HIV This Week

Guo H, Wei JF, Yang H, Huan X, Tsui SK, Zhang C. Rapidly Increasing Prevalence of HIV and Syphilis and HIV-1 Subtype Characterization Among Men Who Have Sex With Men in Jiangsu, China. Sex Transm Dis. 2009;36(2):120-5

Guo and colleagues investigated the prevalence of HIV, hepatitis B (HBV), hepatitis C (HCV), and syphilis among men who have sex with men in 2 cities of Jiangsu, China, and to characterize the HIV-1 subtypes prevalent among this population. During September 2006 and July 2007, 296 and 173 men who have sex with men were recruited from Nanjing and Yangzhou, respectively. Sera samples were collected and tested for HIV, HBV, HCV, and syphilis infections. The nucleotide sequences of p17 and C2V3 regions were determined by reverse transcriptase-nested-PCR and sequencing. HIV-1 subtypes were characterized by phylogenetic analysis. The prevalence of HIV, HBV, HCV, and syphilis infections among men who have sex with men was 5.8%, 11.1%, 0.7%, and 27.7%, respectively. The prevalence of HIV and syphilis was significantly higher in 2006-2007 than in 2003 (P </=0.0013) in Jiangsu than in other regions of China (P </=0.003). In contrast, there was no significant difference in HBV and HCV prevalence between present and 2003 studies (P >0.05). The phylogenetic tree of p17 showed that HIV-1 subtypes B, CRF01_AE, and CRF07_BC accounted for 35.7%, 35.7%, and 28.6%, respectively. The result of C2V3 showed that 45.5%, 36.4%, and 18.2% sequences belonged to HIV-1 subtype B, CRF01_AE, and BC recombinants, respectively. The subtype characterization in Jiangsu was significantly different from those in Beijing (P <0.05). Furthermore, Jiangsu HIV-1 B strains were different from majority of China B’ strains and originated from Beijing. The rapidly increasing prevalence and complex subtypes of HIV-1 suggest that effective prevention and intervention strategies are urgently needed for men who have sex with men in Jiangsu.

Editors' note: In China, gay bars, saunas, and baths are major venues for men who have sex with men to meet. This study used convenience sampling to recruit 433 men in gay baths in 2 cities of Jiangsu province which is located at the Yangtze River Delta, one of the most developed economic areas of China. Although the HIV prevalence for the Nanjing bath subjects (4.7%) was not different from that found in a previous similar study (4.73%), the high (26.7%) and rapidly increasing prevalence of syphilis suggests significant levels of unprotected anal sex. There is an urgent need to work with this community to design and implement effective HIV prevention programmes in the places where men meet and to better document trends in HIV incidence and viral subtype characterisation.