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A Comparison of HIV Infection and Related Risk Factors Between Money Boys and Noncommercial Men Who Have Sex With Men in Shenzhen, China

Zhao, Jin PhD*†; Cai, Wen-De MD*; Gan, Yong-Xia MD*; Zhang, Yan MD*; Yang, Zheng-Rong MD, PhD*; Cheng, Jin-Quan MD, PhD*; Lin, Si-Hao PhD; He, Ming-Liang PhD; Chen, Lin MD*; Wang, Xiao-Rong PhD

doi: 10.1097/OLQ.0b013e31826f356f
Original Study

Background HIV transmission among men who have sex with men (MSM) has become an increasing concern in China. Money boys (MBs) are a subgroup of MSM who sell sex to men. Direct comparison of HIV prevalence and related risk factors between MB and noncommercial MSM (ncMSM) has rarely been done. This study was conducted to make the comparison.

Methods Eight hundred fifty MBs and 801 ncMSM were parallel recruited in Shenzhen by time-location sampling. Their behavioral and serologic data on HIV and syphilis were collected and compared. Multiple logistic regression analysis was performed to evaluate the determinants for HIV risk in MBs and ncMSM, respectively.

Results The prevalence of HIV was 4.5% in MBs and 7.0% in ncMSM. Although MBs tended to have more male partners than ncMSM, they were more likely to report a consistent condom use in male anal intercourse, especially in commercial sex. Noncommercial MSM were more likely to visit parks and saunas instead of bars, massage centers, recreational centers, and home-based venues. Syphilis infection and recruitment venue were associated with HIV infection in both MBs and ncMSM. Being from a hometown with a high HIV prevalence and without a male partner from Hong Kong were found to be risk factors for HIV infection in MBs, and early sexual debut was a risk factor in ncMSM.

Conclusion Money boys differed from ncMSM in the rate of HIV infection and some sexual characteristics and behaviors. Formatting separate interventions specifically targeting the 2 subgroups may be necessary.

A comparison study between money boys and noncommercial men who have sex with men in China found that money boys differed from noncommercial men who have sex with men in HIV prevalence and behavioral characteristics.

From the *Shenzhen Center for Disease Control and Prevention, Shenzhen; and †School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR, China

Acknowledgments: The authors thank all participants, men who have sex with men volunteers from 258 Rainbow Workgroup, and the staff of the medical key laboratory of Shenzhen for sample preparation. They are also grateful to Dr Willi McFarland and Henry Fisher Raymond from the San Francisco Department of Public health and Dr Jinkou Zhao from the Global Fund to Fight AIDS, Tuberculosis and Malaria for their help in designing the program.

Partially supported by the National Nature Science Foundation of China (30901224), the National Key Science and Technology projects of China (2009ZX10001-018 and 2012ZX1001-002), Shenzhen Technology and Research Fund (200902082), and a special grant from the Medical Key Laboratory of Shenzhen.

J. Zhao and W.D. Cai contribute equally to this work.

Conflicts of interest: None.

Correspondence: Xiao-Rong Wang, PhD, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR, China. E-mail:

Received for publication March 11, 2012, and accepted July 20, 2012.

© Copyright 2012 American Sexually Transmitted Diseases Association