-time HIV testing was associated with younger age (adjusted odds ratio [aOR] 2.55, 95% CI 1.91-3.42), lower education (aOR 1.39, 95% CI 1.03-1.88), student status (aOR 1.35, 95% CI 1.04-1.75), low income (aOR 1.55, 95% CI 1.16-2.08), insertive anal sex role (aOR 1.28, 95% CI 1.05-1.56), bisexuality (aOR 1.69, 95% CI 1.40-2.03), fewer sex partners (aOR 1.44, 95% CI 1.13-1.83), use of rush poppers (aOR 2.06, 95% CI 1.70-2.49), unknown HIV status of sex partners (aOR 1.40, 95% CI 1.17-1.69), lack of awareness of HIV pre-exposure prophylaxis (aOR 1.39, 95% CI 1.03-1.88), and offline HIV testing uptake (aOR 2.08, 95% CI 1.80-2.41). CONCLUSIONS A notable 12.9% (982/7629) of MSM had never undergone HIV testing before this large internet survey. We recommend enhancing HIV intervention and testing through internet-based platforms and gay apps to promote testing among MSM and achieve the target of diagnosing 95% of patients infected with HIV by 2030.
Collapse
Affiliation(s)
- Lin He
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Tingting Jiang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Wanjun Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | | | - Jinlei Zheng
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Weiyong Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Hui Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Qiaoqin Ma
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Chengliang Chai
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| |
Collapse
|
2
|
Fu J, Dai Z, Wang H, Si M, Chen X, Wu Y, Xiao W, Huang Y, Yu F, Mi G, Su X. Willingness to use long-acting injectable PrEP among HIV-negative/unknown men who have sex with men in mainland China: A cross-sectional online survey. PLoS One 2023; 18:e0293297. [PMID: 37856527 PMCID: PMC10586652 DOI: 10.1371/journal.pone.0293297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/09/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Men who have sex with men (MSM) are at high risk of HIV acquisition. Long-acting injectable-pre-exposure prophylaxis (LAI-PrEP), requiring less frequent dosing, is being studied as an alternative method to daily oral HIV PrEP. With the addition of this potential new prevention method, it expands the scope for a wider user choice and is expected to increase the acceptability and uptake of HIV prevention measures. The aim of our study was to explore the willingness to use LAI-PrEP and associated influential factors. METHODS Participants were recruited from December 2020 to March 2021 through banner advertisements on web- and mobile app-based platforms on Blued, a large gay Chinese social media platform. MSM in our cross-sectional study was HIV-negative and currently lived in mainland China. Participants were asked about their willingness to use LAI-PrEP and reasons why they might be or not be willing to use LAI-PrEP. Multivariable logistic regression was used to analyze the factors associated with the willingness to use LAI-PrEP. RESULTS In total, 969 participants met the inclusion criteria and finished the survey. Nearly twenty percent (19.5%) of participants had never tested for HIV; 66.8% of MSM had multiple male partners; and 51.6% of MSM engaged in condomless sex with their partner. About three-fifths (66.3%) of MSM were aware of PrEP, and only 3.9% of MSM had used PrEP before. The willingness to use LAI-PrEP among MSM was 74.0% (95% CI: 71.4%-76.6%). MSM with higher education levels were less likely to show a willingness to use LAI-PrEP (AOR = 0.56, 95%CI: 0.38-0.84). Participants who had a history of HIV test (AOR = 1.68, 95%CI: 1.11-2.55), were willing to use daily oral PrEP (AOR = 10.64, 95%CI:7.43-15.21), had multiple male sexual partners (AOR = 1.33, 95%CI:0.93-1.90), who used rush popper(AOR = 1.49, 95%CI:1.05-2.13), and who were aware of PEP (AOR = 1.66, 95%CI: 1.02-2.70) were more likely to show willingness to use LAI-PrEP. CONCLUSIONS In our study, MSM had quite high awareness but low uptake of PrEP. As LAI-PrEP is expected to be approved for use in China in the future, our study of MSM highlights the need for key population-focused education programs about PrEP and healthy sexual behavior. This study also provides some evidence for LAI-PrEP use among the Chinese MSM population in the future.
