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Ai W, Xie Y, Lu H, Ai T, Wu D, Zhang Y, Marley G, Ong J, Tucker JD, Tang W. Synergistic interaction between pay-it-forward incentives and recreational drug use on hepatitis B virus and hepatitis C virus testing among men who have sex with men in China. Sex Transm Infect 2024; 100:302-309. [PMID: 38862237 PMCID: PMC11283352 DOI: 10.1136/sextrans-2024-056150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 05/28/2024] [Indexed: 06/13/2024] Open
Abstract
OBJECTIVES Pay-it-forward incentives effectively promote hepatitis B virus (HBV) and hepatitis C virus (HCV) testing among men who have sex with men (MSM) by offering free testing and donation opportunities. This study aims to explore the interaction between pay-it-forward incentives and recreational drug use on HBV and HCV testing uptake among Chinese MSM. METHODS We pooled data from two pay-it-forward studies that aimed to promote dual HBV and HCV testing among MSM in Jiangsu, China. We explored factors associated with hepatitis testing uptake in the two study groups and examined the interaction between pay-it-forward incentives and recreational drug use on hepatitis testing uptake. RESULTS Overall, 511 MSM participated in these two studies, with 265 participants in the pay-it-forward incentives group and 246 participants in the standard-of-care group. Among these participants, 59.3% in the pay-it-forward incentive group and 24.8% in the standard-of-care group received dual HBV and HCV testing, respectively. In the pay-it-forward incentives group, participants who used recreational drugs in the past 12 months (adjusted OR (AOR)=1.83, 95% CI 1.09 to 3.06) were more likely to receive dual HBV and HCV testing, compared with those who never used recreational drugs, whereas in the standard-of-care group, those who used recreational drugs were less likely to receive dual HBC and HCV testing (AOR=0.38, 95% CI 0.18 to 0.78). MSM with higher community connectedness (AOR=1.10, 95% CI 1.00 to 1.21) were also more likely to receive hepatitis testing with pay-it-forward incentives. There was a synergistic interaction on both the multiplicative (ratio of ORs=4.83, 95% CI 1.98 to 11.7) and additive scales (the relative excess risk of interaction=2.97, 95% CI 0.56 to 5.38) of pay-it-forward incentives and recreational drug use behaviours on dual HBV and HCV testing uptake among MSM. CONCLUSION Pay-it-forward incentives may be particularly useful in promoting hepatitis testing among MSM who use recreational drugs.
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Affiliation(s)
- Wei Ai
- Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
- The University of North Carolina at Chapel Hill UNC Project-China, Guangzhou, Guangdong, China
| | - Yewei Xie
- The University of North Carolina at Chapel Hill UNC Project-China, Guangzhou, Guangdong, China
| | - Haidong Lu
- Department of Epidemiology of Microbial Diseases, Yale University, New Haven, Connecticut, USA
| | - Ting Ai
- Wuhu Hospital Affiliated to East China Normal University, Wuhu, Anhui, China
| | - Dan Wu
- School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Ye Zhang
- School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Gifty Marley
- The University of North Carolina at Chapel Hill UNC Project-China, Guangzhou, Guangdong, China
| | - Jason Ong
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Joseph D Tucker
- The University of North Carolina at Chapel Hill UNC Project-China, Guangzhou, Guangdong, China
- London School of Hygiene & Tropical Medicine, London, UK
| | - Weiming Tang
- Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
- The University of North Carolina at Chapel Hill UNC Project-China, Guangzhou, Guangdong, China
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Jian H, Lu WJ, Chen ZW, Liang SQ, Yue XL, Li J, Zhang JH, Gong XD. Prevalence and trends of Chlamydia trachomatis infection in female sex workers and men who have sex with men in China: a systematic review and meta-analysis. BMC Public Health 2024; 24:1579. [PMID: 38867197 PMCID: PMC11170796 DOI: 10.1186/s12889-024-18804-3] [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: 08/04/2023] [Accepted: 05/09/2024] [Indexed: 06/14/2024] Open
Abstract
INTRODUCTION Chlamydia trachomatis infection can cause a significant disease burden in high-risk populations. This study aimed to assess the overall prevalence of C. trachomatis infection, and determine the long-term trends and geographic distribution of this infection among female sex workers (FSWs) and men who have sex with men (MSM) in China. METHODS The PubMed, Web of Science, CNKI, Wanfang Data and VIP databases were searched from 1 January 1990 through 30 April 2023. Publications in which C. trachomatis infection was detected using nucleic acid amplification tests (NAATs) were included. The Q test and I2 statistics were used to assess the heterogeneity between studies. A random-effect model was used to estimate the pooled prevalence of C. trachomatis infection. Subgroup, meta-regression, and sensitivity analyses were performed to explore the sources of heterogeneity. Publication bias was evaluated using Egger's test. Trend analysis of the prevalence was performed using the Jonckheere-Terpstra trend test method. RESULTS Sixty-one studies were eligible for inclusion (including 38 for FSWs and 23 for MSM). The pooled prevalence of C. trachomatis infection was 19.5% (95% CI: 16.4, 23.0) among FSWs and 12.7% (95% CI: 9.2, 17.7) in the rectum, 6.4% (95% CI: 5.3, 7.8) in the urethra and 1.3% (95% CI: 0.8, 2.1) in the oropharynx from MSM in China. The subgroup analyses showed that the sample size, study period, study region, specimen collection type, molecular diagnosis method, and recruitment site could explain some heterogeneity among studies of FSWs, and the publication language, study period, study region, molecular diagnosis method, and specimen collection anatomical site could explain some heterogeneity among studies of MSM. From 1998 to 2004, 2005 to 2009, 2010 to 2015, and 2016 to 2021, the pooled prevalence of C. trachomatis infection among FSWs were 30.3%, 19.9%, 21.4%, and 11.3%, respectively. For MSM, the pooled prevalence from 2003 to 2009, 2010 to 2015, and 2016 to 2022 were 7.8%, 4.7%, and 6.5%, respectively. However, no overall decline in the prevalence of C. trachomatis infection was observed among FSWs (z = -1.51, P = 0.13) or MSM (z = -0.71, P = 0.48) in China. CONCLUSIONS The prevalence of C. trachomatis infection was high in these two high-risk populations in China. The findings of this study provide evidence for the formulation of effective surveillance and screening strategies for the prevention and control of C. trachomatis infection among these two specific populations.
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Affiliation(s)
- Hui Jian
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- Department of STD Epidemiology, National Center for STD Control, Nanjing, China
| | - Wen-Jie Lu
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Ze-Wei Chen
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- Department of STD Epidemiology, National Center for STD Control, Nanjing, China
| | - Shi-Qing Liang
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xiao-Li Yue
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- Department of STD Epidemiology, National Center for STD Control, Nanjing, China
| | - Jing Li
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- Department of STD Epidemiology, National Center for STD Control, Nanjing, China
| | - Jia-Hui Zhang
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- Department of STD Epidemiology, National Center for STD Control, Nanjing, China
| | - Xiang-Dong Gong
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.
- Department of STD Epidemiology, National Center for STD Control, Nanjing, China.
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Silva VCM, Kerr LRFS, Kendall C, Mota RS, Guimarães MDC, Leal AF, Merchan-Hamann E, Dourado I, Veras MA, de Brito AM, Pontes AK, Macena RHM, Knauth D, Lima LNGC, Cavalcante S, Camillo AC, Díaz-Bermudez XP, Oliveira LC, Magno L, Lemos MF, Compri AP, Motta-Castro ARC, Moreira RC. Hepatitis C virus prevalence among men who have sex with men: a cross-sectional study in 12 Brazilian cities. BMC Infect Dis 2023; 23:705. [PMID: 37858036 PMCID: PMC10588169 DOI: 10.1186/s12879-023-08690-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Despite the preventive policies adopted, reduction in sexually transmitted infections (STIs) among men who have sex with men (MSM) has been limited. The risk of hepatitis C virus (HCV) infection has increased among the most vulnerable population groups, including MSM. The aim of this study was to estimate the prevalence of HCV infection and to assess risky practices among MSM from 12 Brazilian cities. METHODS This study was carried out from June to December 2016 using respondent driven sampling (RDS). Participants completed a self-administered questionnaire to collect behavioral, socioeconomic, and demographic variables. In addition, the rapid diagnostic test (RDT) for HCV was offered. Positive results were sent to Instituto Adolfo Lutz for confirmation. RESULTS A total of 4,176 participants were recruited and 23 samples were sent for confirmation. Of these, 16 were confirmed, resulting in a prevalence of 0.7% (95% CI: 0.3%-1.7%). The Southeast region showed a prevalence of 0.9% (95% CI: 0.3-2.6), followed by the South region, with 0.6% (95% CI: 0.2-2.1). The Northeast region had a prevalence of 0.3% (95% CI: 0.1-1.0) and the Midwest 0.1% (95% CI: 0.0-0.7). No positive cases were found in the North. Single men aged 40 years or older were the majority of participants exposed to HCV. High levels of alcohol consumption, illicit drug use, irregular condom use, in addition to infection with other STIs, were associated with exposure to HCV. CONCLUSIONS STIs continue to be important health problems in Brazil and globally. Many STIs are inapparent for many years until they bring more serious consequences. Extra investment in HCV is also warranted, given that it can be eliminated. Relying solely on clinical data to provide information about inapparent infection, especially in stigmatized populations, will make that goal more difficult to achieve. Surveillance studies, such as the one reported here need to be repeated over time to demonstrate trends and to provide information for evaluation, program and policies. Investments in the most vulnerable populations are critical to achieve the World Health Organization global health goals including the elimination of viral hepatitis by 2030.
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Affiliation(s)
- Vanessa C M Silva
- Laboratório de Hepatites, Centro de Virologia, Instituto Adolfo Lutz, Av. Dr Arnaldo, 355 Pacaembu, São Paulo, SP, Brazil
| | - Lígia R F S Kerr
- Saúde Comunitária, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - Carl Kendall
- Saúde Comunitária, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil
- Department of Social, Behavioral and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Rosa S Mota
- Departamento de Estatística e Matemática Aplicada, Universidade Federal Do Ceará, Fortaleza, CE, Brazil
| | - Mark Drew C Guimarães
- Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Andréa F Leal
- Departamento de Sociologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Edgar Merchan-Hamann
- Faculdade de Ciências da Saúde, Saúde Coletiva, Universidade de Brasília, Brasília, DF, Brazil
| | - Inês Dourado
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Maria Amélia Veras
- Departamento de Saúde Coletiva, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil
| | - Ana Maria de Brito
- Departamento de Saúde Coletiva, Instituto Aggeu Magalhães, Fiocruz, Recife, PE, Brazil
| | - Alexandre K Pontes
- Instituto de Psicologia, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Daniela Knauth
- Departamento de Medicina Social, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | | | | | | | | | | | - Laio Magno
- Departamento de Ciências da Vida, Universidade Do Estado da Bahia (UNEB), Salvador, BA, Brazil
| | - Marcílio F Lemos
- Laboratório de Hepatites, Centro de Virologia, Instituto Adolfo Lutz, Av. Dr Arnaldo, 355 Pacaembu, São Paulo, SP, Brazil
| | - Adriana P Compri
- Laboratório de Hepatites, Centro de Virologia, Instituto Adolfo Lutz, Av. Dr Arnaldo, 355 Pacaembu, São Paulo, SP, Brazil
| | - Ana Rita C Motta-Castro
- Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Universidade Federal de Mato Grosso Do Sul, Campo Grande, MS, Brazil
| | - Regina C Moreira
- Laboratório de Hepatites, Centro de Virologia, Instituto Adolfo Lutz, Av. Dr Arnaldo, 355 Pacaembu, São Paulo, SP, Brazil.
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Cao Z, Jiang H, He W, Pan H, Zhang C, Zhong X. The Potential Risk Compensation after Receiving HPV Vaccination among Men Who Have Sex with Men in Southwest China: A HAPA-Based Analysis. Vaccines (Basel) 2023; 11:1429. [PMID: 37766106 PMCID: PMC10538197 DOI: 10.3390/vaccines11091429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/20/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Background: men who have sex with men (MSM) are a high-risk group for human papillomavirus (HPV) infection, and the HPV vaccine is effective in preventing it. However, according to risk compensation theory, people may increase sexual risk behaviors after receiving HPV vaccination. Based on the Health Action Process Approach (HAPA), this study investigated the influencing factors to predict intention to reduce condom use (risk compensation intention) among MSM after taking HPV vaccination in southwest China. Methods: we conducted a cross-sectional study among 948 MSM in southwest China using a non-probability sampling method and an electronic questionnaire including sociodemographic characteristics, sexual risk behavior characteristics, HPV-related prevention behavior, and the HAPA scale. Confirmatory factor analysis was performed using a structural equation model. Results: among 948 MSM, the incidence rate of reducing the frequency of condom use was 14.1%. The structural equation model showed that self-efficacy (β = -0.378, p = 0.020) and positive outcome expectancy (β = 0.366, p < 0.05) had greater effects on behavioral intention, followed by negative outcome expectancy (β = -0.296, p < 0.05) and risk perception (β = -0.232, p < 0.05). Conclusions: risk compensation may not be a major barrier to receiving HPV vaccination among MSM. Nevertheless, the recognition of possible risk compensation is necessary to implement appropriate interventions to reduce the occurrence of risk compensation.
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Affiliation(s)
| | | | | | | | | | - Xiaoni Zhong
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (Z.C.); (H.J.); (W.H.); (H.P.); (C.Z.)
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Lu WJ, Jian H, Wu YL, Zhu WQ, Yue XL, Fu GF, Gong XD. Prevalence and trend of gonorrhea in female sex workers and men having sex with men in China: a systematic review and meta-analysis. Public Health 2023; 221:106-115. [PMID: 37441994 DOI: 10.1016/j.puhe.2023.06.010] [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: 01/20/2023] [Revised: 05/23/2023] [Accepted: 06/05/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVES This systematic review was conducted to estimate the respective prevalence of gonorrhea among two high-risk populations in China and determine the epidemiological features of gonorrhea in them. STUDY DESIGN Systematic review. METHODS PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang databases were searched to identify studies published between January 1, 1990, and October 31, 2022, with gonorrhea prevalence tested by polymerase chain reaction among female sex workers (FSWs) and men who have sex with men (MSM). Meta-regression and subgroup analyses were used to investigate potential factors of heterogeneity across studies. Trend analysis of prevalence was conducted by the Jonckheere-Terpstra method. RESULTS We identified 88 prevalence data points from 49 studies in China, with 30,853 participants of FSWs and 5523 participants of MSM. Pooled prevalence of gonorrhea among FSWs and MSM were 6.9% (95% confidence interval: 4.6-9.7%) and 2.5% (95% confidence interval: 1.5-3.7%), respectively. The subgroup analyses showed there were period, regional, and specimen collection methods diversities among FSWs, and diversities of the regions and specimen collection anatomical sites were found among MSM, in which the prevalence of rectum and pharynx was significantly higher than the urethra. A decreasing trend in the prevalence of gonorrhea was seen among FSWs (z = -4.03) from 1999 to 2021, not found for MSM in China. CONCLUSION The prevalence of gonorrhea is high in two high-risk groups in China, with extragenital infections requiring particular attention. The findings of this study will provide evidence to formulate national policy and guidance for gonorrhea prevention and control.
