AIDS and Behavior

, Volume 17, Issue 7, pp 2387–2394 | Cite as

HIV Disease Burden and Related Risk Behaviours Among Men Who Have Sex with Men in Yuxi Prefecture, Yunnan Province, China: 2010−2011

  • Eric P. F. Chow
  • Liang Chen
  • Jun Jing
  • Liangmin Gao
  • Jun Zhang
  • David P. Wilson
  • Lei Zhang
Original Paper


The HIV epidemic is rapidly increasing among men who have sex with men (MSM) in China. Data on the disease burden and risk behaviours of MSM related to HIV transmission are needed to inform education and prevention programs. We conducted two cross-sectional surveys among MSM in Yuxi Prefecture in Yunnan Province, China, during 2010–2011. Men were recruited by snowball (participant referrals) and nomination sampling methods at gay-oriented venues and hotspots. Participants were asked to complete a 20-min anonymous questionnaire. Blood samples were collected to determine HIV status and the BED capture enzyme immunoassay was used to estimate the incidence rate. A total of 288 MSM participated in this study across the two surveys. The two-year overall HIV prevalence was 10.7 % and the estimated incidence rate was 5.4 per 100 person-years (95 % CI 1.1–9.6). A reported 37.2 % of MSM were married to a female and 35.1 % had sex with a female in the past 6 months. Condom use with male partners (81.4–93.0 %) and female partners (56.3–77.4 %) at the last penetrative act significantly increased between the survey conducted in 2010 and the survey in 2011. HIV prevalence is high among Chinese MSM in Yunnan. Common bisexual behaviours and low consistent condom use with female partners suggest a potential spread of HIV from MSM to females.