Collapse
Affiliation(s)
- Jiaqi Fu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhenwei Dai
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hao Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mingyu Si
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xu Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yijin Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Weijun Xiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yiman Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Fei Yu
- Danlan Public Welfare, Beijing, China
| | | | - Xiaoyou Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| |
Collapse
|
3
|
Zhao T, Chen G, Sun C, Gong X, Li H, Fu G. The epidemic of HIV and syphilis and the correlation with substance abuse among men who have sex with men in China: A systematic review and meta-analysis. Front Public Health 2023; 11:1082637. [PMID: 36875380 PMCID: PMC9982104 DOI: 10.3389/fpubh.2023.1082637] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/30/2023] [Indexed: 02/19/2023] Open
Abstract
Background In China, the HIV/AIDS epidemic among men who have sex with men (MSM) has been expanding in recent years. Substance abuse in MSM was not well studied as the independent risk factor for HIV and syphilis infection and other sexually transmitted diseases. The present review aimed to determine the correlation between HIV/Syphilis infections and substance abuse and other sexual risk behaviors among MSM. Methods We conducted a comprehensive search of PubMed, Web of Science, Embase, Scopus, Chinese National Knowledge Infrastructure, Chinese Wanfang Data, and VIP Chinese Journal Database for relevant articles of quantitative studies published between 2010 and May 31, 2022. Meta-analysis was performed using R software. Pooled estimated of the association-odds ratio, with 95% confidence intervals were calculated using random-effects models stratified by study design. Q statistics and I2 were used to measure the heterogeneity. Results Our meta-analysis included 61,719 Chinese MSM from 52 eligible studies. The pooled HIV prevalence rate among substance-abusing MSM was 10.0% (95% CI = 0.08-0.13). Substance abusers were more likely to have a higher prevalence of HIV (OR = 1.59) and syphilis (OR = 1.48) infections than non-substance abusers. Substance abusers were also more likely to seek sexual partners through the internet or social media applications (OR = 1.63), engage in unprotected anal intercourse (UAI) (OR = 1.69), group sex (OR = 2.78), and engage in commercial intercourse (OR = 2.04) compared to non-users. Regarding testing behaviors, substance abusers had a higher proportion of HIV or STI testing in their lifetime (OR = 1.70) compared with non-substance abusers (p < 0.05). They were also more likely to have had more sexual partners (≥2; OR = 2.31) and more likely to have consumed alcohol (OR = 1.49) in the past 6 months. Conclusions Our study shows the correlation between substance abuse and HIV/Syphilis infection. Eliminating disparities in HIV/Syphilis infection among substance abusing men who have sex with men (MSM) can be achieved if the Chinese government and public health sectors could provide targeted knowledge popularization and diagnosis interventions among high-risk populations.
Collapse
Affiliation(s)
- Tian Zhao
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Guohong Chen
- Jiangsu Provincial Center for Disease Control and Prevention, Institute for STI and HIV Control and Prevention, Nanjing, China
| | - Chengqing Sun
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xiangdong Gong
- Department of Epidemiology, National Center for STD Control, Nanjing, China
| | - Huiyong Li
- Department of STI and HIV Control and Prevention, Jincheng Center for Disease Control and Prevention, Jincheng, China
| | - Gengfeng Fu
- School of Public Health, Nanjing Medical University, Nanjing, China
| |
Collapse
|
4
|
HIV Disclosure Among Sexually Infected People Living with HIV and AIDS in China: Prevalence, Influencing Factors, and Negative Outcomes. AIDS Behav 2022; 27:2411-2429. [PMID: 36580165 DOI: 10.1007/s10461-022-03968-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2022] [Indexed: 12/30/2022]
Abstract
HIV disclosure is crucial for HIV prevention and control, but may also lead to discrimination, insult, and even violence against people living with HIV and AIDS (PLWHAs). In this study, we examined HIV disclosure, its influencing factors, and its association with intimate partner violence (IPV) among 1153 PLWHAs through the sexual route in Jinan, Shandong Province, China. Our results showed that 76.4% (881/1153) PLWHAs had disclosed someone about their HIV infection, the HIV disclosure rates among family members, friends, spouses, and current fixed partners of PLWHAs were 43.5% (501/1153), 47.9% (552/1153), 56.8% (129/227), and 43.2% (336/777), respectively. HIV disclosure was affected by socio-demographics, disease characteristics, and psycho-social factors and varied among family members, close friends, spouses, and current fixed sexual partners. Age ≤ 33 years (aOR 1.79, 95% CI 1.27-2.53), heterosexual infection route (aOR 1.52, 95% CI 1.06-2.17), HIV diagnosis time > 36 months (aOR 1.84, 95% CI 1.30-2.59), with other chronic diseases (aOR 1.87, 95% CI 1.34-2.61), lower self-stigma (aOR 4.03-4.36, 95% CI 1.98-8.74), higher social support (aOR 1.71-1.73, 95% CI 1.03-2.83), no depression (aOR 1.54, 95% CI 1.12-2.11), and no suicidal ideation (aOR 1.79, 95% CI 1.28-2.50) were all independently associated with increased likelihood of HIV disclosure. HIV disclosure was associated with an increased risk of IPV among current fixed sexual partners (aOR 1.87, 95% CI 1.38-2.54) and spouses (aOR 2.54, 95% CI 1.41-4.56). Our findings suggest that the HIV disclosure rate of PLWHAs is still low and is affected by multiple factors. There is an urgent need to design targeted and comprehensive interventions to improve HIV disclosure. IPV prevention should also be incorporated into the intervention system of HIV disclosure to ensure adequate and continuous support for PLWHAs.