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Affiliation(s)
- W-J Lu
- School of Public Health, Nanjing Medical University, Nanjing, China; Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - H Jian
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Y-L Wu
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - W-Q Zhu
- School of Public Health, Nanjing Medical University, Nanjing, China; Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - X-L Yue
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China; Department of STD Epidemiology, National Center for STD Control, Nanjing, China
| | - G-F Fu
- Department of HIV/STD Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - X-D Gong
- School of Public Health, Nanjing Medical University, Nanjing, China; Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China; Department of STD Epidemiology, National Center for STD Control, Nanjing, China.
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Ni Y, Lu Y, He X, Li Y, Li Y, Guo S, Ong JJ, Xu C, Wang X, Yan X, Tao Y, Liu N, Tang W. Self-sampled specimens demonstrate comparable accuracy and consistency to clinician-sampled specimens for HPV detection among men who have sex with men in China. Sex Transm Infect 2023; 99:104-109. [PMID: 35534231 DOI: 10.1136/sextrans-2022-055408] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/15/2022] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Despite a high risk of human papillomavirus (HPV) infection among men who have sex with men (MSM), few have ever tested. This study aimed to evaluate the feasibility and accuracy of HPV self-sampling among Chinese MSM, with the purpose of measuring the feasibility of self-sampling as an alternative in HPV testing scenarios. METHODS Eligible participants were those who were assigned male at birth, aged 18 or above, had sex with men in the past year and had never gotten HPV vaccine. Participants followed the instructions to self-sample and were also clinician-sampled from the same anatomical sites (oral fluid, penis and rectum) in both approaches. All specimens were processed using multiplex PCR assay. The reference standard of an individual with a true positive for HPV is determined via PCR test, regardless of sampling methods. Sensitivity and specificity were calculated for each approach independently and kappa test was used to assess the consistency between the two approaches. RESULTS Overall, 211 MSM were recruited at the local clinic from April to October 2020 in Zhuhai, China. The mean age was 31 years old. Only 3% of the participants sought help from healthcare providers during self-sampling. The prevalence of HPV was 49% (103 of 211). Clinician sampling detected 91 of 103 MSM infected with HPV, with a sensitivity of 88.3% (95% CI 80.2 to 93.6) and a specificity of 100.0% (95% CI 95.7 to 100.0). Self-sampling detected 81 of 103 MSM infected with HPV, with a sensitivity of 78.6% (95% CI 69.2 to 85.9) and a specificity of 100.0% (95% CI 95.7 to 100.0). The level of agreement was moderate between clinician sampling and self-sampling (k=0.67). CONCLUSIONS Self-sampled HPV testing demonstrated comparable accuracy and consistency to clinician sampling among MSM in China. It holds the potential to complement sexual health services especially among key populations.
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Affiliation(s)
- Yuxin Ni
- University of North Carolina Project-China, Guangzhou, Guangdong, China
| | - Ying Lu
- University of North Carolina Project-China, Guangzhou, Guangdong, China
| | - Xi He
- Zhuhai Xutong Voluntary Services Center, Zhuhai, China
| | | | - Yongqing Li
- Zhuhai Xutong Voluntary Services Center, Zhuhai, China
| | - Shiyu Guo
- BGI Clinical Laboratories (Shenzhen), Shenzhen, China
| | - Jason J Ong
- Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Hospital, Melbourne, Victoria, Australia.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Chen Xu
- University of North Carolina Project-China, Guangzhou, Guangdong, China
| | | | - Xumeng Yan
- University of North Carolina Project-China, Guangzhou, Guangdong, China
| | - Yusha Tao
- University of North Carolina Project-China, Guangzhou, Guangdong, China
| | - Na Liu
- BGI Genomics, Shenzhen, China
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, Guangdong, China .,Guangdong No.2 People's Hospital, Guangzhou, People's Republic of China
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Guo Z, Feng A, Zhou Y, Gao Y, Sun Y, Chen Y, Zhou X, Zou H. Geosocial networking mobile applications use and HIV and other sexually transmitted infections among men who have sex with men in Southern China: A cross-sectional study. Front Public Health 2023; 11:1063993. [PMID: 36844866 PMCID: PMC9944389 DOI: 10.3389/fpubh.2023.1063993] [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: 10/07/2022] [Accepted: 01/18/2023] [Indexed: 02/10/2023] Open
Abstract
Introduction Men who have sex with men (MSM) are increasingly using geosocial networking (GSN) mobile applications (apps) to socialize in the community. Our study aimed to compare sexual behaviors between app-using MSM (app users) and non-app-using MSM (non-app users), and evaluate the association between app use and sexually transmitted infections (STIs). Methods Eligible MSM were recruited from January to August 2017 in three metropolitan cities: Guangzhou, Shenzhen and Wuxi. A self-completed tablet-based questionnaire was collected about socio-demographic characteristics, sexual behaviors and app use. Blood samples were collected to test for HIV and syphilis. Rectal swabs taken by nurses and urine samples taken by participants themselves were collected to test for gonorrhea and chlamydia. Anogenital warts were checked by a clinician. Chi square tests and logistic regression were used to compare the prevalence of STIs and the characteristics between app users and non-app users. Results A total of 572 MSM were included in our analysis, 59.9, 25.7, and 23.4% MSM were recruited from Guangzhou, Shenzhen, and Wuxi, respectively. The majority of participants were 20-29 years old (61.7%). 89.0% of MSM had ever used at least one GSN app, and 63.8% MSM had anal intercourse (AI) partners found via apps. Among app users, 62.7% spent <30 min on apps per day on average in the past 6 months. Compared with non-app users, app users were more likely to have an education level of college and above [adjusted OR (AOR) 3.36, 95% confidence interval (CI) 1.65-7.03], have regular sex partners (2.40, 1.16-5.19), have two or more casual sex partners (2-5: 2.90, 1.21-6.90; ≥6: 13.91, 3.13-82.90), have condomless anal intercourse (CAI) with casual sex partners in the past 6 months (2.50, 1.28-5.04), do not know their last sex partners' HIV status (2.16, 1.13-4.21), have tested for HIV in the past year (2.09, 1.07-4.09) and be circumcised (4.07, 1.29-18.42). Prevalence of HIV (8.3 vs. 7.9%, P = 0.93), syphilis (6.9 vs. 11.1%, P = 0.34), gonorrhea (5.1 vs. 6.3%, P = 0.90), chlamydia (18.5 vs. 12.7%, P = 0.36), and anogenital warts (4.9 vs. 4.8%, P = 1.00) were similar between app users and non-app users. Conclusions GSN app users were more likely to have high-risk sexual behaviors, but the prevalence of HIV and other STIs were similar to non-app users. Longitudinal studies comparing the incidence of HIV/STIs between long-term app users and non-app users may be necessary to clarify the impact of app use on HIV/STIs risk.
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Affiliation(s)
- Zhihui Guo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Anping Feng
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yiguo Zhou
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Yanxiao Gao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yinghui Sun
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yuanyi Chen
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xinyi Zhou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.,Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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Zhai M, Duan Z, Tian J, Jiang Q, Zhu B, Xiao C, Yu B, Yan H. Psychosocial characteristics pattern correlated with HIV-related risky sexual behavior among HIV-negative men who have sex with men: a latent profile analysis. Environ Health Prev Med 2023; 28:2. [PMID: 36631072 PMCID: PMC9845062 DOI: 10.1265/ehpm.22-00157] [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] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Men who have sex with men (MSM) have become a high risk population of HIV infection due to their risky sexual behaviors. The latent pattern of psychosocial characteristics plays an important effect in HIV-related risky behaviors among HIV-negative MSM. METHOD Participants were recruited from Wuhan, Nanchang, and Changsha city from September 2017 to January 2018. Social support was assessed by the multidimensional scale of social support, Connor-Davidson Resilience scale-10 items for reliance, the assessment of Stigma towards Homosexuality for sexual minority stigma, the Likert subscale of nondisclosure for identity concealment, the ACE questionnaire-Kaiser-CDC for adverse childhood experience, the Centers for Epidemiological Studies Depression Scale for depression. Latent profile analysis (LPA) and multivariate regression were used to analyze the data. RESULTS Three psychosocial characteristic patterns were revealed by the LPA. "Social support and resilience group" (SR group), "Identity concealment group" (IC group) and "Adverse childhood experience" (ACE group) were identified, respectively. In comparison with "SR group", "IC group" have a higher likelihood of one-night male partners (AOR = 2.74, 95%CI = [1.54, 4.90]), both fixed and one-night male partners (AOR = 2.01, 95%CI = [1.34, 3.01]) and HIV-unsure male partner (AOR = 2.12, 95%CI = [1.44, 3.13]). Similarly, "ACE group" were more likely having inconsistent condom use (AOR = 2.58, 95%CI = [1.41, 4.73]), and having sex with HIV-positive male partner (AOR = 4.90, 95%CI = [1.95, 12.30]) with comparison of "SR group". In addition, we further revealed that "ACE group" had a higher ratio (90.0%) of inconsistent condom use among MSM whose male partners were HIV-positive. CONCLUSIONS Six important psychosocial factors were divided into three latent pattern classes. Compared with "SR group", "IC group" and "ACE group" were more likely to engage in HIV-related risky sexual behaviors. Further research may pay more attention to "IC group" and "ACE group" for targeted intervention.
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Affiliation(s)
- Mengxi Zhai
- School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Zhizhou Duan
- Preventive Health Service, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Jiawei Tian
- School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Qingqing Jiang
- School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Biao Zhu
- School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Chenchang Xiao
- City College, Wuhan University of Science and Technology, Wuhan, China
| | - Bin Yu
- School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Hong Yan
- School of Public Health, Wuhan University, Wuhan, Hubei Province, China
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9
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Ouedraogo HG, Zida S, Sagna T, Zoure AA, Compaore RT, Soubeiga ST, Ouedraogo O, Kambiré D, Belemsaga/Yugbaré D, Cissé K, Traoré Y, Barro N, Kouanda S. Herpes simplex virus type 2 (HSV-2) and its association with HIV, HCV, HBV, HTLV-1&2 and syphilis among men who have sex with men in Burkina Faso. Indian J Med Microbiol 2022; 42:59-64. [PMID: 36241531 DOI: 10.1016/j.ijmmb.2022.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 09/03/2022] [Accepted: 09/20/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE This study aimed to estimate herpes simplex virus type 2 (HSV-2) seroprevalence and its association with HIV, HBV, HCV, HTLV-1&2 and syphilis among men who have sex with men (MSM) in Ouagadougou, Burkina Faso, West Africa. MATERIALS AND METHODS We screened MSM sera for HSV-2 antibodies. A total of 329 sera were collected from an HIV and syphilis behavioral and biological cross-sectional survey conducted among MSM in Ouagadougou from January to April 2013. Serum samples were tested using Enzyme Linked Immuno-Sorbent Assay (ELISA) for the detection of IgG antibodies to HSV-2. Also, antibodies to HTLV-1&2, HBsAg and anti-HCV antibodies were screened by ELISA. Laboratory assays were performed according to manufacturers' instructions at the Biomedical Research Laboratory at the "Institut de Recherche en Sciences de la Sante" (IRSS) in Burkina Faso. RESULTS The seroprevalence of HSV-2 infection among MSM was 14.3%(95% CI: 10.6-18.1), with disparities according to age and occupation. HSV-2 seroprevalence was high among MSM who were seropositive for HIV (40% versus 13.9%), for syphilis (42.9% versus 13.3%), for HCV (32.5% versus 11.7%) and for HTLV-1&2 (38.5% versus 12.9%) compared to people seronegative for these pathogens. Multivariate analysis showed that HIV-positive (ORa = 5.34, p = 0.027), anti-HCV-positive (ORa = 4.44, p = 0.001), and HTLV-1&2 positive (aOR = 4.11, p = 0.046) were associated with HSV-2 infection among MSM. However, no significant statistical association between HSV-2 and syphilis was found. CONCLUSION HSV-2 seroprevalence among MSM in Burkina Faso is relatively high. Positive associations between sexual transmitted infections including HIV with HSV-2 suggest that HSV-2 infection's prevention should be strengthened through HIV transmission control programs.
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Affiliation(s)
- Henri Gautier Ouedraogo
- Institut de Recherche en Sciences de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique (CNRST), Ouagadougou, Burkina Faso.
| | - Sylvie Zida
- Institut de Recherche en Sciences de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique (CNRST), Ouagadougou, Burkina Faso
| | - Tani Sagna
- Institut de Recherche en Sciences de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique (CNRST), Ouagadougou, Burkina Faso
| | - Abdou Azaque Zoure
- Institut de Recherche en Sciences de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique (CNRST), Ouagadougou, Burkina Faso
| | - Rebeca T Compaore
- Institut de Recherche en Sciences de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique (CNRST), Ouagadougou, Burkina Faso
| | - Serge T Soubeiga
- Institut de Recherche en Sciences de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique (CNRST), Ouagadougou, Burkina Faso
| | - Oumarou Ouedraogo
- Institut de Recherche en Sciences de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique (CNRST), Ouagadougou, Burkina Faso
| | - Dinanibe Kambiré
- Institut de Recherche en Sciences de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique (CNRST), Ouagadougou, Burkina Faso
| | - Danielle Belemsaga/Yugbaré
- Institut de Recherche en Sciences de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique (CNRST), Ouagadougou, Burkina Faso
| | - Kadari Cissé
- Institut de Recherche en Sciences de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique (CNRST), Ouagadougou, Burkina Faso
| | - Yves Traoré
- Unité de Formation et de Recherche en Sciences de la Vie et de la Terre (UFR-SVT), Universite Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Nicolas Barro
- Unité de Formation et de Recherche en Sciences de la Vie et de la Terre (UFR-SVT), Universite Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Seni Kouanda
- Institut de Recherche en Sciences de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique (CNRST), Ouagadougou, Burkina Faso
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10
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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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11
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Zhao Z, Chu M, Guo Y, Yang S, Abudurusuli G, Frutos R, Chen T. Feasibility of Hepatitis C Elimination in China: From Epidemiology, Natural History, and Intervention Perspectives. Front Microbiol 2022; 13:884598. [PMID: 35722351 PMCID: PMC9201439 DOI: 10.3389/fmicb.2022.884598] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/09/2022] [Indexed: 11/20/2022] Open
Abstract
Hepatitis C imposes a heavy burden on many countries, including China, where the number of reported cases and the incidence of hepatitis C virus (HCV) increased yearly from 2005 to 2012, with a stable trend after 2012. The geographical distribution of HCV infections varies widely in China, with the northwest and southwest regions and the Henan Province showing a high disease burden. Elderly, men, sexually active people, drug users, migrants, blood transfusion recipients, and renal dialysis patients have become the target populations for hepatitis C prevention and control. It is important to improve the diagnosis rate in high-risk groups and asymptomatic people. Identifying secondary HCV infections, especially in HCV patients co-infected with the human immunodeficiency virus (HIV) is a priority of hepatitis C prevention and control. Enhancing universal access to direct antiviral agents (DAAs) treatment regimens is an effective way to improve the cure rate of HCV infection. For China to contribute to the WHO 2030 global HCV elimination plan, strategic surveillance, management, and treatment program for HCV are needed.