Men who have sex with men China HIV infection Behaviors 


  1. 1.
    Jia M, Luo H, Ma Y, Wang N, Smith K, Mei J, et al. The HIV epidemic in Yunnan Province, China, 1989–2007. J Acquir Immune Defic Syndr. 2010;53(Suppl 1):S34–40.PubMedCrossRefGoogle Scholar
  2. 2.
    Ministry of Health of the People’s Republic of China. China 2010 UNGASS country progress report (2008–2009). Beijing: Ministry of Health; 2010.Google Scholar
  3. 3.
    Ministry of Health of the People’s Republic of China. UNGASS country progress report P. R. China (2006–2007). Beijing: Ministry of Health; 2008.Google Scholar
  4. 4.
    Zhang BC, Li XF, Shi TX, Yang LG, Zhang JD. A primary estimation of the number of population and HIV prevalence in homosexual and bisexual men in China. China J STD/AIDS Prev Cont. 2002;8:197–9.Google Scholar
  5. 5.
    Chen L, Ma Y, Gao L, Li L, Lu J, Zhang Y. Study on interventions targeted to situation and strategies among MSM in Yuxi. Yuxi Prefecture: Yuxi CDC; 2010.Google Scholar
  6. 6.
    Chow EPF, Wilson DP, Zhang L. HIV and syphilis co-infection increasing among men who have sex with men in China: a systematic review and meta-analysis. PLoS ONE. 2011;6:e22768.PubMedCrossRefGoogle Scholar
  7. 7.
    Calypte Biomedical Corporation. Aware™ BED™ EIA HIV-1 incidence test (IgG-Capture HIV-EIA). Enzyme immunoassay for population estimates of HIV-1 incidence, USA. 2008. p. 24.
  8. 8.
    US Centers for Disease Control and Prevention. Interim recommendations for the use of the BED capture enzyme immunoassay for incidence estimation and surveillance. 2006.
  9. 9.
    Han M, Wang YL, Wang MJ, Zhou QH, Jiang Y. Application of BED-CEIA to estimate the human immunodeficiency virus prevalence among injecting drug users in Chongqing municipality. Zhonghua Liu Xing Bing Xue Za Zhi. 2007;28:1077–80.PubMedGoogle Scholar
  10. 10.
    Wei X, Liu W, Li F, Wang X, Zheng WW. Detection of HIV incidence using BED capture enzyme immunoassay at a surveillance sentinel site of injection drug users in Guangxi. Zhonghua Yu Fang Yi Xue Za Zhi. 2009;43:1096–9.PubMedGoogle Scholar
  11. 11.
    Feng LG, Wang MJ, Han M, Ding XB, Jiang Y. Drug resistance among recent HIV-1 infected men who have sex with men in Chongqing municipality of China. Zhonghua Liu Xing Bing Xue Za Zhi. 2008;29:455–8.PubMedGoogle Scholar
  12. 12.
    Han M, Feng LG, Jiang Y, Shen S, Ling H, Ding XB, et al. Surveillance on HIV-1 incidence among men who have sex with men in Chongqing, China, 2006–2008. Zhonghua Liu Xing Bing Xue Za Zhi. 2009;30:878–81.PubMedGoogle Scholar
  13. 13.
    Wang MJ. Research on BED-CEIA in detecting recent infections and on drug resistance in recent HIV-l infections in Dehong prefecture and Chongqing municipal. China CDC. 2007.Google Scholar
  14. 14.
    Ruan Y, Jia Y, Zhang X, Liang H, Li Q, Yang Y, et al. Incidence of HIV-1, syphilis, hepatitis B, and hepatitis C virus infections and predictors associated with retention in a 12-month follow-up study among men who have sex with men in Beijing, China. J Acquir Immune Defic Syndr. 2009;52:604–10.PubMedCrossRefGoogle Scholar
  15. 15.
    Li SW, Zhang XY, Li XX, Wang MJ, Li DL, Ruan YH, et al. Detection of recent HIV-1 infections among men who have sex with men in Beijing during 2005–2006. Chin Med J (Engl). 2008;121:1105–8.Google Scholar
  16. 16.
    Zhao JX, Chen L, Gao LM, Lu JB, Chen LY, Cai Y, et al. Application of the BED capture enzyme immunoassay for HIV-1 incidence estimation among injecting drug users in Yuxi Prefecture, Yunnan Province. Mod Prev Med. 2012;7:187–9.Google Scholar
  17. 17.
    Chow EP, Wilson DP, Zhang L. What is the potential for bisexual men in China to act as a bridge of HIV transmission to the female population? Behavioural evidence from a systematic review and meta-analysis. BMC Infect Dis. 2011;11:242.PubMedCrossRefGoogle Scholar
  18. 18.
    Dandona L, Dandona R, Gutierrez JP, Kumar GA, McPherson S, Bertozzi SM, et al. Sex behaviour of men who have sex with men and risk of HIV in Andhra Pradesh, India. AIDS. 2005;19:611–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Solomon SS, Srikrishnan AK, Sifakis F, Mehta SH, Vasudevan CK, Balakrishnan P, et al. The emerging HIV epidemic among men who have sex with men in Tamil Nadu, India: geographic diffusion and bisexual concurrency. AIDS Behav. 2010;14:1001–10.PubMedCrossRefGoogle Scholar
  20. 20.
    Wang L, Ding ZW, Yan RX, Li DM, Guo W, Wang N. HIV prevalence among populations at risk, using sentinel surveillance data from 1995 to 2009 in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2011;32:20–4.PubMedGoogle Scholar
  21. 21.
    Wong WC, Zhang J, Wu SC, Kong TS, Ling DC. The HIV related risks among men having sex with men in rural Yunnan, China: a qualitative study. Sex Transm Infect. 2006;82:127–30.PubMedCrossRefGoogle Scholar
  22. 22.
    Mattison AM, Ross MW, Wolfson T, Franklin D. Circuit party attendance, club drug use, and unsafe sex in gay men. J Subst Abuse. 2001;13:119–26.PubMedCrossRefGoogle Scholar
  23. 23.
    Leigh BC, Stall R. Substance use and risky sexual behavior for exposure to HIV. Issues in methodology, interpretation, and prevention. Am Psychol. 1993;48:1035–45.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Eric P. F. Chow
    • 1
    • 3
  • Liang Chen
    • 2
  • Jun Jing
    • 3
  • Liangmin Gao
    • 2
  • Jun Zhang
    • 3
  • David P. Wilson
    • 1
  • Lei Zhang
    • 1
    • 3
  1. 1.Faculty of MedicineThe Kirby Institute, University of New South WalesSydneyAustralia
  2. 2.Division of HIV/AIDS and STI ControlCenters for Disease Control and PreventionYuxi PrefectureChina
  3. 3.Comprehensive AIDS Research CenterTsinghua UniversityBeijingChina

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