Collapse
|
5
|
Yang J, Yi M, Qian HZ, Chen Y, Zhou Q, Li X. Post-lockdown Rebounding High-risk Behaviors and HIV Testing Among MSM in China in the Era of the COVID-19 Pandemic. Curr HIV Res 2022; 20:287-295. [PMID: 35702795 DOI: 10.2174/1570162x20666220613120735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/05/2022] [Accepted: 04/27/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Lockdown measures for controlling the COVID-19 epidemic were enforced in China between January and May 2020. Previous studies showed a decrease in HIV high- Risk Behaviors (HRBs) and updated testing during the lockdown, but little is known about these behaviors during the post-lockdown period. OBJECTIVE We conducted quantitative and qualitative assessments of HIV-related behaviors among MSM during the lockdown and post-lockdown periods in Changsha, south-central China. METHODS Face-to-face structured interviews with open-ended questions were conducted using the TimeLine Follow Back (TLFB) method for collecting retrospective data on frequencies of HRBs and testing. McNemar's Chi-square test and Wilcoxon signed-rank test were used to comparing frequencies of behaviors between lockdown (January-May 2020) and post-lockdown periods (June- October 2020). Content analysis was used to analyze qualitative data on the reasons for rebounding HRBs and testing. RESULTS Of 159 MSM participants, 64% had at least one HRB during the post-lockdown period. Men had increased condomless sex (from 24% to 35%), multiple partners (23% to 35%), and substance abuse (16% to 27%) between the two study periods due to the negative emotions and increased use of social networks during the lockdown. HIV testing frequency also increased from 37% to 66% due to resuming routine testing services in the community-based organizations and increased HRBs among MSM during post-lockdown. CONCLUSION After lifting the lockdown measures, MSM had rebounding HRBs and uptake of testing. Effective preventive measures and healthcare services should be available to MSM after the lockdown measures are lifted.
Collapse
Affiliation(s)
- Jiahui Yang
- Xiangya School of Nursing, Central South University, Changsha City, Hunan Province, China
| | - Mengyao Yi
- Xiangya School of Nursing, Central South University, Changsha City, Hunan Province, China
| | - Han-Zhu Qian
- Xiangya School of Nursing, Central South University, Changsha City, Hunan Province, China.,School of Public Health, Yale University, New Haven, Connecticut, CT 06520, USA
| | - Yuqing Chen
- Xiangya School of Nursing, Central South University, Changsha City, Hunan Province, China
| | - Qidi Zhou
- Xiangya School of Nursing, Central South University, Changsha City, Hunan Province, China
| | - Xianhong Li
- Xiangya School of Nursing, Central South University, Changsha City, Hunan Province, China
| |
Collapse
|
6
|
Jiang H, Li J, Tan Z, Cheng W, Yang Y. The Moderating Effect of Sexual Sensation Seeking on the Association between Alcohol and Popper Use and Multiple Sexual Partners among Men Who Have Sex with Men in Guangzhou, China. Subst Use Misuse 2022; 57:1497-1503. [PMID: 35869639 DOI: 10.1080/10826084.2022.2079134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Introduction: This cross sectional study was conducted to explore the moderating effect of sexual sensation seeking (SSS) on the association between alcohol/popper use before sex and multiple sexual partners (MSP) among men who have sex with men (MSM) in Guangzhou, China. Methods: From June 2017 to April 2018, MSM were recruited from a community-based HIV service center in Guangzhou, China; data on sociodemographics, sexual behaviors and SSS were collected. A product term of SSS and alcohol/popper use before sex was included in a multivariate logistic regression model to test the potential moderating effect of SSS on the association between alcohol/popper use before sex and MSP. Results: Among the 500 MSM included, individuals who reported alcohol use and popper use before sex, and MSP in the last six months accounted for 33.80%, 33.40%, and 60.40%, respectively. MSM with high SSS traits accounted for 54.80%. The association between popper use before sex and MSP was moderated by SSS (P for interaction = 0.007). A significant association between popper use before sex and MSP among MSM with low SSS traits (odds ratio [OR] = 4.22, 95% confidence interval [CI]: 2.06 ∼ 8.67). But not among MSM with high SSS traits (OR = 1.37, 95%CI: 0.77 ∼ 2.43) were observed. However, no moderating effect of SSS on the association between alcohol use before sex and MSP were observed. Conclusion: The moderated analysis indicated that SSS should be taken into consideration when tailoring interventions to prevent popper use before sex to reduce the risk associated with MSP.
