Trends of HIV incidence and prevalence among men who have sex with men in Beijing, China: Nine consecutive cross-sectional surveys, 2008-2016

Abstract

BackgroundSexual transmission of HIV among men who have sex with men (MSM) increased markedly in China during the past decade. HIV incidence is a critical indicator in HIV surveillance and we use a HIV-1 BED-capture-enzyme immunoassay (BED-CEIA) to examine the incidence among MSM in Beijing from 2008 to 2016. Risk factors related to recent HIV infection were also assessed.MethodsConsecutive cross-sectional surveys on MSM were conducted yearly from 2008 through 2016. Demographic and behaviors data were collected. HIV status was determined and HIV positive specimens were tested for recent infection using BED-CEIA. Specimens with ODn values≤0.8 were considered recently infected, HIV incidence rates and prevalence were then calculated. Risk factors associated with recent HIV infection were assessed by univariate and multivariable logistic regression.ResultsFrom 2008 to 2016, the numbers of eligible participants in the nine consecutive years ranged from 472 to 616. All the 261 eligible HIV-positive specimens were subjected to recent HIV infection testing. HIV prevalence ranged from 5.0% (3.3%-6.8%) to 10.2% (7.8%-12.7%), and incidence ranged from 1.57% (0.19%-2.95%) to 6.63% (3.65%-9.61%). MSM who never or sometimes used condoms during anal sex with men in the past 6 months (aOR = 1.515, 95%CI: 1.016–2.257, p = 0.041), or having syphilis infection (aOR = 1.561, 95%CI: 0.946–2.575, p = 0.081) were more likely to be recently infected with HIV. Being a Beijing resident (aOR = 0.409, 95%CI: 0.212–0.790, p = 0.008), or having only one male anal sex partner in the past 6 months (aOR = 0.467, 95%CI: 0.220–0.994, p = 0.048) were associated with a lower risk for recent HIV infection.ConclusionsThe HIV incidence fluctuated among MSM in Beijing. Unprotected anal sex, having multiple sex partners, being a non-registered Beijing resident and having a syphilis infection play important roles in the recent HIV infection. Effective intervention measures for HIV and syphilis control and prevention should be continuously strengthened.

High HIV prevalence and associated risk factors among transgender women in China: a cross‐sectional survey

“…Our figure of 14.8% (95% CI 10.4 to 19.8) is statistically consistent with the pooled estimate of 17.7% for HIV prevalence among transgender women in low-to middleincome countries [1]. The prevalence is notably higher than that of most other key populations at risk for HIV in China [10][11][12][13][14], with rare exceptions in the southwest region of the country [13]. Moreover only three-fourths of transgender women testing positive in our study knew their HIV statusa level that falls well below the UNAIDS target of 90% awareness [19].…”

Barriers and facilitators of Pre-exposure Prophylaxis (PrEP) intention among Chinese men who have sex with men

“…Despite strengthened efforts on HIV prevention and control, new HIV infections continue to increase among men who have sex with men (MSM) in China due to the presence of multiple sex partners and unprotected sex. HIV prevalence among MSM populations ranged from 5.0-20%, while incidence was reported between 1.6-6.6% [1,2]. Similar trends were also observed in other countries in South-East Asia [3].…”

Sexual network distribution of HIV self-testing kits: Findings from the process evaluation of an intervention for men who have sex with men in China

“…In China, MSM account for an estimated 28% of new HIV infections annually and is the only key population with increasing new diagnosis despite strengthened efforts on HIV prevention and control in the past decade, including vast expansion of voluntary HIV counseling and testing sites nationwide [5,6]. Although HIV testing uptake has increased among MSM during the initial periods of expansion, it appears to have plateaued since then and remains suboptimal (e.g., about 50% reported testing in the past year) [7][8][9].…”