HIV This Week

Ma X, Zhang Q, He X, Sun W, Yue H, Chen S, Raymond HF, Li Y, Xu M, Du H, McFarland W. Trends in Prevalence of HIV, Syphilis, Hepatitis C, Hepatitis B, and Sexual Risk Behavior Among Men Who Have Sex With Men: Results of 3 Consecutive Respondent-Driven Sampling Surveys in Beijing, 2004 Through 2006. J Acquir Immune Defic Syndr. 2007;45:581-7

Studies tracking trends in HIV prevalence and risk behaviour among men who have sex with men (MSM) in China are rare. Ma and co-authors report on 3 consecutive cross-sectional surveys measuring the prevalence of HIV, other infectious diseases, and related risk behaviour among MSM in Beijing in 2004, 2005, and 2006. They applied respondent-driven sampling (RDS) to recruit MSM for a structured face-to-face interview on demographic characteristics and HIV risk-related behaviour. Blood specimens were drawn for HIV, syphilis, hepatitis B virus, and hepatitis C virus (HCV) testing. A total of 325 MSM participated in 2004, 427 in 2005, and 540 in 2006. HIV prevalence increased from 0.4% (95% confidence interval [CI]: 0.1 to 0.8 ) in 2004 and 4.6% (95% CI: 2.2 to 7.6) in 2005 to 5.8% (95% CI: 3.4 to 8.5) in 2006. This apparent rise was accompanied by an increase in syphilis and self-reported history of sexually transmitted diseases (STDs), high prevalence of multiple sex partners, and low consistent condom use. HCV prevalence also increased, from 0.4% (95% CI: 0.1 to 0.8 ) in 2004 to 5.2% (95% CI: 2.3 to 8.2) in 2006. The authors conclude that there was a possible rising prevalence of HIV and related risk behaviour among MSM in Beijing using RDS in each of 3 consecutive years. Practical measures, including MSM-friendly HIV testing, STD services, and health provider education, are urgently needed to stop the further spread of HIV in this population.

Editors’ notes: Although homosexuality is no longer a criminal act in China, men who have sex with men face considerable opposition and resistance. Service provision and healthcare provider education are important components of HIV prevention but they need to be accompanied by strategies to reduce the marginalisation of men who have sex with men and increase their engagement and ownership of participatory communication approaches to create protective sexual behaviour norms.