Collapse
Affiliation(s)
- Hongbo Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Zhimin Tan
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Weibin Cheng
- Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| |
Collapse
|
7
|
Chen L, Luo M, Xu Y, Xia Y, Zhou X, Chen W, Wang H, Jiang T, Chen W, Luo Y, Ma Q, Jiang J, Pan X. The first 90: Progress in HIV detection in Zhejiang Province, 2008-2018. PLoS One 2021; 16:e0249517. [PMID: 33831067 PMCID: PMC8031385 DOI: 10.1371/journal.pone.0249517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 03/19/2021] [Indexed: 11/20/2022] Open
Abstract
To analyze the results of HIV screening and the HIV-positive rate based on different HIV detection strategies in Zhejiang Province, China. Data were downloaded from the AIDS Prevention and Control Information System on May 1, 2019. HIV screening, prevalence, and incidence data were analyzed from 2008 to 2018. The incidence of HIV was calculated from the results of BED testing. SPSS software (ver. 19.0) was used for the analysis. The number of people screened for HIV increased by 229.7% from 2008 to 2018, while the incidence of HIV increased from 1.14‱ (2010) to 1.67‱ (2018), peak by 2015 (2.28‱). The proportion of people screened for HIV in medical institutions increased from 62.0% in 2008 to 67.1% in 2018, while of all positive tests, 47.9% were conducted at medical institutions in 2008, which increased to 63.2% in 2018. VCT and STD clinic attendees, who had only 4.5% of all those undergoing HIV tests, accounted for 23.7% of all HIV positive in 2018. The rate of HIV-positive people and incidence of HIV both increased in Zhejiang Province between 2008 and 2015. The most effective strategy for detecting HIV new cases is screening visitors to VCT and STD clinics.
Collapse
Affiliation(s)
- Lin Chen
- Department of AIDS/STD Control and Prevention, Zhejiang Provincial Center for Disease Control, Hangzhou, Zhejiang, People’s Republic of China
| | - Mingyu Luo
- Department of AIDS/STD Control and Prevention, Zhejiang Provincial Center for Disease Control, Hangzhou, Zhejiang, People’s Republic of China
| | - Yun Xu
- Department of AIDS/STD Control and Prevention, Zhejiang Provincial Center for Disease Control, Hangzhou, Zhejiang, People’s Republic of China
| | - Yan Xia
- Department of AIDS/STD Control and Prevention, Zhejiang Provincial Center for Disease Control, Hangzhou, Zhejiang, People’s Republic of China
| | - Xin Zhou
- Department of AIDS/STD Control and Prevention, Zhejiang Provincial Center for Disease Control, Hangzhou, Zhejiang, People’s Republic of China
| | - Wanjun Chen
- Department of AIDS/STD Control and Prevention, Zhejiang Provincial Center for Disease Control, Hangzhou, Zhejiang, People’s Republic of China
| | - Hui Wang
- Department of AIDS/STD Control and Prevention, Zhejiang Provincial Center for Disease Control, Hangzhou, Zhejiang, People’s Republic of China
| | - Tingting Jiang
- Department of AIDS/STD Control and Prevention, Zhejiang Provincial Center for Disease Control, Hangzhou, Zhejiang, People’s Republic of China
| | - Weiyong Chen
- Department of AIDS/STD Control and Prevention, Zhejiang Provincial Center for Disease Control, Hangzhou, Zhejiang, People’s Republic of China
| | - Yan Luo
- Department of AIDS/STD Control and Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, People’s Republic of China
| | - Qiaoqin Ma
- Department of AIDS/STD Control and Prevention, Zhejiang Provincial Center for Disease Control, Hangzhou, Zhejiang, People’s Republic of China
| | - Jianmin Jiang
- Department of AIDS/STD Control and Prevention, Zhejiang Provincial Center for Disease Control, Hangzhou, Zhejiang, People’s Republic of China
| | - Xiaohong Pan
- Department of AIDS/STD Control and Prevention, Zhejiang Provincial Center for Disease Control, Hangzhou, Zhejiang, People’s Republic of China
| |
Collapse
|
8
|
