OBJECTIVETo study the risk sexual behaviors related to AIDS between heterosexual and homosexual men who have had sex with men.

METHODSTarget sampling, anonymous questionnaires were adopted to compare sexual behaviors between the two groups.

RESULTSThe total amount of sex partners with same-sex was 13.8 on average among heterosexual men including 3.8 with male partners in the past 6 months. Numbers of male partners who had oral sex with was 10.5 and anal sex was 12.4 which were both less than with same sex. Among heterosexual men, the total number of female partners was 4.9 on average but number of female partners in the past 6 months was 1.7 which were both more than that among the homosexuals who were all in marriage status. The rate of condom use was 68.8% (lower than that among homosexual men), among heterosexual men when having sex with men. The rate of condom use among heterosexual men during last anal intercourse was 91.3% with male partners or 63.7% with females. Both figures were higher than that among the homosexuals. The rates of condom use among the two groups were 91.3% and 71.0% respectively during the last anal intercourse with men which were higher than the corresponding rate of condom use during the last oral sex. The rate of heterosexual men who ever had engaged in group sex was 9.9% in the previous year and the incidence of bleeding was 16.7% during sexual intercourse. 11.4% of them reported ever having had sex with partners from other areas in the last year and 4.2% had experienced same-sex harassment before 16 years of age. 4.6% had paid for male-male sex. All these figures were lower than that of the homosexuals.

CONCLUSIONThe characteristics of high risk sexual behaviors related to AIDS showed much difference in the two groups which called for attention among these groups of MSM.

Acquired Immunodeficiency Syndrome ; epidemiology ; Adult ; Condoms ; utilization ; Heterosexuality ; statistics & numerical data ; Homosexuality, Male ; statistics & numerical data ; Humans ; Male ; Risk Factors ; Risk-Taking ; Sexual Partners ; Young Adult

OBJECTIVETo understand the trends on HIV and syphilis infections, as well as on risk behaviors and intervention among MSM in China from 2010 to 2013 so as to provide information for the development of intervention strategies for MSM.

METHODSStudy population involved MSM who were recruited for the national HIV sentinel surveillance between 2010 and 2013. Demographic information, HIV related risk behaviors, and results on HIV and syphilis infections were described and trend analysis was performed.

RESULTSBetween 2010 and 2013, the total number of MSM under survey was 149 848. As for sources of the studied population, 12.3% of them were from public bathrooms (Group A), 30.1% from internet (Group B), and 57.5% were others (Group C). Proportions of three groups were similar between 2010 and 2013. The proportion of always using condom in the last six months increased from 30.2% to 37.8%, from 34.7% to 42.9% and from 35.3% to 43.1% in group A, B or C (trend:P < 0.01), from 2010 to 2013. The proportion of using condom in group A was the lowest among the three groups. The prevalence rate of HIV increased from 7.8% in 2010 to 9.2% in 2013 among group A, from 5.0% in 2010 to 6.8% in 2013 among group B, from 5.6% in 2010 to 6.5% in 2013 among group C(trend:P < 0.01). The prevalence rate of syphilis decreased from 13.2% in 2010 to 9.5% in 2013 among group A, from 6.1% in 2010 to 5.7% in 2013 among group B, from 8.7% in 2010 to 6.2% in 2013 among group C (trend:P < 0.01). In this MSM population, 77.1% of them were at age 21-40, 9.4% were at age 41-50 and 2.8% were older than 50 years of age. Both the prevalence rates of HIV and syphilis were the highest-10.1% and 13.6%, among age group of over 50s, respectively.

CONCLUSIONHIV prevalence among MSM increased rapidly in the last four years, especially in older age groups and from public bathrooms. More intervention efforts should be targeting on MSM with the above mentioned characters.

Adult ; China ; epidemiology ; Condoms ; utilization ; Cross-Sectional Studies ; HIV Infections ; epidemiology ; Homosexuality, Male ; statistics & numerical data ; Humans ; Male ; Risk Factors ; Unsafe Sex ; statistics & numerical data ; Young Adult

OBJECTIVETo study the socio-demographic characteristics, acquired immune deficiency syndrome (AIDS) related behaviors of male clients of female sex workers and their determinants.

METHODSContacting subjects through 5 ways including volunteers of female sex workers (FSWs), sexually transmitted disease (STD) clinics, long-distance bus stations, long-distance cargo station while adopting methods as snowballing, employing an anonymous questionnaire. Data was analyzed by logistic regression analysis.

