High HIV Incidence Among Men Who Have Sex With Men in 8 Chinese Cities: Results From a Trial

Author:

Huang Wenting123ORCID,Wang Yehua3,Lu Haidong4,Wu Dan35,Pan Stephen W6,Tucker Joseph D357,Tang Weiming238ORCID

Affiliation:

1. Behavioral Sciences and Health Education, Emory University, Atlanta, Georgia, USA

2. Institute for Global Health and Sexually Transmitted Diseases Research, Southern Medical University, Guangzhou, China

3. University of North Carolina Project-China, Guangzhou, China

4. Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

5. London School of Hygiene and Tropical Medicine, London, UK

6. Department of Public Health, Xi’an Jiaotong-Liverpool University, Suzhou, China

7. School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

8. Dermatology Hospital, Southern Medical University, Guangzhou, China

Abstract

Abstract Background In China, while the overall HIV prevalence has been decreasing within key populations, the epidemic among men who have sex with men (MSM) is still on the rise. This study aims to assess the HIV incidence rate and identify driving forces of HIV seroconversion among MSM in a closed cohort. Methods This study is a secondary analysis of a large trial of HIV testing promotion among Chinese MSM in 2016–2017. Sexual behaviors, HIV testing activities, and HIV serostatus were measured at baseline and follow-up every 3 months. HIV seroconversion in this study was defined as a self-reported HIV-positive test result. Participants who reported testing for HIV at least twice during different follow-up periods were included. Subgroup analysis and Cox regression were used to examine the correlates with HIV seroconversion. Results Overall, 347 participants were included in this study, with a mean age of 25.3 ± 6.1, and 71.2% were migrants. The sociodemographic characteristics of the included participants were similar to the rest of the participants in the trial (n = 1034); 7.2% (25/347) of participants seroconverted during the study period, resulting in an incidence rate of 15.56/100 person-years. In subgroup analysis, the HIV incidence rate was higher among migrants than nonmigrants (incidence rate ratio, 1.26; 95% confidence interval [CI], 0.47–3.87). In the time-dependent Cox regression model, bisexual MSM had a higher risk of contracting HIV than gay men (adjusted hazard ratio, 2.19; 95% CI, 1.02–4.72). Conclusions Our findings suggest a high HIV incidence rate among Chinese MSM. Further expansion of pre-exposure prophylaxis and other effective HIV prevention interventions are urgently needed.

Funder

National Key Research and Development Program of China

Academy of Medical Sciences

Newton Fund

National Institutes of Health

NIMH

National Science and Technology Major Project

National Nature Science Foundation of China

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Oncology

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