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Relationship Between Syphilis and HIV Infections Among Men Who Have Sex With Men in Beijing, China

Ruan, Yuhua PhD*; Li, Dongliang MD; Li, Xinxu MD*; Qian, Han-zhu MD, PhD; Shi, Wei MD, PhD; Zhang, Xiaoxi MD; Yang, Zhenkai MD; Zhang, Xiaoyan MD, PhD*; Wang, Chen MD; Liu, Yingjie MD; Yu, Miao MD; Xiao, Dong BS; Hao, Chun MD*; Xing, Hui MS*; Hong, Kunxue MD, PhD*; Shao, Yiming MD, PhD*

Sexually Transmitted Diseases: August 2007 - Volume 34 - Issue 8 - p 592-597
doi: 10.1097/01.olq.0000253336.64324.ef

Background: Little is known about risk of HIV and other STDs among men who have sex with men (MSM) in China.

Objective: To survey the prevalence and risk factors of HIV and syphilis and evaluate correlation of two infections among MSM in the Chinese capital city.

Methods: A community-based sample of 526 MSM was recruited in 2005 through Internet advertising, community outreach, and peer referring. Interviewer-administered interviews were conducted to collect information on demographics and sexual and other risk behaviors, and blood samples were collected to test for syphilis and HIV infections.

Results: Seventeen (3.2%) participants were HIV seropositive and 59 (11.2%) syphilis seropositive. Sixty-four percent of participants were migrants who did not have Beijing residence. Forty percent had >10 lifetime male sex partners and 28.8% reported having ever had sex with women. Consistent condom use with primary male sex partners ranged from 21% to 24%, with nonprimary male sex partners from 35% to 42%, and with female partners around 33%. Illicit drug use was not common; only 2.5% reported using Ecstasy or ketamine in the past 6 months. Multivariate logistic regression analyses demonstrated that >10 lifetime male sex partners were independently associated with seropositivity of both syphilis (OR, 1.9; 95% CI, 1.1–3.4) and HIV (OR, 4.3; 95% CI, 1.4–13.6). In addition, HIV infection is significantly associated with syphilis seropositivity (OR, 3.8; 95% CI, 1.3–10.8).

Conclusions: High mobility, multiple sexual partners, and high prevalence of unprotected sex behaviors and syphilis infection suggest a potential rapid spread of HIV in Chinese MSM.

Average prevalence for a group may be misleading, since persons face disease prevalence within their own network. Such prevalence may differ from the average based on the disease and the characteristics of individuals.

From the *State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China; †Chaoyang Center for Disease Control and Prevention, Beijing, China; and ‡Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama

We are grateful to the editor and two anonymous referees for their critical review of this manuscript.

This study was supported by grants from the Ministry of Science and Technology of China (2004BA719A01), China Integrated Programs for Research on AIDS (CIPRA, U19AI51915), the National Institute of Allergy and Infectious Diseases, National Institutes of Health, USA.

Correspondence: Yiming Shao, MD, PhD, State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xuanwu District, Beijing 100050, China. E-mail:

Received for publication July 27, 2006, and accepted October 27, 2006.

© Copyright 2007 American Sexually Transmitted Diseases Association