RESULTS(1) The majority of clients were 25-45 years old, married and of junior high school or above educational levels; (2) Among male clients of FSWs, numbers of having had commercial sexual intercourse was between 1 to 240, averaged 24 in the previous year. It significantly related to their occupation and the experience of their friends or colleagues who ever visited female sex workers; (3) 27.98% of them used condom every time during commercial sexual intercourse, which significantly related to the score of knowledge on AIDS, concourse of sex intercourse and inhabitation; (4) 28.36% of them had ever contracted STD, which significantly related to the frequency of commercial sexual intercourse in the previous year, risk awareness of being infected with human immunodeficiency virus, and frequency of condom use during commercial sexual intercourse.

CONCLUSIONThe proportion of always using condom was low among male clients of FSWs, and had had STDs. And it's necessary for active and specific intervention programs to them.

Acquired Immunodeficiency Syndrome ; prevention & control ; Adult ; China ; Condoms ; Humans ; Male ; Middle Aged ; Risk-Taking ; Sex Work ; Sexual Behavior ; Unsafe Sex ; statistics & numerical data

OBJECTIVETo analyze the characteristics of risky behaviors among different age groups of HIV positive female sex workers, and to explore the strengthening of their management.

METHODSFrom January to June 2014, 22 814 female sex workers were investigated and tested HIV in 117 sentinel surveillance sites in Yunnan Province, and 181 were confirmed to be HIV antibody positive, who accepted questionnaire surveys. According to the age, the participants were divided into the < 35 years old age group and ≥ 35 years old age group. The demographic characteristics, knowledge about HIV/AIDS and related risk behaviors characteristics of the two groups were obtained via questionnaire surveys among 181 HIV positive female sex workers, and in-depth qualitative interviews were conducted from among 12 HIV positive sex workers.

RESULTSHIV antibody positive rate was 0.8% (181), the age of the 181 subjects were (35.83 ± 9.17) years old, 76 cases (42.0%) were < 35 years old, and 105 cases (58.0%) were ≥ 35 years old. The differences of marital status, workplace class, the last work site among two groups were statistically significant (χ(2) = 20.80, 28.32, 7.83; P < 0.001, P < 0.001, P = 0.020, respectively). Among 181 HIV, the proportion of AIDS awareness was 95.6% (173); the proportion of drug use among ≥ 35 years old age group was 51.4% (54), which was higher than that in < 35 years old age group (34.2%, 26/76) (χ(2) = 5.30, P = 0.021). 96.7% (175) received condom promotion or HIV counseling and testing in the past year. The proportion of continuing to engage in sexual services over 5 years after HIV infection was 48.5% (51/105) and the proportion of receiving antiretroviral treatment was 69.5% (73/105) in ≥ 35 years old age group, which were higher than those in the < 35 age group (30.2% (23/76), 52.6% (40/76); χ(2) = 12.26, 5.36; P = 0.002, 0.021, respectively). In-depth interviews among 12 HIV positive female sex workers found that regular clients, not consistent use of condoms were the main cause of no condom use. Economic and livelihood factors are important reasons for continuing to engage in sexual services among HIV positive sex workers.

CONCLUSIONHIV positive sex workers still have high risk behaviors including continuing to engage in commercial sexual service and no condom use after knowing their HIV infection status, and the proportion of using drugs in the ≥ 35 years old group was higher than that in < 35 years old group.

Adult ; China ; Condoms ; Female ; HIV Seropositivity ; Humans ; Marital Status ; Risk Factors ; Risk-Taking ; Safe Sex ; Sex Workers ; statistics & numerical data ; Sexual Behavior ; Substance-Related Disorders ; Surveys and Questionnaires

OBJECTIVEThe migrant population is a vulnerable group for HIV infection in China. Understanding potential epidemic trends among migrants is critical for developing HIV preventative measures in this population.

METHODSThe Estimation and Projection Package (EPP) model was used to process prefecture and county-level surveillance data to generate HIV prevalence and epidemic trends for migrant populations in China.

RESULTSThe prevalence of HIV among migrants in 2009 was estimated at 0.075% (95% CI: 0.042%, 0.108%) in China. The HIV epidemic among migrants is likely to increase over the next 5 years, with the prevalence expected to reach 0.110% (95% CI: 0.070%, 0.150%) by 2015.

