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

• Type of Material: Article
• Authors: Wenting Huang, Emory University; Yehua Wang, University of North Carolina Project-China; Haidong Lu, University of North Carolina; Dan Wu, University of North Carolina Project-China; Stephen W Pan, Xi’an Jiaotong-Liverpool University; Joseph D Tucker, University of North Carolina Project-China; Weiming Tang, Southern Medical University
• Language: English
• Date: 2020-05-01
• Publisher: OXFORD UNIV PRESS INC
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1093/ofid/ofaa147
• Title of Journal or Parent Work: OPEN FORUM INFECTIOUS DISEASES
• Volume: 7
• Issue: 5
• Start Page: ofaa147
• End Page: ofaa147
• Grant/Funding Information: This work was supported by the National Key Research and Development Program of China (2017YFE0103800), Academy of Medical Sciences and the Newton Fund (NIF\R1\181020), the National Institutes of Health (NIAID 1R01AI114310-01, NIAID K24AI143471), the NIMH (R34MH109359 and R34MH119963), the National Science and Technology Major Project (2018ZX10101-001-001-003), and the National Nature Science Foundation of China (81903371). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
• Keywords: MSM; Immunology; HIV; China; Science & Technology; Life Sciences & Biomedicine; SYPHILIS; RISK; Microbiology; Infectious Diseases; DEBUT; incidence; PREVALENCE; EPIDEMIC
• Research Categories: Health Sciences, Public Health

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 prophylaxisand other effective HIV prevention interventions are urgently needed.