Starks TJ, Jones SS, Sauermilch D, Benedict M, Adebayo T, Cain D, Simpson KN. Evaluating the impact of COVID-19: A cohort comparison study of drug use and risky sexual behavior among sexual minority men in the U.S.A. Drug Alcohol Depend 2020; 216:108260. [PMID: 32890975 PMCID: PMC7453210 DOI: 10.1016/j.drugalcdep.2020.108260] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Sexual minority men who use drugs have high sexual HIV transmission risk. Sexual interactions may also increase COVID-19 risk.This study compared marijuana use, other illegal drugs use (i.e. cocaine/crack, methamphetamine, MDMA/ecstasy, GHB, and ketamine) and sexual behavior with casual partners among sexual minority cismen active on social networking and dating applications before and during the COVID-19 epidemic. METHODS This cohort-control study compared 455 adult respondents (surveyed May 6th to 17th, 2020) and a matched sample selected from 65,707 respondents surveyed pre-COVID. Participants were recruited on social networking and dating applications and completed surveys online. RESULTS The proportion reporting marijuana use declined significantly in the COVID cohort (34.5 % versus 45.7 % pre-COVID,p < .001) as did their illegal drug use (11.0 % versus 22.9 % pre-COVID, p < .001). While the number of casual partners per month was stable, the proportion reporting condomless anal sex with casual partners declined significantly during COVID (26.4 % versus 71.6 % pre-COVID, p < .001). The effect of illegal drug use (excluding marijuana) on number of casual partners per month (aRR = 1.45 pre-COVID versus 2.84, p < .01) and odds of condomless anal sex (aOR = 2.00 pre-COVID versus 5.22, p = .04) were significantly greater in the COVID cohort. CONCLUSIONS While the proportion of participants reporting drug use and condomless anal sex with casual partners declined in the COVID cohort, the association between drug use and sexual behavior was magnified. Sexual minority men who use drugs are significantly more likely to engage in sexual behaviors that place them at risk for HIV and COVID-19 transmission.
Collapse
Affiliation(s)
- Tyrel J. Starks
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA,Health Psychology and Clinical Science Program, The Graduate Center, of the City University of New York, New York, NY, USA,Corresponding author at: Hunter College, CUNY, 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA
| | - S. Scott Jones
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
| | | | - Matthew Benedict
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Trinae Adebayo
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Demetria Cain
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Kit N. Simpson
- College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
| |
Collapse
|
9
|
Chen J, Huang YL, Chen HL, Xia J. Nitrite inhalants use, sexual behaviors and HIV/syphilis infection among men who have sex with men in Chongqing, China. Infect Dis Poverty 2020; 9:127. [PMID: 32887643 PMCID: PMC7650275 DOI: 10.1186/s40249-020-00748-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/31/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Emerging evidence indicates nitrite inhalants have become increasingly prevalent among men who have sex with men (MSM). The present study aimed to describe the prevalence and correlates of nitrite inhalants use and its association with risky sexual behaviors and human immunodeficiency virus (HIV)/syphilis infection among MSM in Chongqing, a city in China where MSM were burdened with the highest pooled HIV prevalence in the country. METHODS This cross-sectional study was conducted in Chongqing between March 2019 and February 2020. Information of demographics, drug use, sexual behaviors and HIV testing was collected through an anonymous survey. Blood samples were drawn from each participant for the diagnoses of HIV and syphilis. Logistic regression analysis was performed to evaluate factors correlated with nitrite inhalants use and its relationship with risky sexual behaviors and HIV/syphilis infection. RESULTS Of the 1151 eligible participants, 