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Affiliation(s)
- Zeyu Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- CIRAD, Intertryp, Montpellier, France
| | - Meijie Chu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Yichao Guo
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Shiting Yang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Guzainuer Abudurusuli
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | | | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
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12
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Xu W, Reipold EI, Zhao P, Tang W, Tucker JD, Ong JJ, Wang J, Easterbrook P, Johnson CC, Jamil MS, Wang C. HCV Self-Testing to Expand Testing: A Pilot Among Men Who Have Sex With Men in China. Front Public Health 2022; 10:903747. [PMID: 35712303 PMCID: PMC9194083 DOI: 10.3389/fpubh.2022.903747] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/11/2022] [Indexed: 11/23/2022] Open
Abstract
Background Hepatitis C virus self-testing (HCVST) may increase test uptake especially among marginalized key populations such as men who have sex with men (MSM). We conducted an observational study to assess the usability, acceptability and feasibility of HCVST among MSM in China. Methods An observational study with convenience sampling was performed among MSM in Guangzhou, China in 2019. The OraQuick® HCV Rapid Antibody Test kits were used in this study. Participants performed all 12 HCVST steps and interpreted the results in the presence of a trained observer. Usability was defined as the number and percentage of participants who completed all testing steps correctly without assistance and interpreted the results correctly. Inter-reader concordance was calculated as the percentage agreement between the results interpreted by the participant and those interpreted by a trained staff member. The same process was used to estimate inter-operator agreement between the self-testing and professional use test results. Acceptability was assessed using an interviewer-administered semi-structured questionnaire. Results Among 100 participants with median age 27 (interquartile range 23-30) years, 4% reported prior history of HCV testing, 41% reported using blood-based HIV self-testing in the past, 54% (95%CI: 43.7-64.0%) completed all self-testing steps correctly without assistance and interpreted the results correctly. Both the inter-reader and inter-operator concordance were excellent at 97% (95%CI: 91.5-99.4%) and 98% (95%CI: 93.0-99.8%), respectively. The majority rated the HCVST process as very easy (52%, 95%CI: 41.8-62.1%) or easy (41%, 95%CI: 31.3-51.3%), 76% (95%CI: 66.4-84.0%) were willing to use HCVST again, and 75% (95%CI: 65.3-83.1%) would recommend it to their family and friends. Conclusions Our findings demonstrate that oral fluid HCVST has high usability and acceptability among Chinese MSM. More implementation research is needed to plan how best to position and scale-up HCVST alongside other facility-and community-based testing approaches and ensure data linkage into health systems.
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Affiliation(s)
- Wenqian Xu
- School of Public Health, Southern Medical University, Guangzhou, China
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Southern Medical University Institute for Global Health, Guangzhou, China
- Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
| | | | - Peizhen Zhao
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Southern Medical University Institute for Global Health, Guangzhou, China
- Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
| | - Weiming Tang
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Southern Medical University Institute for Global Health, Guangzhou, China
- Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
| | - Joseph D. Tucker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- School of Medicine, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jason J. Ong
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Jinshen Wang
- School of Public Health, Southern Medical University, Guangzhou, China
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Southern Medical University Institute for Global Health, Guangzhou, China
- Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
| | - Philippa Easterbrook
- Department of Global HIV, Hepatitis, and STI Programmes, World Health Organization, Geneva, Switzerland
| | - Cheryl Case Johnson
- Department of Global HIV, Hepatitis, and STI Programmes, World Health Organization, Geneva, Switzerland
| | - Muhammad S. Jamil
- Department of Global HIV, Hepatitis, and STI Programmes, World Health Organization, Geneva, Switzerland
| | - Cheng Wang
- School of Public Health, Southern Medical University, Guangzhou, China
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Southern Medical University Institute for Global Health, Guangzhou, China
- Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
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13
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Whelan J, Abbing-Karahagopian V, Serino L, Unemo M. Gonorrhoea: a systematic review of prevalence reporting globally. BMC Infect Dis 2021; 21:1152. [PMID: 34763670 PMCID: PMC8582208 DOI: 10.1186/s12879-021-06381-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) recommends periodic gonorrhoea prevalence assessments in the general population or proxies thereof (including pregnant women, women attending family planning clinics, military recruits, and men undergoing employment physicals for example) and in population groups at increased risk, including men-who-have-sex-with-men (MSM) and sex workers. METHOD We evaluated reported prevalence data, including estimates from proxy general population samples to reflect the WHO recommendations. We describe the outcomes from the general population country-by-country and extend previous reviews to include MSM, sex workers, and extragenital infections. RESULT AND CONCLUSION In our systematic search, 2015 titles were reviewed (January 2010-April 2019) and 174 full-text publications were included. National, population-based prevalence data were identified in only four countries (the United States of America, the United Kingdom, Peru, New Caledonia) and local population-based estimates were reported in areas within five countries (China, South Africa, Brazil, Benin, and Malawi). The remaining studies identified only reported test positivity from non-probability, proxy general population samples. Due to the diversity of the reviewed studies, detailed comparison across studies was not possible. In MSM, data were identified from 64 studies in 25 countries. Rectal infection rates were generally higher than urogenital or pharyngeal infection rates, where extragenital testing was conducted. Data on sex workers were identified from 41 studies in 23 countries; rates in female sex workers were high. Current prevalence monitoring was shown to be highly suboptimal worldwide. Serial prevalence monitoring of critical epidemiological variables, and guidelines to optimize prevalence study conduct and reporting beyond antenatal settings are recommended.
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Affiliation(s)
- Jane Whelan
- Clinical and Epidemiology Research and Development, GSK, Amsterdam, The Netherlands.
| | | | - Laura Serino
- Clinical and Epidemiology Research and Development, GSK, Siena, Italy
| | - Magnus Unemo
- WHO Collaborating Centre for Gonorrhoea and other STIs, Department of Laboratory Medicine, Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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14
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Sindhuja T, Gupta V, Bhari N, Gupta S. Asian guidelines for genital herpes. J Infect Chemother 2021; 27:1389-1399. [PMID: 34332884 DOI: 10.1016/j.jiac.2021.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/12/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Tekumalla Sindhuja
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Neetu Bhari
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
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15
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Zhang J, Huang XJ, Tang WM, Chu Z, Hu Q, Liu J, Ding H, Han X, Zhang Z, Jiang YJ, Geng W, Xia W, Xu J, Shang H. Rapid Clinical Progression and Its Correlates Among Acute HIV Infected Men Who Have Sex With Men in China: Findings From a 5-Year Multicenter Prospective Cohort Study. Front Immunol 2021; 12:712802. [PMID: 34367176 PMCID: PMC8339583 DOI: 10.3389/fimmu.2021.712802] [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: 05/21/2021] [Accepted: 07/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background In the “treat all” era, there are few data on the nature of HIV clinical progression in middle-income countries. The aim of the current study was to prospectively analyze the clinical progression of HIV and its indicators among men in China with acute HIV who have sex with men. Methods From 2009–2014 a total of 400 men with acute HIV infection (AHI) were identified among 7,893 men who have sex with men via periodic pooled nucleic acid amplification testing, and they were assigned to an AHI prospective cohort in Beijing and Shenyang, China. Rapid progression was defined as two consecutive CD4+ T cell counts < 350/µL within 3–24 months post-infection. Kaplan−Meier and Cox-regression analyses were conducted to identify predictors of rapid progression. Results Among 400 men with AHI 46.5% were rapid progressors, 35.1% reached rapid progressor status by 12 months post-infection, and 63.9% reached rapid progressor status by 24 months. Rapid progression was associated with herpes simplex-2 virus coinfection (adjusted hazard ratio [aHR] 1.7, 95% confidence interval [CI] 1.2–2.3], depression (aHR 1.9, 95% CI 1.5–2.6), baseline CD4+ T cell count < 500/μL (aHR 3.5, 95% CI 2.4–5.1), higher baseline HIV viral load (aHR 1.6, 95% CI 1.2–2.3), acute symptoms lasting ≥ 2 weeks (aHR 1.6, 95% CI 1.1–2.2), higher body mass index (aHR 0.9, 95% CI 0.9–1.0), higher HIV viral load (aHR 1.7, 95% CI 1.4–2.1), set point viral load at 3 months (aHR 2.0, 95% CI 1.6–2.5), each 100-cell/μL decrease in CD4+ T cell count at 3 months (aHR 2.2, 95% CI 1.9–2.5), and baseline routine blood tests including white blood cell count < 5.32, hemoglobin ≥ 151, mean corpuscular hemoglobin ≥ 30.5, hemoglobin concentration ≥ 342, mean platelet count ≥ 342, lymphocytes ≥ 1.98, and mixed cell count ≥ 0.4 (all p < 0.05). Conclusion Almost half of the patients underwent rapid clinical progression within 2 years after HIV infection. A treat-all policy is necessary and should be strengthened globally. Rapid progression was correlated with herpes simplex-2 virus coinfection, depression, low CD4+ T cell counts, and high set point viral load in acute infection stage. Rapid progression can be identified via simple indicators such as body mass index and routine blood test parameters in low and middle-income countries.
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Affiliation(s)
- Jing 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.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Xiao-Jie Huang
- Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Wei-Ming Tang
- Dermatology Hospital, Southern Medical University, Guangzhou, China.,University of North Carolina Project-China, Guangzhou, China.,School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - 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.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Qinghai Hu
- 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.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Jing Liu
- 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.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Haibo Ding
- 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.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Xiaoxu Han
- 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.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Zining 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.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, 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.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Wenqing Geng
- 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.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Wei Xia
- Beijing Youan Hospital, Capital Medical University, Beijing, 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.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Hong Shang
- 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.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
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16
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Smith MK, Searle KM, Yang W, Rapheal E, Wang C, Zhao P, Yang L, Huang S, Yang B. Spatiotemporal analysis of 11 years of Chlamydia trachomatis data from southern China. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2021; 11:100143. [PMID: 34327356 PMCID: PMC8315467 DOI: 10.1016/j.lanwpc.2021.100143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/08/2021] [Accepted: 03/19/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Urogenital Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection (STI) globally. Reviews suggest high and persistently endemic STI epidemics in low and middle income countries. However population-based prevalence estimates in these settings are less common, underscoring the need for analyses of available data to characterize patterns of disease burden. We identified spatio-temporal clusters and key behavioral, social, or environmental factors contribution to transmission in order to inform the prioritization and targeting of evidence based interventions. METHODS Using 11 years of data (2006-2016) from the chlamydia case report system of Guangdong, China, we identified county level spatio-temporal hot and cold spots using the Getis-Ord Gi* statistic and discrete Poisson models in SaTScan 9.6. We also estimated associations between observed distribution patterns and area-level demographic, social, and economic factors using quasi-Poisson regression models that controlled for annual counts of certified laboratories to account for fluctuations in location-specific detection capacity. FINDINGS Cluster analysis indicates an expanding chlamydia epidemic in Guangdong, with cases clustered in regions of greatest economic activity. Greater male-to-female sex ratio (RR, 3.63; 95% CI, 1.41-9.45) and greater urbanicity (RR, 2.44; 95% CI, 1.98-2.99) were predictive of higher chlamydia case occurrence. INTERPRETATION We found that chlamydia case occurrence in Guangdong province has been accelerating over the past 11 years and that its expansion is tied to indicators of social and economic development. These estimates not only identify high prevalence regions to target but also areas where data gaps potentially remain. The salience of sex ratios and urbanicity may best be understood through the lens of China's modern history of labor migration which has reshaped the gender dynamics and health access landscape of urban China. Future chlamydia control efforts will require a population-based approach focused on reengaging sexually active adults of diverse economic and migratory backgrounds. FUNDING This was an unfunded study using routinely collected public health data.
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Affiliation(s)
- M. Kumi Smith
- Division of Epidemiology & Community Health, University of Minnesota Twin Cities, 1300 South 2 Street, Ste 300, Minneapolis, MN, USA
| | - Kelly M. Searle
- Division of Epidemiology & Community Health, University of Minnesota Twin Cities, 1300 South 2 Street, Ste 300, Minneapolis, MN, USA
| | - Wenyue Yang
- College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, China
| | - Erica Rapheal
- Division of Epidemiology & Community Health, University of Minnesota Twin Cities, 1300 South 2 Street, Ste 300, Minneapolis, MN, USA
| | - Cheng Wang
- Dermatology Hospital of the Southern Medical University, No. 2 Lujing Road, Guangzhou, China
| | - Peizhen Zhao
- Dermatology Hospital of the Southern Medical University, No. 2 Lujing Road, Guangzhou, China
| | - Ligang Yang
- Dermatology Hospital of the Southern Medical University, No. 2 Lujing Road, Guangzhou, China
| | - Shujie Huang
- Dermatology Hospital of the Southern Medical University, No. 2 Lujing Road, Guangzhou, China
| | - Bin Yang
- Dermatology Hospital of the Southern Medical University, No. 2 Lujing Road, Guangzhou, China
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17
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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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18
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Wang R, Cui N, Long M, Mu L, Zeng H. Barriers to uptake of hepatitis C virus (HCV) health intervention among men who have sex with men in Southwest China: A qualitative study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:445-452. [PMID: 32667104 DOI: 10.1111/hsc.13104] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 05/24/2020] [Accepted: 06/25/2020] [Indexed: 06/11/2023]
Abstract
Men who have sex with men (MSM) are at risk of contracting the hepatitis C virus (HCV). Previous studies have documented low uptake of sexually transmitted disease (STD) prevention and health services among Chinese MSM. We carried out qualitative research among MSM in Southwest China. By taking the Health Brief Model (HBM) as a framework, we aimed to determine the underlying factors related to use of HCV health intervention services among MSM. From May to July 2018, we conducted in-depth interviews in Southwest China with 20 participants. Our research revealed that a lack of knowledge about HCV prevention was the main reason why MSM failed to perceive their susceptibility to HCV and had low motivation to seek preventive services. Poor service accessibility and unpleasant experiences seeing doctors also exerted negative influences on health care-seeking behaviour in MSM. More trust and understanding needs to be built between health providers and MSM. Protection of privacy for MSM should be guaranteed in the delivery of health interventions. In addition, the interviewees showed refusal to engage with health interventions being specifically targeted at MSM, which would create a sense of being 'labelled'. Tailored health interventions may overemphasise their sexuality, segregate them from heterosexuals, and make them feel alienated. Therefore, we speculate that differential treatment may be an obstacle for MSM to become involved in health interventions.
