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Factors Associated with Unprotected Anal Intercourse Among Men Who Have Sex with Men: Results from a Respondent Driven Sampling Survey in Nanjing, China, 2008

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Abstract

Unprotected anal intercourse (UAI) is a well-documented risk factor for acquiring HIV, but not well-studied in China. We studied demographic and behavioral correlates for UAI among men who have sex with men (MSM) in a respondent-driven-sampling (RDS) survey in Nanjing, China. Four hundred and thirty MSM (including ten seeds) participated in this study, rendering an adjusted rate of UAI as 62.3 % (95 % CI 56.4–68.4 %). Adjusted HIV and syphilis prevalence rates were 6.6 % (95 % CI 3.0–10.4) and 12.6 % (95 % CI 8.1–18.3), respectively. HIV- and syphilis-positive cases were more likely to have engaged in UAI. Being unwilling to use condoms, meeting partners in non-conventional venues, having multiple male sex-partners in the past 6 months, having sex with regular and casual male partners in the past 6 months, and consumption of alcohol before sex were all positively associated with UAI. Based on the observed high prevalence of UAI among MSM in Nanjing, we can conclude that implementation of strategies to motivate MSM with high-risk behaviors to use condoms is urgently required in Nanjing.

Resumen

Examinamos los factores asociados con sexo anal sin protección entre hombres que tienes sexo con hombres en Nanjing, China. Sexo anal sin protección es un factor riesgoso muy bien documentado por adquirir la infección del VIH, pero no ha sido muy bien estudiado en China. Datos sobre el sexo anal sin protección, información demográfica y de comportamiento de hombres que tienen sexo con hombres fue colectada en un muestreo dirigido por los participantes en Nanjing, China. Un análisis dirigido a los participantes fue usado para generar promedios ponderados de sexo anal sin protección y SPSS para llevar a cabo el análisis de regresión logística para factores asociados con sexo anal sin protección. Se estudio un total de 430 participantes (incluyendo 10 semillas), arrojando un promedio ajustado de sexo anal sin protección de 62.3 % (95 % intervalo de confianza 56.4–68.4 %). La práctica de sexo anal sin protección fue significantemente más frecuente entre casos positivos de VIH y sífilis, con tasas de prevalencia de VIH y sífilis de 6.6 % (95 % intervalo de confianza 3.0–10.4) y 12.6 % (95 % intervalo de confianza 8.1–18.3) respectivamente. El consumo de alcohol antes de tener sexo, conocer parejas en lugares que no sean lugares de encuentro convencional, haberse divorciado o enviudado, tener mas de una pareja sexual en los últimos seis mese y tener relaciones sexuales con parejas ocasionales en los últimos seis meses fue positivamente asociado a tener sexo anal sin protección. En conclusión, existe una alta prevalencia de sexo anal sin protección entre hombre que tienen sexo con hombres en Nanjing y es un determinante significativo del riesgo de VIH. Programas de prevención y estrategias deben ser implementadas urgentemente, como motivación para usar condones a las personas que tienen múltiples parejas sexuales y distribución gratuita de condones en los spas, casas de baño, saunas, salones de masaje, y otros lugares de encuentro convencional.

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Acknowledgments

This study was financially supported by Jiangsu Provincial Technologies Research Program (BE2009685), Jiangsu Province’s Outstanding Medical Academic Leader Program (RC2011087, 2011086) and the Bill & Melinda Gates Foundation.

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Authors and Affiliations

  1. Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, 71-267 CHS, S. 650 Charles Young Drive, Los Angeles, CA, 90095-1772, USA

    Weiming Tang, Tanmay Mahapatra, Songyuan Tang & Roger Detels

  2. Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, Jiangsu, China

    Xiping Huan, Hongjing Yan, Gengfeng Fu & Haitao Yang

  3. Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China

    Jianjun Li

  4. Monitoring and Evaluation Unit, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Cheminde Blandonnet 8, 1214, Vernier, Geneva, Switzerland

    Jinkou Zhao

Authors
  1. Weiming Tang
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  2. Xiping Huan
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  3. Tanmay Mahapatra
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  4. Songyuan Tang
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  7. Gengfeng Fu
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  8. Haitao Yang
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  9. Jinkou Zhao
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  10. Roger Detels
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Corresponding authors

Correspondence to Jinkou Zhao or Roger Detels.

Additional information

Weiming Tang and Xiping Huan contributed equally to the study.

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Tang, W., Huan, X., Mahapatra, T. et al. Factors Associated with Unprotected Anal Intercourse Among Men Who Have Sex with Men: Results from a Respondent Driven Sampling Survey in Nanjing, China, 2008. AIDS Behav 17, 1415–1422 (2013). https://doi.org/10.1007/s10461-013-0413-4

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  • DOI: https://doi.org/10.1007/s10461-013-0413-4

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