CONCLUSIONAlthough the 2009 estimates for the HIV/AIDS epidemic in China indicate a slower rate of increase compared with the national HIV/AIDS epidemic, it is estimated to persistently increase among migrants over the next 5 years. Migrants will have a strong impact on the overall future of the HIV epidemic trend in China and evidence-based prevention and monitoring efforts should be expanded for this vulnerable population.

China ; epidemiology ; Condoms ; Epidemics ; statistics & numerical data ; Female ; HIV Infections ; epidemiology ; Humans ; Male ; Models, Theoretical ; Prevalence ; Risk Factors ; Safe Sex ; Sexual Behavior ; Transients and Migrants

Objective: To understand the prevalence of HIV infection and syphilis in clients in Ya'an of Sichuan province. Methods: A survey was conducted in clients recruited through snowball method in Ya'an of Sichuan from April 2014 to December 2015. The information of the clients, including basic demography characteristics, AIDS knowledge awareness, high-risk behaviors and others, were collected through face-to-face interviews. Blood sample (5 ml) was taken from each client to test antibodies against HIV and syphilis. Statistical software SPSS 18.0 was used for data analysis. Results: Among the 708 clients, the constituent ratio of those aged ≥50 years was 51.27% (363/708), those in Han ethnic group was 99.72% (706/708), those with junior high school educational level or below was 90.11% (638/708), those who got married or cohabitated with others was 74.15% (525/708), and those who used condoms at each sex was 27.40% (194/708). Seven HIV positive cases were detected and 4 cases were aged ≥50 years. Seven syphilis cases were detected and all the cases were aged ≥50 year. No HIV-syphilis co-infection case was detected. The prevalence of HIV infection and syphilis were all 0.99% (95%CI: 0.30%-1.70%). Results from the multivariate logistic regression analysis showed that the clients who had their first commercial sex behavior at age <30 years (OR=6.61, 95%CI: 1.09-40.18) would have higher HIV positive rate. Conclusion: The rate of condom use was low in the clients in Ya'an and they didn't pay enough attention to their self-protection in sexual activities. Especially the clients aged ≥50 years were with low educational level and had high risk commercial sexual behaviors for HIV infection and syphilis. Close attention needs to be paid to them.
Aged ; Coinfection/epidemiology* ; Condoms/statistics & numerical data* ; HIV Infections/ethnology* ; Humans ; Middle Aged ; Prevalence ; Risk Factors ; Sex Work ; Sexual Behavior/ethnology* ; Surveys and Questionnaires ; Syphilis/ethnology*

Heterosexual transmission has become the main route of HIV transmission in China. As the main body of commercial heterosexual transmission, female sex workers (FSW) have a high-risk behavior of inconsistent condom use that increase the risk of HIV infection and spread. This review summarizes associated factors of condom use among FSW such as demographic characteristics, condom negotiation, sexual partner type, sexual intercourse, violence and HIV testing, which can provide reference for the future prevention and research among the FSWs.
Adult ; China ; Coitus ; Condoms/statistics & numerical data* ; Female ; HIV Infections/prevention & control* ; Heterosexuality ; Humans ; Male ; Research/trends* ; Safe Sex ; Sex Work ; Sex Workers ; Sexual Partners

OBJECTIVEThis study was to investigate the condom use and its factors on sex workers in Shandong province, and to provide effective suggestions for AIDS prevention strategies and interventions.

METHODSFrom April to July in 2009, 4732 female sex workers were investigated through anonymous questionnaires from 11 cities which were selected based on the AIDS epidemic, geographic location, economic conditions in Shandong province. Serum samples were collected and antibodies were tested by ELISA and TPPA from 4641 people.

RESULTS4732 female sex workers who were 15 - 58 years old were investigated and the majority belonged to the low age group (≤ 24 years old) which accounted for 61.5% (2912/4732). Among the 4732 female sex workers, the unmarried, the divorced, or the widowed females accounted for 72.8% (3441/4725) and 72.0% (3403/4726) of them were poorly educated.42.3% (1994/4719) of them were found from other provinces. The right answers for knowledge of AIDS accounted for 45.7% (2164/4732). 80.6% (3416/4236) of these females were found to used condoms in the most recent commercial sex activity. The rate of consistently using condoms in sex activity during the last month was 58.4% (2467/4221). In this survey, 7.3% (337/4637) of investigated females had been diagnosed with sexually transmitted diseases, 30.7% (1449/4726) of them had received HIV antibody test, 70.4% (3323/4732) of these people had received the AIDS intervention services, and 3.6% (167/4668) of them had ever used drug. Multivariate logistic regression analysis showed that high education level (junior high school or lower vs senior high school or higher, adjusted OR = 0.77, 95%CI: 0.67 - 0.90), having received the HIV intervention (received vs unreceived, adjusted OR = 1.36, 95%CI: 1.17 - 1.58), antibody detection (done vs not done, adjusted OR = 1.33, 95%CI: 1.15 - 1.55), and good knowledge about AIDS (low score group vs high score group, adjusted OR = 0.37, 95%CI: 0.32 - 0.44) were independent factors that increased safe sex behavior; while using drug (drug vs not drug, adjusted OR = 0.22, 95%CI: 0.15 - 0.31) was a negative factor.