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Affiliation(s)
- Ruoxi Wang
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Blood Components Department, Chengdu Blood Center, Chengdu, Sichuan Province, China
| | - Nianqi Cui
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU), Hangzhou, Zhejiang Province, China
| | - Mengyun Long
- Medical Faculty, Yunnan College of Business Management, Kunming, Yunnan Province, China
| | - Lihong Mu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Governance in Health, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Huan Zeng
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Governance in Health, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
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19
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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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20
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Wang C, Cheng W, Li C, Tang W, Ong JJ, Smith MK, Fu H, Marks M, Nie J, Zheng H, Tucker JD, Yang B. Syphilis Self-testing: A Nationwide Pragmatic Study Among Men Who Have Sex With Men in China. Clin Infect Dis 2021; 70:2178-2186. [PMID: 31260513 DOI: 10.1093/cid/ciz603] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 06/28/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Syphilis self-testing may help expand syphilis testing among men who have sex with men (MSM). China has rapidly scaled up human immunodeficiency virus (HIV) self-testing, creating an opportunity for integrated syphilis self-testing. However, there is a limited literature on implementing syphilis self-testing. METHODS A cross-sectional online survey was conducted among Chinese MSM in 2018. Participants completed a survey instrument including sociodemographic characteristics, sexual behaviors, syphilis self-testing, and HIV self-testing history. Multivariable logistic regression was conducted to identify correlates of syphilis self-testing. We also recorded potential harms associated with syphilis self-testing. RESULTS Six hundred ninety-nine MSM from 89 cities in 21 provinces in China completed the study. A total of 361/699 (51.7%) men tested for syphilis, of whom 174/699 (24.9%) men used syphilis self-testing. Among 174 who had self-tested, 90 (51.7%) reported that the self-test was their first syphilis test and 161 (92.5%) reported that they undertook syphilis self-testing together with HIV self-testing. After adjusting for covariates, syphilis self-testing was correlated with disclosure of sexual orientation to family or friends (adjusted odds ratio [aOR], 1.90; 95% confidence interval [CI], 1.32-2.73), reporting 2-5 male sexual partners (aOR, 1.81; 95% CI, 1.04-3.16), HIV self-testing (aOR, 39.90; 95% CI, 17.00-93.61), and never tested for syphilis in the hospital (aOR, 2.96; 95% CI, 1.86-4.72). Self-reported harms associated with syphilis self-testing were minimal. CONCLUSIONS Scaling up syphilis self-testing could complement facility-based testing in China among MSM. Self-testing may increase first-time testing and has limited harms. Our findings suggest that syphilis self-testing could be integrated into HIV self-testing services.
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Affiliation(s)
- Cheng Wang
- Dermatology Hospital of Southern Medical University, Guangzhou, China.,Guangdong Center for Skin Diseases and Sexually Transmitted Infection Control, Guangzhou, China.,University of North Carolina Project-China, Guangzhou, China
| | - Weibin Cheng
- Dermatology Hospital of Southern Medical University, Guangzhou, China.,Guangdong Center for Skin Diseases and Sexually Transmitted Infection Control, Guangzhou, China
| | - Changchang Li
- Dermatology Hospital of Southern Medical University, Guangzhou, China.,Guangdong Center for Skin Diseases and Sexually Transmitted Infection Control, Guangzhou, China
| | - Weiming Tang
- Dermatology Hospital of Southern Medical University, Guangzhou, China.,Guangdong Center for Skin Diseases and Sexually Transmitted Infection Control, Guangzhou, China.,University of North Carolina Project-China, Guangzhou, China
| | - Jason J Ong
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom.,Central Clinical School, Monash University, Melbourne, Australia
| | - M Kumi Smith
- Division of Epidemiology and Community Health, University of Minnesota Twin Cities, Minneapolis
| | - Hongyun Fu
- Division of Community Health and Research, Eastern Virginia Medical School, Norfolk
| | - Michael Marks
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Juan Nie
- Dermatology Hospital of Southern Medical University, Guangzhou, China.,Guangdong Center for Skin Diseases and Sexually Transmitted Infection Control, Guangzhou, China
| | - Heping Zheng
- Dermatology Hospital of Southern Medical University, Guangzhou, China.,Guangdong Center for Skin Diseases and Sexually Transmitted Infection Control, Guangzhou, China.,University of North Carolina Project-China, Guangzhou, China
| | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom.,Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill
| | - Bin Yang
- Dermatology Hospital of Southern Medical University, Guangzhou, China.,Guangdong Center for Skin Diseases and Sexually Transmitted Infection Control, Guangzhou, China
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21
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First Responses to the Symptoms of Sexually Transmitted Infections and Treatment-Seeking Behavior Among Men Who Have Sex With Men in 13 Cities in China. Sex Transm Dis 2020; 47:28-33. [PMID: 31651711 DOI: 10.1097/olq.0000000000001074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Data are scarce on sexually transmitted infection (STI) treatment-seeking behavior among men who have sex with men (MSM) in China. The purpose of the study was to characterize the first response to STI symptoms, treatment-seeking behavior, and its associated factors among MSM in China. METHODS A cross-sectional study with convenience sampling design was conducted in 13 cities from April to July 2017. Face-to-face interviews were conducted to collect information on demographics, STI symptoms, and treatment-seeking behavior. Logistic regression analysis was conducted to evaluate variables associated with not seeking treatment. RESULTS Among 3925 recruited participants, 628 (16.0%) reported STI symptoms in the past 12 months and were included in the analysis. Upon or after being notified of the symptoms, MSM sought help from various sources or self-tested using rapid testing kits. Only 322(51.3%) went to see a doctor in clinic. In multiple logistic regression analyses, younger age, lower income, less STI knowledge (adjusted odds ratio [AOR], 1.8; 95% confidence interval [CI], 1.2-2.5), not knowing own STI risk (AOR, 1.8; 95% CI, 1.2-2.7), no symptoms of anogenital ulcers (AOR, 2.3; 95% CI, 1.3-3.8) or anogenital warts (AOR, 2.4; 95% CI, 1.6-3.7), no syphilis testing in the past 12 months (AOR, 2.1; 95% CI, 1.5-3.0) were associated with higher probability of not seeking treatment in clinics. CONCLUSIONS We found a high prevalence of STI symptoms among MSM and only half sought treatment. Prevention efforts should promote STI education, testing, and adequate treatment-seeking behavior.
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22
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Xu X, Chow EPF, Ong JJ, Hoebe CJPA, Williamson D, Shen M, Kong FYS, Hocking JS, Fairley CK, Zhang L. Modelling the contribution that different sexual practices involving the oropharynx and saliva have on Neisseria gonorrhoeae infections at multiple anatomical sites in men who have sex with men. Sex Transm Infect 2020; 97:183-189. [PMID: 33208511 DOI: 10.1136/sextrans-2020-054565] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 09/28/2020] [Accepted: 10/03/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The spectrum of sexual practices that transmit Neisseria gonorrhoeae in men who have sex with men (MSM) is controversial. No studies have modelled potential Neisseria gonorrhoeae transmission when one sexual practice follows another in the same sexual encounter ('sequential sexual practices'). Our aim was to test what sequential practices were necessary to replicate the high proportion of MSM who have more than one anatomical site infected with gonorrhoea ('multisite infection'). METHODS To test our aim, we developed eight compartmental models. We first used a baseline model (model 1) that included no sequential sexual practices. We then added three possible sequential transmission routes to model 1: (1) oral sex followed by anal sex (or vice versa) (model 2); (2) using saliva as a lubricant for penile-anal sex (model 3) and (3) oral sex followed by oral-anal sex (rimming) or vice versa (model 4). The next four models (models 5-8) used combinations of the three transmission routes. RESULTS The baseline model could only replicate infection at the single anatomical site and underestimated multisite infection. When we added the three transmission routes to the baseline model, oral sex, followed by anal sex or vice versa, could replicate the prevalence of multisite infection. The other two transmission routes alone or together could not replicate multisite infection without the inclusion of oral sex followed by anal sex or vice versa. CONCLUSIONS Our gonorrhoea model suggests sexual practices that involve oral followed by anal sex (or vice versa) may be important for explaining the high proportion of multisite infection.
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Affiliation(s)
- Xianglong Xu
- China Australia Joint Research Center for Infectious Diseases, Xian Jiaotong University, Xi'an, Shaanxi, China.,Central Clinical School, Monash University, Clayton, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
| | - Eric P F Chow
- Central Clinical School, Monash University, Clayton, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Victoria, Australia
| | - Jason J Ong
- China Australia Joint Research Center for Infectious Diseases, Xian Jiaotong University, Xi'an, Shaanxi, China.,Central Clinical School, Monash University, Clayton, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
| | - Christian J P A Hoebe
- Department of Infectious Diseases, South Limburg Public Health Services, Geleen, The Netherlands.,Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Deborah Williamson
- Melbourne Diagnostic Unit Public Health Laboratory, University of Melbourne, Melbourne, Victoria, Australia.,Doherty Applied Microbial Genomics, Doherty Institute, The University of Melbourne, Melbourne, Victoria, Australia.,Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology & Immunology, Doherty Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mingwang Shen
- China Australia Joint Research Center for Infectious Diseases, Xian Jiaotong University, Xi'an, Shaanxi, China
| | - Fabian Yuh Shiong Kong
- Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Victoria, Australia
| | - Jane S Hocking
- China Australia Joint Research Center for Infectious Diseases, Xian Jiaotong University, Xi'an, Shaanxi, China.,Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Christopher K Fairley
- China Australia Joint Research Center for Infectious Diseases, Xian Jiaotong University, Xi'an, Shaanxi, China.,Central Clinical School, Monash University, Clayton, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
| | - Lei Zhang
- China Australia Joint Research Center for Infectious Diseases, Xian Jiaotong University, Xi'an, Shaanxi, China .,Central Clinical School, Monash University, Clayton, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.,Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
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23
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Wang L, Yang B, Tso LS, Zhao P, Ke W, Zhang X, Chen Z, Ren X, Liang C, Liao Y, Chen H, Huang J, Yang L. Prevalence of co-infections with other sexually transmitted infections in patients newly diagnosed with anogenital warts in Guangzhou, China. Int J STD AIDS 2020; 31:1073-1081. [PMID: 32842906 DOI: 10.1177/0956462419890496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Prevalence of co-infecting sexually transmitted infections (STIs) among patients newly diagnosed with anogenital warts is under-reported. Our objective is to determine the prevalence of six common STIs, Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), genital herpes (herpes simplex virus type 2 [HSV-2]), HIV, and syphilis for patients visiting a sexual health clinic in Guangzhou, China. Demographics, sexual health, and medical histories were collected at patient intake. Patients diagnosed with anogenital warts (N = 200) were invited to participate. We collected urine samples, and urethral, cervical, and rectal swabs to test for CT, NG, and MG, and blood samples for serological detection of HSV-2, syphilis, and HIV. Overall 49 (24.5%) had a co-infection (22.2% of men and 27.7% of women). All six STIs were observed among men: CT (6.8%), NG (3.4%), MG (5.1%), HIV (4.3%), HSV-2 (4.3%), and syphilis (1.7%). Women had fewer STIs, but at higher rates: CT (13.3%), MG (6.0%), and HSV-2 (8.4%). Individual men had up to two co-infections, while women had no more than one co-infection. Chlamydia was the most common STI. Patients aged 18-25 years (35.4%) had the highest prevalence. Although opportunistic screening is often applied for high-risk groups, expansion to patients with anogenital warts in all health-care settings would improve detection of problematic asymptomatic co-infections, thereby increasing China's capacity to contribute toward global surveillance systems.
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Affiliation(s)
- Liuyuan Wang
- Department of Dermatology and Venerology, The First Affiliated Hospital, Jinan University, Guangzhou, China.,Department of Venerology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Bin Yang
- Department of Dermatology and Venerology, The First Affiliated Hospital, Jinan University, Guangzhou, China.,Department of Venerology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Lai S Tso
- Department of Culture Studies and Oriental Languages, University of Oslo, Oslo, Norway.,Anthropology, Massachusetts Institute of Technology, Cambridge, MA, USA.,Center for Health and Human Development Studies, Sun Yat-sen University, Guangzhou, China
| | - Peizhen Zhao
- Department of Venerology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Wujian Ke
- Department of Venerology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Xiaohui Zhang
- Department of Venerology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Zhengyu Chen
- Department of Venerology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Xuqi Ren
- Department of Venerology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Chunmei Liang
- Department of Venerology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Yuying Liao
- Department of Venerology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Huiru Chen
- Department of Venerology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Jinmei Huang
- Department of Venerology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Ligang Yang
- Department of Venerology, Dermatology Hospital, Southern Medical University, Guangzhou, China
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Zhang J, Huang X, Chen Y, Wang H, Zhang Y, Wang H, Mei Z, Jia Y, Chu Z, Hu QH, He X, Zhang L, Hu Z, Bao R, Li S, Ding H, Jiang Y, Geng W, Tang W, Xu J. HIV and other STIs self-testing to reduce risk compensation among men who have sex with men who use oral pre-exposure prophylaxis in China: protocol for a randomised waitlist-controlled trial. BMJ Open 2020; 10:e036231. [PMID: 32690516 PMCID: PMC7371146 DOI: 10.1136/bmjopen-2019-036231] [Citation(s) in RCA: 2] [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: 01/12/2023] Open
Abstract
INTRODUCTION Pre-exposure prophylaxis (PrEP) reduces the risk of HIV infection among men who have sex with men by up to 99%. However, in real-world settings, PrEP users may exhibit risk compensation after uptake of PrEP, including more condomless anal intercourse (CAI) and increased sexually transmitted infection (STI) acquisition. HIV self-testing (HIVST) decreases CAI among men who have sex with men (MSM) by providing awareness of the HIV status of oneself and one's sexual partners. Here, we describe the rationale and design of a randomised waitlist-controlled trial to examine the impact of HIVST on risk compensation among PrEP users. METHODS AND ANALYSIS The study is a two-arm randomised waitlist-controlled trial with 1000 HIV-negative MSM in four major cities in China who will be taking oral PrEP (involving tenofovir disoproxil fumarate/emtricitabine) either daily (n=500) or in an event-driven regimen (n=500). The participants will be randomised (1:1) to either the immediate HIVST intervention arm (HIVST plus standard facility-based counselling and testing from 0 to 12 months) or the waitlist arm (standard facility-based counselling and testing from 0 to 6 months, then crossover to receive the HIVST intervention in months 7-12). Participants will provide blood samples to assess the incidence of syphilis and herpes simplex virus type 2 (HSV-2) during a follow-up. The primary outcomes will be the occurrence of CAI, number of sexual partners and incidence of syphilis and HSV-2 during a follow-up. The secondary outcomes will be the HIV and STI testing frequency and STI treatment adherence during a follow-up. The planned start and end dates for the study is 26 December 2018 and 31 December 2020. ETHICS AND DISSEMINATION The Medical Science Research Ethics Committee of The First Affiliated Hospital of China Medical University has approved the study (IRB(2018)273). TRIAL REGISTRATION NUMBER ChiCTR1800020374.
