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Volume 15, Issue 4 (July 2013) 15, 545–549; 10.1038/aja.2013.51

Factors influencing HIV infection in men who have sex with men in China

Hong-Lv Xu1, Man-Hong Jia2, Xiang-Dong Min2, Ren-Zhong Zhang2, Chun-Jie Yu1, Jue Wang2, You-Fang Li2, Ling Wang2, Song-Feng Pan2 and Lin Lu1,2

1 Kunming Medical University, Kunming, Yunnan 650500, China
2 Yunnan Center for Disease Control and Prevention, Kunming, Yunnan 650022, China

Correspondence: Dr L Lu, (lulin@yncdc.cn)

Received 19 December 2012; Revised 25 February 2013; Accepted 30 March 2013; Advance online publication 27 May 2013


To identify risk factors for HIV infection among men who have sex with men (MSM) and to provide a theoretical basis for prevention interventions. Between December 2011 and August 2012, a case–control study was conducted among MSM who underwent voluntary counselling and testing for HIV. Confirmed HIV-positive MSM were included in the case group, and HIV-negative MSM were included in the control group. Information on possible risk factors was collected by a survey questionnaire and a qualitative interview. The results of a conditional logistic regression showed that the following were influencing factors for HIV infection: average monthly income between 2001 and 3000 Yuan (odds ratio (OR)=6.341, 95% CI: 1.714–12.544), only sometimes using condoms when having anal sex with men in the last 6 months (OR=7.601, 95% CI: 1.359–23.083), having HIV-positive sex partners (OR=5.273, 95% CI: 1.572–17.691), rectal trauma with bleeding in the last 6 months (OR=2.947, 95% CI: 1.308–6.638), not using condoms at last sexual encounter (OR=1.278, 95% CI: 1.012–5.595), engaging in commercial sex (OR=5.925, 95% CI: 1.923–13.890) and having more than 16 sex partners in the last 6 months (OR=1.175, 95% CI: 1.021–1.353). These seven factors were the risk factors of HIV infection (OR>1). However, having anal sex less than 10 times in the previous 1 month (OR=0.002, 95% CI: 0.000–0.287) was a protective factor against HIV infection among MSM (OR<1), and insertive (OR=0.116, 95% CI: 0.000–0.236) (OR<1) anal intercourse influenced HIV infection. Interventions should be targeted at MSM whose average monthly income is between 2001 and 3000 Yuan, and who engage in commercial sex. In addition, the importance of using condoms at every sexual encounter should be emphasised in health education, as should the treatment of rectal trauma with bleeding. Finally, MSM should decrease the number of sex partners and frequency of anal sex to decrease the rate of HIV infection.

case–control study; HIV infection; influencing factors; men who have sex with men (MSM)

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