CONCLUSIONThe prevalence rate of HIV infection among female sex workers was low in Shandong province. However, the low rate of condom use and the high prevalence of self-reported STD-related symptoms suggested that more attentions should be paid to the factors of risk behaviors, and more targeted interventions are critically needed.

Acquired Immunodeficiency Syndrome ; prevention & control ; Adolescent ; Adult ; China ; Condoms ; utilization ; Female ; Humans ; Middle Aged ; Population Surveillance ; Prevalence ; Safe Sex ; statistics & numerical data ; Sex Workers ; statistics & numerical data ; Sexually Transmitted Diseases ; prevention & control ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo understand the prevalence of high risk behaviors and influencing factors among HIV infected persons aged ≥50 years.

METHODSFace to face questionnaire interview was conducted among the HIV infected persons selected in Jianshui, Gejiu and Mengzi counties in Yunnan province through random sampling in June 2015. The sample size was 450.

RESULTSAmong the HIV infected persons surveyed, 41.2% (122/296) had sexual behaviors with their spouses during past year, and the consistent condom use rate was 66.4% (81/122). Among the HIV infected males, 8.9% (28/313) had commercial sexual behaviors during past year, and the consistent condom use rate was 17.9% (5/28). Among the HIV infected females, 0.7% were still engaged in commercial sex service during past year. Among the 450 HIV infected persons, 32 (7.1%) reported having casual sex behaviors during past years, and the consistent condom use rate was 18.7% (6/32). The rate of commercial sexual behavior in urban residents (13.4%, 19/115) was higher than that in rural residents (4.5%, 9/198), the difference was statistically significant (χ(2)=11.715, P=0.001). The risk factors for commercial sex behaviors included lack of family and social support, aged 50-59 years, living in urban area, higher income and being male. The risk factors for using no condom included living in rural area, lower education level, lack of family and social support and higher income.

CONCLUSIONSRisk sex behaviors are still prevalent in HIV infected people aged >50 years, which exacerbated HIV transmission. Further efforts should be focused on the education about AIDS prevention and control and promoting protected sexual behaviors. Additional effort should be done to improve the family and social support for HIV infected people aged >50 years. Moreover, comprehensive intervention for low-paid female sex workers also needs to be strengthened.

China ; epidemiology ; Condoms ; utilization ; Female ; HIV Infections ; epidemiology ; Humans ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Risk-Taking ; Sex Work ; psychology ; statistics & numerical data ; Sexual Behavior ; psychology ; statistics & numerical data ; Surveys and Questionnaires

OBJECTIVETo assess the effectiveness of an educational intervention program in sexually transmitted disease (STD) and condom-related knowledge and promoting condom use among STD patients.

METHODSSTD clinic patients were randomly assigned to three groups (A, control group; B, video viewing group; group C, video viewing plus education with talk) after administered with baseline questionnaire. Each patient was then scheduled to complete the questionnaire regarding the change of STD knowledge and use of condom in two weeks and 3 months.

RESULTSSix hundred and forty-eight patients entered the study. More than half of the patients were aware of STD-related knowledge. However the rate of condom use was very low. When having intercourse with the casual sexual partners the percentage of condom use was only 20%. Seventeen per cent of the patients knew nothing about how to use condom correctly. Follow up results showed that the education program increased the knowledge about STD to some degree. However the percentage of condom use in the latest sexual intercourse increased greatly both in intervention and control groups, but more in intervention groups (P < 0.05).

CONCLUSIONSTD education should be focused on advocating and correcting condom use.

Adult ; Condoms ; statistics & numerical data ; utilization ; Female ; Health Knowledge, Attitudes, Practice ; Health Promotion ; methods ; statistics & numerical data ; Humans ; Male ; Patient Education as Topic ; methods ; Sexually Transmitted Diseases ; prevention & control ; Videotape Recording