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Affiliation(s)
- Jing 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
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China
- Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Xiaojie Huang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Yaokai Chen
- Chongqing Public Health Medical Center, Chongqing, China
| | - Hui Wang
- Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China
| | - Yonghui 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
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China
- Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Hongyi Wang
- 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
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China
- Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Zhu Mei
- 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
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China
- Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Yueru Jia
- 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
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China
- Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, 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
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China
- Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Qing-Hai Hu
- 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
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China
- Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Xiaoqing He
- Chongqing Public Health Medical Center, Chongqing, China
| | - Lukun Zhang
- Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China
| | - Zhili Hu
- 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
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China
- Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Rantong Bao
- 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
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China
- Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Shangcao Li
- 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
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China
- Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Haibo Ding
- 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
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China
- Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Yongjun 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
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China
- Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Wenqing Geng
- 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
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China
- Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Weiming Tang
- University of North Carolina at Chapel Hill Project-China, Guangzhou, 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
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China
- Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
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Fan S, Li P, Ouyang L, Yuan T, Gong H, Ding Y, Luo Z, Wu G, Yu M, Zou H. Anal Human Papillomavirus Infection among MSM Attending University in China: Implications for Vaccination. Vaccines (Basel) 2020; 8:vaccines8020175. [PMID: 32283842 PMCID: PMC7348703 DOI: 10.3390/vaccines8020175] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 11/16/2022] Open
Abstract
Men who have sex with men (MSM) attending university are a high-risk population for human papillomavirus (HPV) infection and are a neglected population of HPV vaccination programs in China. To provide evidence for HPV vaccination policies, we conducted this study to examine the prevalence and factors associated with anal HPV infection among MSM attending university in China. A self-administered online questionnaire was conducted to collect information on social demographics and sexual behaviors. A self-collected rectal swab specimen was collected to test for 37 HPV types. A total of 426 participants were tested for HPV. The median age was 20 years. HPV prevalence was 37.5% for any type, 29.8% for nine-valent vaccine types, 24.6% for four-valent vaccine types, 11.5% for HPV-16/18, and 15.7% for HPV-6/11. Men enrolled in a technical diploma, living in Northern China, having more than two sex partners, being bottom or versatile in anal sex, and having a human immunodeficiency virus (HIV) testing history were more likely to have positive anal HPV of any type. Our study found a high prevalence of anal HPV infection among MSM attending university in China, with HPV vaccine-preventable types being the most popular types in this group. Thus, our findings highlight the urgency of promoting HPV vaccination among teenage MSM.
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Affiliation(s)
- Song Fan
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (S.F.); (P.L.)
- Department of Social Medicine, School of Public Health, Southwest Medical University, Luzhou 646000, China
| | - Peiyang Li
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (S.F.); (P.L.)
| | - Lin Ouyang
- Department of AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing 400042, China; (L.O.); (G.W.)
| | - Tanwei Yuan
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 510006, China;
| | - Hui Gong
- Department of AIDS/STD Control and Prevention, Tianjin Center for Disease Control and Prevention, Tianjin 300011, China;
| | - Yi Ding
- Nanshan Center for Chronic Disease Control, Shenzhen 518000, China; (Y.D.); (Z.L.)
| | - Zhenzhou Luo
- Nanshan Center for Chronic Disease Control, Shenzhen 518000, China; (Y.D.); (Z.L.)
| | - Guohui Wu
- Department of AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing 400042, China; (L.O.); (G.W.)
| | - Maohe Yu
- Department of AIDS/STD Control and Prevention, Tianjin Center for Disease Control and Prevention, Tianjin 300011, China;
- Correspondence: (M.Y.); (H.Z.); Tel.: +86-20-8733-5651 (H.Z.); Fax: +86-20-8733-0446 (H.Z.)
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 510006, China;
- Kirby Institute, University of New South Wales, Sydney 2052, Australia
- Department of Community Health and Behavioral Medicine, School of Public Health, Shanghai Jiao Tong University, School of Medicine, Shanghai 200025, China
- Correspondence: (M.Y.); (H.Z.); Tel.: +86-20-8733-5651 (H.Z.); Fax: +86-20-8733-0446 (H.Z.)
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Prevalence and genotypes of anal human papillomavirus infection among HIV-positive vs. HIV-negative men in Taizhou, China. Epidemiol Infect 2020; 147:e117. [PMID: 30868975 PMCID: PMC6518779 DOI: 10.1017/s0950268818003205] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
This study aims to investigate the prevalence and genotype distribution of anal human papillomavirus (HPV) infection among men with different sexual orientations with or without human immunodeficiency virus (HIV) in China. A cross-sectional study was conducted during 2016-2017 in Taizhou City, Zhejiang Province. Convenient sampling was used to recruit male participants from HIV voluntary counselling and testing clinics and Center for Disease Control and Prevention. A face-to-face questionnaire interview was administered and an anal-canal swab was collected for HPV genotyping. A total of 160 HIV-positive and 113 HIV-negative men participated in the study. The prevalence of any type HPV was 30.6% for heterosexual men, 74.1% for homosexual and 63.6% for bisexual men among HIV-positive participants, while the prevalence was 8.3%, 29.2% and 23.8% respectively among HIV-negatives. The most prevalent genotypes were HPV-58 (16.9%), HPV-6 (15.6%) and HPV-11 (15.0%) among HIV-positive men, and were HPV-16 (4.4%), HPV-52 (4.4%) and HPV-6 (3.5%) among HIV-negative men. Having ever had haemorrhoids and having ever seen blood on tissue after defaecation was associated with HPV infection. One-fourth of the HPV infections in this study population can be covered by the quadrivalent vaccine in market. The highly prevalent anal HPV infection among men especially HIV-infected men calls for close observation and further investigation for anal cancer prevention.
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Shen K, Yang NS, Huang W, Fitzpatrick TS, Tang W, Zhao Y, Wang Y, Li L, Tucker JD. A crowdsourced intervention to decrease hepatitis B stigma in men who have sex with men in China: A cohort study. J Viral Hepat 2020; 27:135-142. [PMID: 31571341 PMCID: PMC8163661 DOI: 10.1111/jvh.13213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 08/29/2019] [Indexed: 12/19/2022]
Abstract
Stigma against people with hepatitis B virus (HBV) is a barrier to prevention, diagnosis and treatment of HBV in China. Our study examined an innovative intervention to reduce HBV stigma among men who have sex with men (MSM) in China. We extracted data from a randomized controlled trial conducted in May 2018, where the intervention consisted of crowdsourced images and videos to promote viral hepatitis testing and reduce HBV stigma. HBV stigma was assessed using a 20-item scale at baseline and four weeks post-enrolment. Participants were divided into three groups based on their exposure to intervention: full exposure, partial exposure and no exposure. Linear regression was used to determine associations between baseline stigma and participant characteristics. Data from 470 MSM were analysed. Mean participant age was 25 years old and 56% had less education than a college bachelor's degree. Full exposure to intervention was associated with significant stigma reduction (adjusted beta = -3.49; 95% CI = -6.11 to -0.87; P = .01), while partial exposure led to stigma reduction that was not statistically significant. The mean stigma score was 50.6 (SD ± 14.7) at baseline, and stigma was most prominent regarding physical contact with HBV carriers. Greater HBV stigma was associated with not having a recent doctor's visit (adjusted beta = 4.35, 95% CI = 0.19 to 8.52; P = .04). In conclusion, crowdsourcing can decrease HBV stigma among MSM in China and may be useful in anti-stigma campaigns for vulnerable populations in low- and middle-income countries.
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Affiliation(s)
- Karen Shen
- Department of Internal Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Nancy S. Yang
- University of Minnesota Medical School – Twin Cities, Minneapolis, MN, USA
| | - Wenting Huang
- University of North Carolina at Chapel Hill, Project China, Guangzhou, China,Social Entrepreneurship to Spur Health Global, Guangzhou, China
| | - Thomas S. Fitzpatrick
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Weiming Tang
- University of North Carolina at Chapel Hill, Project China, Guangzhou, China,Social Entrepreneurship to Spur Health Global, Guangzhou, China,Dermatology Hospital of Southern Medical University, Guangzhou, China
| | - Yang Zhao
- University of North Carolina at Chapel Hill, Project China, Guangzhou, China,School of Social Science, University of Queensland, Brisbane, Queensland, Australia
| | - Yehua Wang
- University of North Carolina at Chapel Hill, Project China, Guangzhou, China,Social Entrepreneurship to Spur Health Global, Guangzhou, China
| | - Linghua Li
- Center for Infectious Diseases, Guangzhou Eighth People’s Hospital, Guangzhou, China
| | - Joseph D. Tucker
- University of North Carolina at Chapel Hill, Project China, Guangzhou, China,Social Entrepreneurship to Spur Health Global, Guangzhou, China,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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Wang Z, Mo PKH, Fang Y, Ip M, Lau JTF. Factors predicting first-time hepatitis C virus testing uptake among men who have sex with men in China: an observational prospective cohort study. Sex Transm Infect 2020; 96:258-264. [PMID: 31919274 DOI: 10.1136/sextrans-2019-054248] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 12/10/2019] [Accepted: 12/13/2019] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Men who have sex with men (MSM) are at high risk of hepatitis C virus (HCV). This study investigated predictors of first-time HCV testing uptake during a 6-month period among a sample of MSM in Hong Kong. METHODS Participants were 351 Chinese-speaking MSM who had never received HCV testing. Participants completed two telephone surveys 6 months apart. At baseline, participants reported on sociodemographics, sexual behaviours, risk perception, depressive symptoms and anxiety symptoms. Illness representations, which refers to how people think about HCV, was measured by the Brief Illness Perception Questionnaire (BIPQ) at baseline. The BIPQ assessed identity (identifying symptoms of HCV), timeline (whether HCV is acute/chronic), consequences (severity of HCV), personal control and treatment control (whether HCV is under volitional control), concern, emotions (anger, guilt or shame) and coherence (overall comprehensibility of HCV). Six months later, participants reported on HCV testing uptake. Logistic regression was used to analyse the associations between baseline predictors and HCV testing uptake. RESULTS Most participants were aged ≤30 years (55.0%) and had attained college education or above (85.2%). Among 242 participants (68.9%) who completed the month 6 follow-up, 12.4% had tested for HCV during the follow-up period. After adjustment for HIV testing and chemsex in the last year, participants who perceived more severe consequences of HCV reported higher HCV testing uptake (adjusted ORs (AOR): 2.22, 95% CI: 1.65 to 3.00). Belief that treatment can control HCV (AOR: 1.75, 95% CI: 1.35 to 2.26) and having negative emotions related to HCV (AOR: 1.59, 95% CI: 1.25 to 2.03) were also positively associated with HCV testing uptake. CONCLUSIONS Targeted health promotion efforts are needed to increase HCV testing among MSM in Hong Kong. Healthcare workers engaged in HCV-related programming should consider modifying the illness representations of HCV. Integrating HCV and HIV testing services may also be beneficial.
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Affiliation(s)
- Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China .,Shenzhen Research Institute, Chinese University of Hong Kong, Shenzhen, China
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuan Fang
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, China
| | - Mary Ip
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - 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, China
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Fitzpatrick T, Tang W, Mollan K, Pan X, Chan PL, Zhou K, Cheng Y, Li L, Wong WCW, Tucker JD. A crowdsourced intervention to promote hepatitis B and C testing among men who have sex with men in China: A nationwide online randomized controlled trial. EClinicalMedicine 2019; 16:64-73. [PMID: 31832621 PMCID: PMC6890946 DOI: 10.1016/j.eclinm.2019.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 10/01/2019] [Accepted: 10/14/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Crowdsourcing may be an effective strategy to develop test promotion materials. We conducted an online randomized controlled trial (RCT) to evaluate a crowdsourced intervention to promote hepatitis B virus (HBV) and hepatitis C virus (HCV) testing among men who have sex with men (MSM) in China. METHODS MSM never previously tested for hepatitis were recruited through social media. Eligible men were randomized to receive an online crowdsourced intervention or no testing promotion materials. Outcomes including self-reported and confirmed HBV and HCV test uptake were assessed after four weeks. Odds ratios (OR) with 95% confidence intervals (95% CI) of men achieving primary and secondary outcomes between the intervention and control arms were calculated. FINDINGS 556 eligible men were enrolled. Overall, 17•4% (97/556) of men self-reported HBV and HCV testing and 7•9% (44/556) confirmed HBV and HCV test uptake. The intervention was seen by 72•1% and 29•0% of men in the intervention and control arms, respectively. In intention-to-treat analysis, confirmed HBV and HCV test uptake was similar between the two arms, both when using a missing=failure approach (OR 0•98, 95% CI 0•53-1•82) or multiple imputation (OR 1•46, 95% CI 0•72-2•95). INTERPRETATION This RCT extends the literature by developing and evaluating an intervention to spur hepatitis testing in a middle-income country with a high burden of hepatitis. Overall test uptake among MSM in China was similar to previous interventions promoting hepatitis testing in high-income countries. We found frequent intervention sharing, complicating interpretation of the results, and the role of crowdsourcing to promote hepatitis testing remains unclear.
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Affiliation(s)
- Thomas Fitzpatrick
- Department of Medicine, University of Washington, Seattle, WA, USA
- Corresponding author.
| | - Weiming Tang
- UNC Project China, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katie Mollan
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Xin Pan
- UNC Project China, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Po-Lin Chan
- Division of Communicable Disease, World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - Kali Zhou
- Division of Gastrointestinal and Liver Diseases, University of Southern California, Los Angeles, CA
| | - Yu Cheng
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Linghua Li
- Center for Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou, China
| | - William CW Wong
- Department of Family Medicine and Primary Care, Hong Kong University, Hong Kong, China
- Department of General Practice, HKU-Shenzhen Hospital, Shenzhen, China
| | - Joseph D. Tucker
- UNC Project China, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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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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31
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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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Missed Opportunities for Human Immunodeficiency Virus and Syphilis Testing Among Men Who Have Sex With Men in China: A Cross-Sectional Study. Sex Transm Dis 2019; 45:382-386. [PMID: 29750773 DOI: 10.1097/olq.0000000000000773] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Men who have sex with men (MSM) are at high risk of human immunodeficiency virus (HIV)/syphilis. To inform strategies for dual testing, we describe patterns of HIV/syphilis testing, and examine factors associated with never testing for HIV/syphilis in China. METHODS An online survey (2016) was completed by MSM from 8 cities: men born biologically male, 16 years or older, and had sex with another man at least once during their lifetime. Demographic, sexual behavioral, and HIV/syphilis testing data were collected. Multivariable multinomial logistic regression identified characteristics associated with men who never tested for HIV/syphilis compared with men who ever tested for both infections. RESULTS Overall, 2105 men participated. Among them, 35.1% (738/2105) never tested for HIV/syphilis, and in those ever tested for HIV, only half (54.0%, 709/1312) had tested for syphilis. Relative to men who had ever tested for both infections, those with increased probability of never testing for HIV/syphilis include non-gay sexual identity (prevalence odds ratio [POR] 1.86; 95% confidence interval [CI], 1.45-2.37), not disclosed their sexuality/sexual history with men other than their regular partner (POR, 2.22; 95% CI, 1.75-2.78]) or with health professionals (POR, 11.11; 95% CI, 7.69-14.29), no condomless sex with casual partners in the last 3 months (POR, 1.89; 95% CI, 1.37-2.56), no community engagement in sexual health (POR, 15.16; 95% CI, 9.40-24.45), and mainly met partners offline (POR, 1.49; 95% CI, 1.16-1.92). CONCLUSIONS There are significant gaps in lifetime testing for HIV/syphilis among Chinese MSM. Strategies to target never testers and integrate syphilis testing within HIV testing services are urgently needed. Future opportunities include point-of-care dual test kits, and testing in China's expanding primary healthcare system.