18.9% (218) reported use of at least one type of recreational drugs in the past 6 months, and nitrite inhalants were the most commonly used substance (17.7, 95% confidence interval [CI]: 15.6-20.2%). The proportions of participants reported engaging in group sex and practicing condomless internal ejaculation during anal sex in the past six months were 5.8% (95% CI: 4.4-7.2%) and 41.7% (95% CI: 38.7-44.7%), respectively. The general prevalence of HIV and syphilis infection among the enrolled MSM were 16.8% (95% CI: 14.7-19.0%) and 12.6% (95% CI: 10.7-14.4%), respectively. Factors positively associated with nitrite inhalants use included: age ≤ 25 (adjusted odds ratio [aOR] = 2.08, 95% CI: 1.10-3.94), monthly individual income ≥ CNY 3000 (Chinese Yuan) (aOR = 1.95, 95% CI: 1.18-3.22), preferring receptive anal intercourse (aOR = 2.27, 95% CI: 1.34-3.84) and versatile anal intercourse (aOR = 2.60, 95% CI: 1.64-4.13), age at first anal intercourse < 18 (aOR = 1.79, 95% CI: 1.21-2.67), engaging in group sex in the past six months (aOR = 9.34, 95% CI: 4.95-17.63), having multiple male sex partners in the past 6 months (aOR = 2.32, 95% CI: 1.50-3.58), practicing CIE during anal sex in the past six months (aOR = 1.71, 95% CI: 1.19-2.46), HIV infection (aOR = 1.72, 95% CI: 1.11-2.66) and syphilis infection (aOR = 1.98, 95% CI: 1.23-3.17). CONCLUSIONS This study found that nitrite inhalants were the most commonly used recreational substance among MSM and nitrite inhalants use were associated with higher probability of HIV and syphilis infection. Therefore, increased attention and counselling should be given to nitrite inhalants-using MSM.
Collapse
Affiliation(s)
- Jin Chen
- Department of Medical Records Management, the People's Hospital of Tongliang District, Chongqing, China
| | - Yu-Ling Huang
- Department of STD/HIV Control and Prevention, Sichuan provincial Center for Disease Control and Prevention, Chengdu, China
| | - Huai-Liang Chen
- Department of Infectious Diseases Prevention and Healthcare, the People's Hospital of Chengdu Tianfu New Area, Chengdu, China.
| | - Ji Xia
- Department of Medical Records Management, the People's Hospital of Tongliang District, Chongqing, China
| |
Collapse
|
10
|
Chen X, Mo PKH, Li J, Lau JTF. Factors Associated with Drug Use Among HIV-Infected Men Who Have Sex with Men in China. AIDS Behav 2020; 24:1612-1620. [PMID: 31486007 DOI: 10.1007/s10461-019-02660-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Drug use is globally more prevalent in HIV-positive men who have sex with men (HIVMSM) than their heterosexual counterparts. Yet, few studies have investigated the factors associated with drug use among this population beyond Western societies. A cross-sectional survey was conducted to examine factors associated with drug use among 415 HIVMSM in Chengdu, China. The results show that 10.8% of the participants had used drugs in the past 30 days. Among participants who had anal intercourse in the past 30 days, 11.5% had used drugs during anal intercourse. After adjusting for background variables, logistic regression models show that life satisfaction was associated with past 30-day drug use [Adjusted Odds Ratio (ORa) = 0.90, p < 0.001], and with drug use during anal intercourse in the past 30 days (ORa = 0.89, p < 0.01). Participants with more nonregular partners were more likely to use drugs with or without sex in the past 30 days, whereas those with one regular partner were less likely to use drugs during anal intercourse compared to their counterparts with no regular partners. The findings of this study are informative for designing effective substance-use intervention programs targeting HIVMSM.
Collapse
Affiliation(s)
- Xi Chen
- Centre for Health Behaviours Research, School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Jinghua Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Joseph T F Lau
- Centre for Health Behaviours Research, School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong.