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Abstract
This Review presents current epidemiological trends of the most common liver diseases in Asia-Pacific countries. Hepatitis B virus (HBV) remains the primary cause of cirrhosis; despite declining prevalence in most Asian nations, this virus still poses a severe threat in some territories and regions. Mortality resulting from HBV infection is declining as a result of preventive measures and antiviral treatments. The epidemiological transition of hepatitis C virus (HCV) infection has varied in the region in the past few decades, but the medical burden of infection and the prevalence of its related cancers are increasing. The lack of licensed HCV vaccines highlights the need for novel treatment strategies. The prevalence of nonalcoholic fatty liver disease (NAFLD) has risen in the past decade, mostly owing to increasingly urbanized lifestyles and dietary changes. Alternative herbal medicine and dietary supplements are major causes of drug-induced liver injury (DILI) in some countries. Complications arising from these chronic liver diseases, including cirrhosis and liver cancer, are therefore emerging threats in the Asia-Pacific region. Key strategies to control these liver diseases include monitoring of at-risk populations, implementation of national guidelines and increasing public and physician awareness, in concert with improving access to health care.
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Identifying MSM-competent physicians in China: a national online cross-sectional survey among physicians who see male HIV/STI patients. BMC Health Serv Res 2018; 18:964. [PMID: 30545370 PMCID: PMC6293610 DOI: 10.1186/s12913-018-3781-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 11/29/2018] [Indexed: 11/12/2022] Open
Abstract
Background Men who have sex with men (MSM) are at high risk of human immunodeficiency virus (HIV) infection and sexually transmitted infection (STI) in China. Inadequate clinical services and poor clinical competency among physicians are major barriers to improving the sexual health of MSM. This study aims to understand physician clinical competency in providing MSM health services in China. Methods We conducted an online cross-sectional survey among Chinese physicians who have seen male patients for STI complaints in the past year. We obtained information on individual demographics, clinical practice, attitudes toward MSM, and interest in contributing to MSM clinical services. We defined an MSM-competent physician as one who asked male patients about sexual orientation, sexual practices, and recommended HIV/ STI testing during a clinic visit. We conducted multivariable logistic regression to identify factors associated with MSM competency. Results In total, 501 physicians completed the survey. The most common subspecialties were dermatovenereology (33.1%), urology (30.1%), and general medicine (14.4%). Roughly half (n = 267, 53.3%) reported seeing MSM in the past 12 months. Among physicians who saw MSM in the past 12 months, 60.3% (n = 161) met criteria as MSM-competent physicians, and most (n = 234, 87.6%) MSM-competent physicians reported positive or neutral attitudes towards MSM. Over 60% of all physicians were willing to participate in activities for improving MSM services, such as training and being on a list of physicians willing to serve MSM. MSM-competent physicians showed no sociodemographic differences compared with non MSM-competent physicians. MSM-competent physicians were more willing to have their medical institution named on a public clinic list capable of serving MSM (aOR: 1.70, 95%CI: 1.01–2.86) and being on a public physician list capable of serving MSM (aOR: 1.77, 95%CI: 1.03–3.03). Conclusions MSM-competent physicians included a broad range of individuals that practiced in diverse clinical settings. Most physicians were interested in improving and expanding MSM clinical services, despite having neutral attitudes toward same-sex behavior. Future interventions should focus on developing MSM clinical competency and expanding services that meet the needs of MSM.
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Fitzpatrick T, Zhou K, Cheng Y, Chan PL, Cui F, Tang W, Mollan KR, Guo W, Tucker JD. A crowdsourced intervention to promote hepatitis B and C testing among men who have sex with men in China: study protocol for a nationwide online randomized controlled trial. BMC Infect Dis 2018; 18:489. [PMID: 30268114 PMCID: PMC6162889 DOI: 10.1186/s12879-018-3403-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 09/20/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The World Health Organization recommends all men who have sex with men (MSM) receive Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) testing. MSM in China are a high-risk group for HBV and HCV infection, but test uptake is low. Crowdsourcing invites a large group to solve a problem and then shares the solution with the public. This nationwide online randomized controlled trial will evaluate the effectiveness of a crowdsourced intervention to increase HBV and HCV testing among MSM in China. METHODS Seven hundred MSM will be recruited through social media operated by MSM organizations in China. Eligible participants will be born biologically male, age 16 years or older, report previous anal sex with another man, and reside in China. After completing a baseline online survey, participants will be randomly assigned to intervention or control arms with a 1:1 allocation ratio. The intervention will include two components: (1) a multimedia component will deliver two videos and two images promoting HBV and HCV testing developed through a crowdsourcing contest in China; (2) a participatory component will invite men to submit suggestions for how to improve crowdsourced videos and images. The control arm will not view any images or videos and will not be invited to submit suggestions. All participants will be offered reimbursement for HBV and HCV testing costs. The primary outcome is HBV and HCV test uptake confirmed through electronic submission of test report photos within four weeks of enrolment. Secondary outcomes include self-reported HBV and HCV test uptake, HBV vaccination uptake, and change in stigma toward people living with HBV after four weeks. Primary and secondary outcomes will be calculated using intention to treat and as-exposed analyses and compared using two-sided 95% confidence intervals. DISCUSSION Few previous studies have evaluated interventions to increase HBV and HCV testing in middle-income countries with a high burden of hepatitis. Delivering a crowdsourced intervention using social media is a novel approach to increasing hepatitis testing rates. HBV and HCV test uptake will be confirmed through test report photos, avoiding the limitations of self-reported testing outcomes. TRIAL REGISTRATION NCT03482388 (29 March 2018).
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Affiliation(s)
| | - Kali Zhou
- Department of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, USA
| | - Yu Cheng
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Po-Lin Chan
- Division of Communicable Disease, World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology, Peking University, Beijing, China
| | - Weiming Tang
- UNC - Project China, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katie R Mollan
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Wilson Guo
- Gillings School of Global Public Health - Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joseph D Tucker
- UNC - Project China, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Ong JJ, Liao M, Lee A, Fu H, Pan SW, Tang W, Wei C, Dan W, Yang B, Yang L, Wang C, Tucker JD. Bridging the HIV-syphilis testing gap: dual testing among men who have sex with men living in China. Sex Transm Infect 2018; 95:251-253. [PMID: 30126948 DOI: 10.1136/sextrans-2018-053527] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 06/30/2018] [Accepted: 07/24/2018] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The WHO recommends dual testing for HIV and syphilis among key populations, including men who have sex with men (MSM). We assessed the proportion of men who had dual tested and reasons for not dual testing. METHODS In 2017, an online survey of MSM was conducted in eight cities from two provinces in China. Data on sociodemographics and sexual behaviours were collected. Descriptive analysis was used to examine the experience of dual testing. Multivariable logistic regression identified characteristics associated with men who had dual tested. RESULTS Among 802 men who had ever tested for HIV, 297 dual tested (37%, 95% CI 34 to 40). Men dual tested in a variety of settings: public hospital (35%), voluntary counselling and testing sites (28%), self-testing at home (18%), community-based organisation (8%), community health centre (7%), other (3%) or private hospital (1%). Greater odds for dual testing was found in men who had disclosed their sexuality to a healthcare provider (adjusted OR (AOR) 1.81, 95% CI 1.27 to 2.59, p=0.001), and who had substantial (AOR 2.71, 95% CI 1.67 to 4.41, p<0.001) or moderate community engagement in sexual health (AOR 2.30, 95% CI 1.49 to 3.57, p<0.001), compared with those with no community engagement. The most common reasons for not dual testing were no knowledge that they could be dual tested (34%), did not ask the doctor to be dual tested (25%) and did not believe they were at risk for syphilis (19%). CONCLUSIONS Chinese MSM are dual testing through a variety of test sites, including home self-testing. However, the overall dual testing rate remains low despite recent efforts to integrate HIV and syphilis testing.
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Affiliation(s)
- Jason J Ong
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.,Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China.,Central Clinical School, Monash University, Melbourne, Australia
| | - Meizhen Liao
- Shandong Centre for Disease Control and Prevention, Jinan, China
| | - Amy Lee
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
| | - Hongyun Fu
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China.,Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Stephen W Pan
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China.,University of North Carolina, Chapel Hill, North Carolina, USA.,Department of Public Health, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Weiming Tang
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China.,University of North Carolina, Chapel Hill, North Carolina, USA
| | - Chongyi Wei
- School of Public Health, Rutgers University, New Brunswick, New Jersey, USA
| | - Wu Dan
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China.,University of North Carolina, Chapel Hill, North Carolina, USA
| | - Bin Yang
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China.,Southern Medical University Dermatology Hospital, Guangzhou, China
| | - Ligang Yang
- Southern Medical University Dermatology Hospital, Guangzhou, China
| | - Cheng Wang
- Southern Medical University Dermatology Hospital, Guangzhou, China
| | - Joseph D Tucker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK .,Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China.,University of North Carolina, Chapel Hill, North Carolina, USA
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Mboumba Bouassa RS, Mbeko Simaleko M, Camengo SP, Mossoro-Kpinde CD, Veyer D, Matta M, Robin L, Longo JDD, Grésenguet G, Péré H, Meye JF, Belec L. Unusual and unique distribution of anal high-risk human papillomavirus (HR-HPV) among men who have sex with men living in the Central African Republic. PLoS One 2018; 13:e0197845. [PMID: 29795661 PMCID: PMC5967740 DOI: 10.1371/journal.pone.0197845] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 04/27/2018] [Indexed: 12/05/2022] Open
Abstract
Background High-risk (HR) human papillomavirus (HPV) infection remains a great concern in relation to African men who have sex with men (MSM), especially those infected with HIV. The prevalence of HR-HPV and associated risk factors was estimated in a cross-sectional observational study covering MSM living in Bangui, Central African Republic. Methods MSM receiving care at the Centre National de Référence des Infections Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, were included. HIV serostatus and socio-demographic and behavioral characteristics were collected. HPV DNA was detected and genotyped on anal swabs using Anyplex™ II HPV28 test (Seegene, South Korea), and HSV DNA by in-house real-time PCR. Logistic regression analyses were used to determine risk factors associated with HPV outcomes. Results 42 MSM (mean age, 23.2 years; range, 14–39) including 69.1% HIV-1-positive and 30.9% HIV-negative were prospectively enrolled. The prevalence of anal HPV was 69.1%, including 82.7% of HR-HPV which were multiple in 52.0%. The most prevalent genotypes were HPV-35, HPV-58, HPV-59 and HPV-31. While, HPV-16 and HPV-18 were present in a minority of samples. Multiple HR-HPV infection was more frequent in HIV-positive MSM (41.4%) with 2.7 genotypes per anal samples than in HIV-negative (7.7%) with 1.5 genotypes per anal samples. HPV types included in the prophylactic Gardasil-9® vaccine were detected in 68.9% of specimens and HPV-58 was the most frequently detected. MSM infected by HPV-16 and HPV-18 were all infected by HIV-1. Few anal swabs (11.9%) contained HSV-2 DNA without relationship with HPV detection. Condomless receptive anal intercourse was the main risk factor to being infected with any type of HPV and condomless insertive anal intercourse was significantly less associated with HPV contamination than receptive anal intercourse (Odd ratio = 0.02). Conclusion MSM in Bangui are at-risk of HIV and HR-HPV anal infections. The unusual distribution of HPV-35 as predominant HPV suggests possible geographic specificities in the molecular epidemiology of HR-HPV in sub-Saharan Africa. Scaling up prevention strategies against HPV infection and related cancers adapted for MSM in Africa should be prioritized. Innovative interventions should be conceived for the MSM population living in Bangui.
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Affiliation(s)
- Ralph-Sydney Mboumba Bouassa
- Ecole Doctorale Régionale d’Infectiologie Tropicale de Franceville, Franceville, Gabon
- Ecole Doctorale Bio Sorbonne Paris Cité, BioSPC, Paris Descartes, Paris, France
| | - Marcel Mbeko Simaleko
- Centre National de Référence des Infection Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic
| | - Serge Police Camengo
- Servivce de Gastro-entérologie, Hôpital de l’Amitié, Bangui, Central African Republic
- Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
| | - Christian Diamant Mossoro-Kpinde
- Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
- Laboratoire National de Biologie Clinique et de Santé Publique, Bangui, Central African Republic
- * E-mail:
| | - David Veyer
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Mathieu Matta
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Leman Robin
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Jean De Dieu Longo
- Centre National de Référence des Infection Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic
- Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
- Unité de Recherches et d’Intervention sur les Maladies Sexuellement Transmissibles et le SIDA, Département de Santé Publique, Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
| | - Gérard Grésenguet
- Centre National de Référence des Infection Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, Central African Republic
- Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
- Unité de Recherches et d’Intervention sur les Maladies Sexuellement Transmissibles et le SIDA, Département de Santé Publique, Faculté des Sciences de la Santé de Bangui, Bangui, Central African Republic
| | - Hélène Péré
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Jean-François Meye
- Service de Gynécologie Obstétrique, Centre Hospitalo-Universitaire d’Angondjé, Libreville et Faculté de Médecine de Libreville, Université des Sciences de la Santé, Libreville, Gabon
| | - Laurent Belec
- Laboratoire de virologie, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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Fitzpatrick T, Pan SW, Tang W, Guo W, Tucker JD. HBV and HCV test uptake and correlates among men who have sex with men in China: a nationwide cross-sectional online survey. Sex Transm Infect 2018; 94:502-507. [PMID: 29779005 DOI: 10.1136/sextrans-2018-053549] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 04/18/2018] [Accepted: 04/28/2018] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Hepatitis B virus (HBV) and hepatitis C virus (HCV) cause substantial morbidity and mortality in low-income and middle-income countries, including China. WHO guidelines recommend men who have sex with men (MSM) receive HBV and HCV screening. The purpose of this study was to determine the proportion of MSM in China who have HBV and HCV tested and identify correlates of test uptake. METHODS We conducted an online cross-sectional survey of young MSM in China. Respondents were asked to report previous HBV and HCV testing, sociodemographic information, sexual risk factors for hepatitis infection, other STI testing and primary care physician (PCP) status. Associations were analysed by logistic regression. RESULTS 503 eligible MSM completed the survey. 41.0% (206/503) of MSM had HCV tested, and 38.2% (60/157) of MSM with no or uncertain HBV vaccination had HBV tested. In multivariate analysis, HCV testing was correlated with HBV testing (adjusted OR (aOR) 22.98, 95% CI 12.11 to 43.60), HIV testing (aOR 3.64, 95% CI 1.92 to 6.91), HIV-positive status (aOR 1.78, 95% CI 1.07 to 2.98) and having a PCP (aOR 2.40, 95% CI 1.44 to 3.98). Among MSM with no or uncertain HBV vaccination, HBV testing was correlated with HCV testing (aOR 80.85, 95% CI 20.80 to 314.33), HIV testing (aOR 5.26, 95% CI 1.81 to 15.28), HIV-positive status (aOR 3.00, 95% CI 1.22 to 7.37) and having a PCP (aOR 2.69, 95% CI 1.00 to 7.26). CONCLUSIONS Our data suggest many young MSM in China have not received hepatitis testing. HCV testing rates were lower than those recently reported among MSM in Australia and the USA. The strong correlation between HBV and HCV testing suggests bundled testing interventions may be useful for MSM in China. Men with a PCP were more likely to have received hepatitis testing, consistent with literature demonstrating the importance of primary care in expanding access to testing.