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China.
| |
Collapse
|
11
|
HIV Testing and Risks of Sexual Behavior among HIV-Negative Men Who Have Sex with Men in Ningbo, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041322. [PMID: 32092851 PMCID: PMC7068381 DOI: 10.3390/ijerph17041322] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 02/11/2020] [Accepted: 02/14/2020] [Indexed: 12/31/2022]
Abstract
Human immunodeficiency virus (HIV) testing is confirmed as a preventive strategy for HIV control. However, the testing rate and risk behaviors of HIV-negative men who have sex with men (MSM) remain unclear. We aimed to examine factors associated with HIV testing and high-risk behaviors among HIV-negative MSM. From July 2016 to June 2017, participants were recruited by snowball sampling from WeChat groups, bars, and other venues. HIV testing was performed to exclude HIV-positive MSM. Face-to-face questionnaires regarding HIV testing and high-risk behaviors were conducted; 988 MSM were included, and 57.1% of participants underwent HIV testing in the past year. The proportion of high-risk behaviors was 49.9%. Factors associated with HIV testing were bisexual orientation, substance use to adjust psychiatric disorders, and receiving acquired immune deficiency syndrome (AIDS) interventions. Being married, bisexual orientation, and receiving AIDS interventions were risk factors for high-risk sexual behaviors, while college or higher degree was a protective factor. We determined that HIV transmission factors are widespread, and the rate of HIV testing is relatively low. Attention should be given to marital status, using substances to adjust psychiatric disorders, or bisexual HIV-negative MSM, and AIDS interventions should be strengthened to promote HIV testing and reduce high-risk behaviors.
Collapse
|
12
|
Wu H, Xiu C, Fu X, Li M, Wang Z, Li X, Wu J, Vermund SH, Hu Y. Syphilis associated with recreational drug use, depression and high-risk sexual behaviour in men who have sex with men: a case-control study in China. Sex Transm Infect 2019; 95:267-272. [PMID: 30842346 PMCID: PMC11093516 DOI: 10.1136/sextrans-2018-053878] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/24/2019] [Accepted: 02/11/2019] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE We investigated syphilis prevalence among men who have sex with men (MSM) in China, as well as potential risk factors. Our principal hypothesis was that syphilis would be associated with the use of recreational drugs such as methamphetamines. METHODS From April to October 2013, we used several methods to recruit MSM in Qingdao, collecting demographic/behavioural information via self-administrated questionnaires. Trained health workers collected blood for the Treponema pallidum particle assay (TPPA) with positives confirmed by a toluidine red unheated serum test. We used an unmatched case-control study to identify factors that might predict syphilis infection using multivariable logistic regression. RESULTS We recruited 447 MSM who agreed to participate and who completed syphilis testing. Of 71 (15.9%) syphilis-positive MSM, 44 (62.0%) used drugs. Of 376 (84.1%) syphilis-negative MSM, 186 (49.5%) used drugs. We found a positive association with syphilis for any recreational drug use (crude OR (cOR) 1.7, 95 % CI 1.0 to 2.8), frequent methamphetamine use (cOR 2.4, 95% CI 1.1 to 5.3) and multiple drug use (adjusted OR (aOR) 3.4, 95% CI 1.3 to 9.2). Syphilis-positive men were more likely to have a higher physical depression score (aOR 5.2, 95% CI 1.1 to 24.4), be > 30 years old (aOR 2.7, 95% CI 1.5 to 4.8), report a prior STI (aOR 4.1, 95% CI 2.3 to 7.3) and report a sex party experience (aOR 2.2, 95% CI 1.1 to 4.4). CONCLUSIONS Recreational drug use, depression and high-risk sexual behaviours were associated with syphilis infection among MSM in China. Only a multifaceted approach is likely be effective in control of both syphilis and HIV .
Collapse
Affiliation(s)
- Huichao Wu
- Child and Adolescent Health and Maternal Health, School of Public Health, Capital Medical University, Beijing, China, Beijing, China
| | - Cuizhen Xiu
- Department of HIV/STD Prevention and Control, Qingdao Center for Disease Control and Prevention, Qingdao, China
| | - Xiaojing Fu
- Division of Biostatistics, School of Public Health and Management, Weifang Medical University, Weifang, China
| | - Menglong Li
- Child and Adolescent Health and Maternal Health, School of Public Health, Capital Medical University, Beijing, China, Beijing, China
| | - Zhenhong Wang
- Department of Dermatology, The Third Hospital of Chengyang, Qingdao, China
| | - Xiufang Li
- The Sex Center, The Affiliated Hospital of Medical College Qingdao University, Qingdao, China
| | - Jing Wu
- School of Agroforestry and Medicine, The Open University of China, Beijing, China
| | - Sten H Vermund
- Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Yifei Hu
- Child and Adolescent Health and Maternal Health, School of Public Health, Capital Medical University, Beijing, China, Beijing, China
| |
Collapse
|