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Affiliation(s)
| | - Stephen W Pan
- Department of Public Health, Xi'an Jiaotong-Liverpool University, Suzhou, Jiangsu, China.,UNC Project-China, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Weiming Tang
- UNC Project-China, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Wilson Guo
- Gillings School of Global Public Health-Health Policy and Management, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Joseph D Tucker
- UNC Project-China, University of North Carolina, Chapel Hill, North Carolina, USA.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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39
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Cheng SH, Liao KS, Wang CC, Cheng CY, Chu FY. Multiple types of human papillomavirus infection and anal precancerous lesions in HIV-infected men in Taiwan: a cross-sectional study. BMJ Open 2018; 8:e019894. [PMID: 29374678 PMCID: PMC5829585 DOI: 10.1136/bmjopen-2017-019894] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES This study aimed to assess the relationship between infection with multiple human papillomavirus (HPV) types and abnormal anal cytology in HIV-infected men. DESIGN An observational, cross-sectional study. SETTING A regional referral hospital in Taiwan. PARTICIPANTS In total, 714 HIV-infected men were enrolled between March 2011 and June 2016. Thin preparation anal Pap smears were interpreted according to the 2001 Bethesda System. Thirty-seven types of HPV were detected by reverse line blotting, including 13 oncogenic types and 24 non-oncogenic types. OUTCOME MEASURES The relationship between anal HPV infection and abnormal anal cytology in people of Asian ethnicity and the coverage efficacy in HPV-vaccinated HIV-infected men. RESULTS On anal cytology, 175 (24.5%) subjects had atypical squamous cells of undetermined significance (ASCUS) or higher grades of dysplasia, including 87 (49.7%) with ASCUS, 73 (41.7%) with low-grade squamous intraepithelial lesions (LSILs) and 15 (8.6%) with high-grade squamous intraepithelial lesions (HSILs). A higher proportion of subjects with those without LSIL/HSIL (93.1% vs 67.3%, P<0.0001) had multiple HPV types. The odds of having LSIL/HSIL increased with an increasing number of HPV types: the ORs ranged from 1 for no HPV types to 6.96 (95% CI 2.38 to 20.37) for more than five types (Ptrend <0.0001). Multivariate logistic regression analysis showed a significant association between LSIL/HSIL and the number of HPV genotypes present (OR 1.20; 95% CI 1.02 to 1.42, P<0.05). HPV types covered by the nonavalent HPV vaccine (types 6/11/16/18/31/33/45/52/58) were detected in 70.1% of the patients in this study. CONCLUSIONS The odds of having anal LSIL/HSIL are approximately seventimes greater in HIV-infected men with than withoutsix or more types of HPV. Multiple HPV types in HIV-infected patients deserves aggressive follow-up, and HPV vaccination programme require scaling up.
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Affiliation(s)
- Shu-Hsing Cheng
- School of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Kuo-Sheng Liao
- Department of Pathology, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Chi-Chao Wang
- Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Chien-Yu Cheng
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
- School of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Fang-Yeh Chu
- Department of Medical Laboratory Science and Biotechnology, Yuanpei University of Medical Technology, Hsinchu, Taiwan
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan
- School of Medical Laboratory Science and Biotechnology, Taipei Medical University, Taipei, Taiwan
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan
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Zou H, Meng X, Grulich A, Huang S, Jia T, Zhang X, Luo Z, Ding Y, Yang L, Han J, Chen W, Zheng H, Yang B. A randomised controlled trial to evaluate the impact of sexual health clinic based automated text message reminders on testing of HIV and other sexually transmitted infections in men who have sex with men in China: protocol for the T2T Study. BMJ Open 2017; 7:e015787. [PMID: 28698334 PMCID: PMC5541733 DOI: 10.1136/bmjopen-2016-015787] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 05/16/2017] [Accepted: 05/22/2017] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION The frequency of screening for HIV and other sexually transmitted infections (STIs) among men who have sex with men (MSM) is still low in China. METHODS AND ANALYSIS A sexual health clinic based randomised controlled trial will be conducted in Guangzhou, Wuxi and Shenzhen, China, enrolling 600 MSM. Eligibility will be judged by the pre-programed iPad based questionnaire: (1) age ≥18 years and (2) have had two or more male anal sex partners, or condomless anal sex with a casual male sex partner, or an STI history, in the past 6 months, and (3) provides a valid mobile phone number. Eligible men will be randomly allocated 1:1 to the intervention arm (with monthly text messages reminding them to test for HIV/STIs) or to the control arm (with no reminders). Men in both arms will complete a questionnaire onsite at enrolment and after 12 months, and another questionnaire online at 6 months. Men in both arms will be tested for HIV, syphilis, anal gonorrhoea/chlamydia and penile gonorrhoea/chlamydia at enrolment and at 12 months. The primary outcome is the rate and frequency of HIV testing within the 12 months after enrolment. The secondary outcome is the rate of unprotected anal intercourse. An assessment of the cost effectiveness of this intervention is also planned. ETHICS AND DISSEMINATION The study has been approved by the ethical review committees of the University of New South Wales, Australia (HC16803), the Guangdong Provincial Centre for Skin Disease and STI Control (GDDHLS-20160926) and the Wuxi Centre for Disease Control and Prevention (WXCDC2016009), China. Study findings will be submitted to academic journals and disseminated to local health authorities. TRIAL REGISTRATION NUMBER Chinese Clinical Trial Registry at: http://www.chictr.org.cn/showprojen.aspx?proj=15752 and WHO International Clinical Trials Registry Platform at: http://apps.who.int/trialsearch/Trial2.aspx?TrialID=ChiCTR-IOR-16009304.
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Affiliation(s)
- Huachun Zou
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Xiaojun Meng
- Department of Infectious Disease Control, Wuxi Municipal Centre for Disease Control and Prevention, Wuxi, China
| | - Andrew Grulich
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Shujie Huang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Dermatology Hospital, Guangzhou, China
| | - Tianjian Jia
- Department of Infectious Disease Control, Wuxi Municipal Centre for Disease Control and Prevention, Wuxi, China
| | - Xuan Zhang
- Department of Infectious Disease Control, Wuxi Municipal Centre for Disease Control and Prevention, Wuxi, China
| | - Zhenzhou Luo
- Nanshan District Centre for Chronic Disease Control and Prevention, Shenzhen, China
| | - Yi Ding
- Nanshan District Centre for Chronic Disease Control and Prevention, Shenzhen, China
| | - Ligang Yang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Dermatology Hospital, Guangzhou, China
| | - Jinmei Han
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Dermatology Hospital, Guangzhou, China
| | - Weiying Chen
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Dermatology Hospital, Guangzhou, China
| | - Heping Zheng
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Dermatology Hospital, Guangzhou, China
| | - Bin Yang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Dermatology Hospital, Guangzhou, China
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Tang W, Best J, Zhang Y, Liu FY, Tso LS, Huang S, Yang B, Wei C, Tucker JD. Gay mobile apps and the evolving virtual risk environment: a cross-sectional online survey among men who have sex with men in China. Sex Transm Infect 2016; 92:508-514. [PMID: 27288414 PMCID: PMC5148710 DOI: 10.1136/sextrans-2015-052469] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 05/03/2016] [Accepted: 05/18/2016] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The expansion of gay sex-seeking application (gay app) use among men who have sex with men (MSM) may create new virtual risk environments that facilitate STI transmission. The goals of this study were to compare sexual behaviours between gay app users and non-users, and to describe sexual behaviours among gay app users in China. METHODS In October 2014, we recruited MSM from three Chinese gay websites. Data on sociodemographics, sexual behaviours and gay app use were collected. Logistic regressions were used to compare gay app users with non-app users and to identify factors associated with condomless sex among gay app users. RESULTS Of the 1424 participants, most were <30 years old (77.5%), single (83.8%) and self-identified as gay (72.9%). Overall, 824 (57.9%) had used gay apps for partner-seeking in the last 6 months. Among gay app users, 36.4% met their last partner within 24 hours of first message exchange through gay apps, and 59.0% negotiated condom use before in-person meeting. Compared with non-users, gay app users reported engaging in more condomless sex in the last 6 months (adjusted OR (aOR) =1.52, 95% CI 1.19 to 1.94) and more group sex (aOR =1.49, 95% CI 1.02 to 2.18). Negotiating condom use before in-person meeting was positively associated with condom use with partners met through gay apps (aOR =1.83, 95% CI 1.29 to 2.60). CONCLUSIONS Gay apps are linked to risky sexual behaviours and may foster a virtual risk environment for STI transmission among Chinese MSM. App-based interventions could target young gay man and facilitate condom negotiation.
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Affiliation(s)
- Weiming Tang
- University of North Carolina Project-China, Guangzhou, China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China
- SESH Global, Guangzhou, China
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - John Best
- University of North Carolina Project-China, Guangzhou, China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China
- School of Medicine, University of California, San Francisco, San Francisco California, USA
| | - Ye Zhang
- University of North Carolina Project-China, Guangzhou, China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China
- SESH Global, Guangzhou, China
| | - Feng-Ying Liu
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China
- SESH Global, Guangzhou, China
| | - Lai Sze Tso
- University of North Carolina Project-China, Guangzhou, China
- SESH Global, Guangzhou, China
| | - Shujie Huang
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China
- SESH Global, Guangzhou, China
| | - Bin Yang
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China
- SESH Global, Guangzhou, China
| | - Chongyi Wei
- Department of Epidemiology and Biostatistics & Global Health Sciences, University of California, San Francisco, San Francisco California, USA
| | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China
- SESH Global, Guangzhou, China
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Prevalence, Risk Behaviors, and Virological Characteristics of Hepatitis B Virus Infection in a Group of Men Who Have Sex with Men in Brazil: Results from a Respondent-Driven Sampling Survey. PLoS One 2016; 11:e0160916. [PMID: 27508385 PMCID: PMC4980030 DOI: 10.1371/journal.pone.0160916] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 07/27/2016] [Indexed: 12/20/2022] Open
Abstract
Background Men who have sex with men (MSM) are at increased risk of exposure to hepatitis B virus (HBV) compared with the general population. This study aims to assess the epidemiological and virological characteristics of HBV infection in a sample of MSM in Brazil, where data are scarce. Methods A cross-sectional study was conducted among MSM in the City of Goiânia, Central Brazil, from March to November 2014, using Respondent-Driven Sampling (RDS). After signing the consent form, participants were interviewed and a blood sample collected. All samples were tested for HBV serological markers and HBV DNA. HBV nucleotide sequence analysis was also performed. Results A total of 522 MSM were recruited in the study. The prevalence of HBV infection (current or past [presence of anti-HBc marker]) was 15.4% (95% CI: 8.7–25.8) and the rate of HBsAg carriers was 0.6% (95% CI: 0.2–1.6). About 40% (95% CI: 32.3–48.8) of the participants had serological evidence of previous HBV vaccination (reactive for isolated anti-HBs). In addition, 44.3% (95% CI: 36.1–52.9) were seronegative for all HBV markers. Age over 25 years old, receptive anal intercourse, previous sex with women, and history of sexually transmitted infections (STIs) were factors associated with HBV infection. HBV DNA was detected only in HBsAg-positive individuals. HBV isolates were classified into genotype A (subgenotypes A1 and A2), and some mutations were identified throughout the genome. Therefore, occult HBV infection was not observed in the study population. Conclusions Public health strategies should be improved for the MSM population in order to prevent HBV and other STIs, as well as to provide appropriate management of patients with active infections.
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Ibragimov U, Harnisch JA, Nehl EJ, He N, Zheng T, Ding Y, Wong FY. Estimating self-reported sex practices, drug use, depression, and intimate partner violence among MSM in China: a comparison of three recruitment methods. AIDS Care 2016; 29:125-131. [PMID: 27367038 DOI: 10.1080/09540121.2016.1201191] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Men who have sex with men (MSM) are the group at highest risk for HIV in China. Researchers have used various recruitment methods to reach this population hidden from the hetero-normative culture. To inform future recruitment strategies, we compared estimates of socio-demographic characteristics, HIV risk behaviors, depression, and intimate partner violence (IPV) across three samples of MSM and money boys in Shanghai, China. Data were collected from three community-based samples of MSM and money boys (n = 1352) recruited via respondent-driven sampling (RDS) (n = 404), community popular opinion leaders (CPOL) (n = 385), and Internet and venue-based sampling (VBS) (n = 546). Different recruitment methods generated samples with statistically significant differences among a number of socio-demographic characteristics, sexual behaviors, drug use, depression scores, and exposure to IPV. Specifically, RDS participants had lower education (p = .002), income levels (p < .001), and were more likely to report condomless sex with a woman (p < .001). CPOL participants were younger (p < .001), more likely to report lifetime condomless anal sex (p = .009), more than 10 male partners in the past 30 days (p < .001), and were less likely to experience violence by a male intimate partner (p = .001). VBS participants had lowest depression score (p = .005) and were more likely to report lifetime drug use (p = .003). Our findings reinforce that each recruitment method may reach a sub-group of MSM with a specific risk profile, so multiple methods may be needed to obtain a representative sample of MSM. Interventions may use specific recruitment methods to target certain segments of the MSM population.
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Affiliation(s)
- Umedjon Ibragimov
- a Department of Behavioral Sciences & Health Education , Emory University Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Jessica A Harnisch
- a Department of Behavioral Sciences & Health Education , Emory University Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Eric J Nehl
- a Department of Behavioral Sciences & Health Education , Emory University Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Na He
- a Department of Behavioral Sciences & Health Education , Emory University Rollins School of Public Health, Emory University , Atlanta , GA , USA.,b Department of Epidemiology , Fudan University School of Public Health , Shanghai , China
| | - Tony Zheng
- c Shanghai Piaoxue Cultural Media, Ltd ., Shanghai , China
| | - Yingying Ding
- b Department of Epidemiology , Fudan University School of Public Health , Shanghai , China
| | - Frank Y Wong
- a Department of Behavioral Sciences & Health Education , Emory University Rollins School of Public Health, Emory University , Atlanta , GA , USA.,d Hubert Department of Global Health , Emory University Rollins School of Public Health , Atlanta , GA , USA.,e Department of Epidemiology , Emory University Rollins School of Public Health , Atlanta , GA , USA.,f Department of Sociology , Emory College, Emory University , Atlanta , GA , USA
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Zhang W, Xu JJ, Zou H, Zhang J, Wang N, Shang H. HIV incidence and associated risk factors in men who have sex with men in Mainland China: an updated systematic review and meta-analysis. Sex Health 2016; 13:SH16001. [PMID: 27294689 DOI: 10.1071/sh16001] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 03/15/2016] [Indexed: 12/15/2022]
Abstract
Background: The national annually reported proportion of men who have sex with men (MSM) among people living with HIV (PLWH) is growing in China. To better inform the public health sector how to improve HIV prevention strategies, it is necessary to understand the current level of HIV incidence and its correlates. Methods: Google Scholar, PubMed, Web of Science and three major Chinese electronic publication databases (http://qikan.cqvip.com/, http://g.wanfangdata.com.cn/, http://www.cnki.net/, respectively) were searched for studies reporting HIV incidence. Comprehensive Meta-Analysis (CMA) 2.0 statistical software (Biostat, Inc. Englewood, NJ, USA) was used to calculate the pooled HIV incidence and perform subgroup-analysis to find correlates for HIV seroconversion in Chinese MSM. Random effects modelling was then conducted. Results: Twenty-five eligible studies were included in this meta-analysis. The calculated pooled HIV incidence was 5.61/100 person years (PY), with an increasing trend over time (3.24/100PY, 5.29/100PY, 5.50/100PY in 2005-2008, 2009-2011, 2012-2014 respectively, χ2 test for trend P = 0.04). Subgroup analyses indicated that age <25 years (rate ratio (RR) = 1.85), junior college education and below (RR = 1.87), having ≥ 2 male sexual partners in past 6 months (RR = 2.50), baseline syphilis infection (RR = 2.99), homosexual orientation (RR = 1.91), preferred bottom/versatile roles in anal sexual intercourse (RR = 2.33), and having unprotected anal intercourse in the past 6 months (RR = 2.16) significantly increased the risk for HIV seroconversion (each P < 0.05). Uncircumcised MSM had a marginal statistically significant higher HIV incidence (RR = 3.35, P = 0.051). Conclusion: HIV incidence is still alarmingly high among Chinese MSM. Stronger HIV intervention strategies should be implemented, in particular targeting young, less educated and syphilis-infected MSM.
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Epidemiology of sexually transmitted viral hepatitis in human immunodeficiency virus-positive men who have sex with men in Asia. J Formos Med Assoc 2015; 114:1154-61. [PMID: 26375778 DOI: 10.1016/j.jfma.2015.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 07/02/2015] [Accepted: 08/11/2015] [Indexed: 01/10/2023] Open
Abstract
Both human immunodeficiency virus (HIV) and viral hepatitis constitute major disease burden globally. As with other parts of the world, the HIV epidemic in Asia impacts mainly on men who have sex with men, one of the at-risk populations for sexually transmitted viral hepatitis. With the increasing availability of effective antiretroviral therapy, HIV-related mortality of people living with HIV has markedly reduced. Liver disease has become an important cause of mortality and morbidity in the HIV-infected population. With the improvement of socioeconomic conditions and availability of healthcare in Asian countries in recent years, the epidemiology of sexually transmitted viral hepatitis among HIV-positive men who have sex with men has also evolved. This review updates the epidemiology of different types of sexually transmitted viral hepatitis in this defined population in Asia.
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Zou H, Wang W, Ma Y, Wang Y, Zhao F, Wang S, Zhang S, Ma W. How university students view human papillomavirus (HPV) vaccination: A cross-sectional study in Jinan, China. Hum Vaccin Immunother 2015; 12:39-46. [PMID: 26308701 DOI: 10.1080/21645515.2015.1072667] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The acceptability of HPV vaccination among university students in China is not well understood. Our study was of cross-sectional study design. We collected a questionnaire about socio-demographic characteristics, knowledge of, attitude toward and acceptability of HPV vaccination. A total of 351 students were included in data analyses, among whom 47.6% were males and 70.0% aged 19-21. Only 10.3% had previously heard of HPV and 5.4% HPV vaccine. Male and female students were equally likely to accept HPV vaccine (71.8 vs 69.4%, p = 0.634) and recommend it to sexual partners (73.1 vs 76.7%, p = 0.441). The great majority of students could only afford RMB 300 (USD 50) or less for HPV vaccination. HPV vaccination acceptance was associated with being in year-one (Adjusted odds ratio (AOR) = 3.78, 95% confidence interval (CI): 2.12-6.75), being from a key university (AOR = 1.88, 95%CI: 1.07-3.31), having heard of HPV-related morbidities (AOR = 1.88, 95% CI: 1.05-3.35), being concerned about HPV-related morbidities (AOR = 2.23, 95% CI: 1.16-4.27) and believing the vaccine should be given before first sexual contact (AOR = 2.44, 95% CI: 1.38-4.29). Female students were more likely to anticipate a late uptake of HPV vaccination (p = 0.002). The relatively lower levels of HPV knowledge but higher levels of vaccine acceptance among undergraduates highlighted the need for education on the roles of sexual behaviors in HPV transmission.
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Affiliation(s)
- Huachun Zou
- a Kirby Institute; University of New South Wales ; Sydney , Australia
| | - Wei Wang
- b Department of Epidemiology ; School of Public Health; Shandong University ; Jinan , China
| | - Yuanyuan Ma
- c School of Finance & Economics; Shandong Jiaotong University ; Jinan , China
| | - Yongjie Wang
- d School of Public Health; Shandong University ; Jinan , China
| | - Fanghui Zhao
- e Department of Epidemiology ; Cancer Institute of Chinese Academy of Medical Sciences; Peking Union Medical College ; Beijing , China
| | - Shaoming Wang
- e Department of Epidemiology ; Cancer Institute of Chinese Academy of Medical Sciences; Peking Union Medical College ; Beijing , China
| | - Shaokai Zhang
- e Department of Epidemiology ; Cancer Institute of Chinese Academy of Medical Sciences; Peking Union Medical College ; Beijing , China
| | - Wei Ma
- b Department of Epidemiology ; School of Public Health; Shandong University ; Jinan , China
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Martínez AA, Zaldívar Y, Arteaga G, de Castillo Z, Ortiz A, Mendoza Y, Castillero O, Castillo JA, Cristina J, Pascale JM. Phylogenetic Analysis of Hepatitis B Virus Genotypes Circulating in Different Risk Groups of Panama, Evidence of the Introduction of Genotype A2 in the Country. PLoS One 2015; 10:e0134850. [PMID: 26230260 PMCID: PMC4521924 DOI: 10.1371/journal.pone.0134850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 07/14/2015] [Indexed: 02/06/2023] Open
Abstract
The Hepatitis B Virus (HBV) can cause acute or chronic infection it is also associated with the development of liver cancer, thousands of new infections occur on a yearly basis, and many of these cases are located in certain areas of the Caribbean and Latin America. In these areas, the HBV prevalence is still high which makes this virus a serious public health concern to the entire region. Studies performed in Panama suggest a complex pattern in the distribution of HBV among the country’s different risk groups. We use phylogenetic analysis in order to determine which HBV genotypes were circulating in these specific groups; for this we used a fragment of the PreS2/2 region of the HBV genome. Subsequently whole HBV genome sequences were used for Bayesian analysis of phylodynamics and phylogeography. Two main genotypes were found: genotype A (54.5%) and genotype F (45.5%). There was a difference in the distribution of genotypes according to risk groups: 72.9% of high risk groups were associated to genotype A, and 55.0% of samples of genotype F were associated to the low risk group (p<0.002). The Bayesian analysis of phylogeny-traits association revealed a statistically significant geographical association (p<0.0001) with both genotypes and different regions of the country. The Bayesian time of most recent common ancestor analysis (tMRCA) revealed a recent tMRCA for genotype A2 circulating in Panama (1997, 95% HPD: 1986—2005), when it is compared with Panamanian genotype F1c sequences (1930, 95% HPD: 1810 – 2005). These results suggest a possible change in the distribution of HBV genotypes in Panama and Latin America as a whole. They also serve to encourage the implementation of vaccination programs in high-risk groups, in order to prevent an increase in the number of new HBV cases in Latin America and worldwide.
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Affiliation(s)
- Alexander A. Martínez
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama, Panama
- Department of Biotechnology, Acharya Nagarjuna University, Guntur City, Andhra Pradesh, India
- INDICASAT-AIP, Clayton, City of Knowledge, Panama
| | - Yamitzel Zaldívar
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama, Panama
| | - Griselda Arteaga
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama, Panama
- Department of Microbiology, School of Medicine, University of Panama, Panama City, Panama, Panama
| | - Zoila de Castillo
- Nucleic Acid Test Unit, Complejo Hospitalario Dr. Arnulfo Arias Madrid, Caja de Seguro Social, Panama City, Panama
| | - Alma Ortiz
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama, Panama
| | - Yaxelis Mendoza
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama, Panama
- Department of Biotechnology, Acharya Nagarjuna University, Guntur City, Andhra Pradesh, India
- INDICASAT-AIP, Clayton, City of Knowledge, Panama
| | - Omar Castillero
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama, Panama
| | - Juan A. Castillo
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama, Panama
| | - Juan Cristina
- Laboratorio de Virología Molecular, Centro de Investigaciones Nucleares, Facultad de Ciencias, Universidad de la República, Igua, Montevideo, Uruguay
| | - Juan M. Pascale
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama, Panama
- Department of Microbiology, School of Medicine, University of Panama, Panama City, Panama, Panama
- * E-mail:
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Bien CH, Best JM, Muessig KE, Wei C, Han L, Tucker JD. Gay Apps for Seeking Sex Partners in China: Implications for MSM Sexual Health. AIDS Behav 2015; 19:941-6. [PMID: 25572834 DOI: 10.1007/s10461-014-0994-6] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Anti-gay stigma and harsh local environments in many low and middle-income countries (LMIC) encourage men who have sex with men (MSM) partner-seeking mobile application (gay app) use. To investigate the sexual risk profiles of gay app users and guide future HIV prevention programs, we conducted a cross-sectional online survey among 1,342 MSM in China examining associations between gay app use and sexual behaviors, including HIV and sexually transmitted disease testing. Compared to non-app users, app users were more likely to be younger, better educated, "out" about their sexual orientation, and single. They were also more likely to report multiple recent sex partners and HIV testing, but there was no difference in condomless sex between the two groups. Future research among MSM in LMIC is needed to characterize gay app use and explore its potential for future public health interventions.
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Affiliation(s)
- Cedric H Bien
- University of North Carolina-Project-China, Number 2 Lujing Road, Guangzhou, 510095, China
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Liu J, Qu B, Zhu Y, Hu B. The influence of social support on quality of life of men who have sex with men in China: a preliminary study. PLoS One 2015; 10:e0127644. [PMID: 26010133 PMCID: PMC4444086 DOI: 10.1371/journal.pone.0127644] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 04/17/2015] [Indexed: 11/19/2022] Open
Abstract
The quality of life (QOL) of men who have sex with men (MSM) has received increasing attention in recent years. Our study surveyed the QOL and explored the influence of social support on QOL in Chinese MSM. A cross-sectional survey was conducted from September 2013 to March 2014 of 438 MSM in Huludao and Zhengzhou City, China. The results of univariate analysis showed that higher QOL scores were associated with receiving psychosocial counseling, higher health education, younger age and marital status of being single or unmarried p < 0.05). The structural equation model fitted well, with χ2 = 2083.47 (p < 0.05), RMSEA = 0.07, and GFI = 0.88. Among the latent factors, social support, with a factor load of 0.47, had greater impact on QOL than demographic characteristics. Within social support, the item loads for psychosocial counseling and health education were 0.17 and 0.29, respectively. Basic demographic characteristics also influenced social support, with a factor load of -0.65. For demographic characteristics, the greatest item loads were for marital status and age (0.77 and 0.71, respectively). These findings suggest that strengthening social support, especially for older and married individuals, would improve QOL in MSM in China.
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Affiliation(s)
- Jie Liu
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, Liaoning Province, China
| | - Bo Qu
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, Liaoning Province, China
- * E-mail:
| | - Yaxin Zhu
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, Liaoning Province, China
| | - Bingxue Hu
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, Liaoning Province, China
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Tang W, Mahapatra T, Liu F, Fu G, Yang B, Tucker JD, Zhao J, Detels R. Burden of HIV and Syphilis: A Comparative Evaluation between Male Sex Workers and Non-Sex-Worker Men Who Have Sex with Men in Urban China. PLoS One 2015; 10:e0126604. [PMID: 25961721 PMCID: PMC4427281 DOI: 10.1371/journal.pone.0126604] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 04/04/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The increasing burden of sexually transmitted infections (STIs) including HIV and syphilis among male sex workers (MSWs) is a major global concern. The aim of our study was to evaluate the difference between MSWs and non-commercial MSMs in China. METHODS During 2008-09, in a cross-sectional study, 2618 adult MSM were recruited through respondent-driven and snowball sampling from seven cities of China. Information regarding socio-demographics, risk behaviors, HIV-related knowledge and STI-related symptoms were collected and participants were tested for HIV and syphilis. RESULTS Among 2618 participating MSM, 9.97% sold sex to males. HIV prevalence was 7.45% (6.13% among MSWs and 7.59% among non-MSW MSM) and syphilis prevalence was 14.32% (10.73% for MSWs and 14.72% for non-MSW MSM). Compared to non-MSW MSM, MSWs were more likely to be younger (adjusted odds ratio: aOR = 0.91, 95% confidence interval: 95%CI=0.88-0.93), never married (aOR = 4.38, 95% CI = 2.38-6.80), less educated, heterosexual (aOR = 13.04, 95% CI = 6.08-27.95), less knowledgeable regarding HIV (aOR = 0.70, 95% CI=0.51-0.96), experiencing symptoms of STI (aOR = 2.16, 95% CI = 1.47-3.19), engaging in condomless vaginal intercourse (aOR = 2.16, 95% CI = 1.47-3.19) and less likely to engage in condomless anal intercourse (aOR = 0.62, 95% CI = 0.46-0.85). CONCLUSIONS High HIV and syphilis prevalence warranted urgent intervention targeting MSWs as a separate sentinel group for efficient surveillance owing to their different distribution from non-MSW MSM. Although male sex workers and non-commercial homosexuals have similar rates of HIV and syphilis, MSWs have different characteristics which should be considered in designing intervention programs targeting them.
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Affiliation(s)
- Weiming Tang
- Guangdong Provincial Center for Skin Diseases and STIs Control, No. 2 Lujing Road, Guangzhou, 510085, China
- University of North Carolina Project-China, No. 2 Lujing Road, Guangzhou, 510085, China
- * E-mail: (WT); (JZ)
| | - Tanmay Mahapatra
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Fengying Liu
- Guangdong Provincial Center for Skin Diseases and STIs Control, No. 2 Lujing Road, Guangzhou, 510085, China
| | - Gengfeng Fu
- Jiangsu Provincial Central for Disease Prevention and Control, Nanjing, Jiangsu, China
| | - Bin Yang
- Guangdong Provincial Center for Skin Diseases and STIs Control, No. 2 Lujing Road, Guangzhou, 510085, China
| | - Joseph D. Tucker
- University of North Carolina Project-China, No. 2 Lujing Road, Guangzhou, 510085, China
| | - Jinkou Zhao
- Monitoring and Evaluation Unit, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
- * E-mail: (WT); (JZ)
| | - Roger Detels
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, United States of America
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