Trends in HIV prevalence among men who have sex with men in China 2003-09: a systematic review and meta-analysis.

BACKGROUND The year-by-year trend of HIV prevalence among men who have sex with men (MSM) in China is not well documented. METHODS Published studies on HIV prevalence among MSM in China were reviewed and grouped by year, region and age group. Meta-analysis was used to summarise the estimates of national and regional HIV prevalence rates and trends among MSM from 2003 to 2009. HIV prevalence among MSM in different age groups (<25 years old v. ≥25 years old) was also calculated. RESULTS Eighty-three publications were included in the meta-analysis. The pooled HIV prevalence among MSM in China increased from 0.6% (95% confidence interval (CI): 0.0-2.1%) in 2003 to 7.4% (95% CI: 5.7-9.2%) in 2009. A yearly increase of 1.1% (95% CI: 0.5-1.5%, P<0.001) in HIV prevalence was detected. The pooled regional HIV prevalence among MSM ranged from 2.3% (95% CI: 1.7-2.9%) in east China to 11.4% (95% CI: 9.2-13.6%) in south-west China. No difference was detected (χ(2)=0.5160, P=0.4726) between HIV prevalence in the <25-year-old age group (3.1%, 95% CI: 1.6-4.6%) and that in the ≥25-year-old age group (4.0%, 95% CI: 1.8-6.3%). CONCLUSION The HIV prevalence among MSM in China is high and climbing. Effective strategies are required to prevent the epidemic from continuing to spread.

[1]  Geng Yijie.  Study on HIV/syphilis infections among men who have sex with men and their behavioral feature , 2012 .

[2]  Jingyuan Yang,et al.  Study on HIV and syphilis infections among men who have sex with men in selected cities of Inner Mongolia , 2009 .

[3]  W. Mcfarland,et al.  HIV prevalence and related risk factors among male sex workers in Shenzhen, China: results from a time–location sampling survey , 2009, Sexually Transmitted Infections.

[4]  L. Zhang,et al.  Meta-analysis: prevalence of HIV infection and syphilis among MSM in China , 2009, Sexually Transmitted Infections.

[5]  Liu Huai-liang.  Investigation of HIV,Syphilis and HCV Infection Situation and Sexual Behavioral Characteristics among MSM in Ningbo City , 2010 .

[6]  Lin Ai-hong.  Survey of risk factors of HIV infection in MSM in Shenzhen City , 2007 .

[7]  R. Detels,et al.  A Survey of Condom Use Behaviors and HIV/STI Prevalence Among Venue-Based Money Boys in Shenzhen, China , 2012, AIDS and Behavior.

[8]  Chunming Lu,et al.  A rapidly increasing incidence of HIV and syphilis among men who have sex with men in a major city of China. , 2011, AIDS research and human retroviruses.

[9]  Ning Wang,et al.  The development of HIV/AIDS surveillance in China. , 2007, AIDS.

[10]  Hongguo Wu,et al.  High risk sexual behavior and HIV/STD infection rate among 122 MSM from students , 2007 .

[11]  Min Xu,et al.  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 , 2007, Journal of acquired immune deficiency syndromes.

[12]  Xiangsheng Chen,et al.  Prevalence of syphilis and human immunodeficiency virus infections among men who have sex with men in Shenzhen, China: 2005 to 2007. , 2008, Sexually transmitted diseases.

[13]  Su Hao-hao.  HIV and syphilis infection in male homosexuality in Tangshan city , 2009 .

[14]  W. Ning.  Study on infection rate of HIV/SYPHILIS among men who have sex with men in a balneary , 2007 .

[15]  L. Wenzhong,et al.  Survey on HIV infection status among men who have sex with men and their behavioral feature. , 2010 .

[16]  W. Guo,et al.  [Survey on AIDS/STD risk behaviors and prevalence among men who have sex with men in Langfang, Hebei]. , 2008, Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi.

[17]  David P. Wilson,et al.  HIV and Syphilis Co-Infection Increasing among Men Who Have Sex with Men in China: A Systematic Review and Meta-Analysis , 2011, PloS one.

[18]  David P. Wilson,et al.  Human Immunodeficiency Virus Prevalence Is Increasing Among Men Who Have Sex With Men in China: Findings From a Review and Meta-Analysis , 2011, Sexually transmitted diseases.

[19]  Zhu Jianjing,et al.  Survey on the MSM group of knowledge and related HIV/AIDS characteristics and STD/HIV infection in Nanning. , 2010 .

[20]  Yao Zhong-zha.  Related serological surveillance and analysis in 145 men who have sex with men in Wuhan City , 2006 .

[21]  David P. Wilson,et al.  What is the potential for bisexual men in China to act as a bridge of HIV transmission to the female population? Behavioural evidence from a systematic review and meta-analysis , 2011, BMC infectious diseases.

[22]  Dong Yong-hui,et al.  Laboratory Study on Detective Results of Male Homosexuality Population in Urumqi,Xinjiang , 2008 .

[23]  Pan Chuanbo,et al.  Analysis of the infection of HIV/Syphilis and influence factors of MSM in a certain main district of Chongqing. , 2010 .

[24]  H. Zou,et al.  HIV Testing Among Men Who Have Sex with Men in China: A Systematic Review and Meta-Analysis , 2012, AIDS and Behavior.

[25]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement , 2009, BMJ : British Medical Journal.

[26]  Haibo Ding,et al.  Syphilis and HIV Seroconversion Among a 12-Month Prospective Cohort of Men Who Have Sex With Men in Shenyang, China , 2010, Sexually transmitted diseases.

[27]  W. Mcfarland,et al.  Potential Bridges for HIV Infection to Men Who Have Sex With Men in Guangzhou, China , 2006, AIDS and Behavior.

[28]  Xu Yong-fang.  INVESTIGATION OF HIV HIGH-RISK BEHAVIOR AND INFECTION AMONG MEN WHO HAVE SEX WITH MEN IN NANNING , 2009 .

[29]  Std Prevention,et al.  Study of HIV and syphilis infection situation and sexual behavioral characteristics among 416 MSM , 2007 .

[30]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. , 2010, International journal of surgery.

[31]  Liu Yingjie,et al.  Survey of HIV and syphilis infection and influential factors associated with unprotected anal intercourse in men who have sex with men in Beijing. , 2010 .

[32]  Li Yan-chu.  A survey of HIV/STDs prevalence in 200 MSM and related factors in Beijing , 2008 .

[33]  Tao Xiao-run.  A Survey on HIV/AIDS Related Information in Men Who Have Sex with Men in Shandong Province , 2007 .

[34]  L. Lei.  Survey on AIDS/STD Risk Behaviors and Prevalence Among Men Who Have Sex with Men in Zhongshan, Guangdong , 2010 .

[35]  Zunyou Wu,et al.  Sexual Risk Behaviors and HIV Infection Among Men Who Have Sex With Men Who Use the Internet in Beijing and Urumqi, China , 2010, Journal of acquired immune deficiency syndromes.

[36]  Huang Bin.  A survey of HIV/STD,HBV and HCV infections and risk behaviors among MSM in two central districts of Guiyang city , 2008 .

[37]  Pan Yun-jiao.  Serological Surveillance and Analysis among Men Having Sex with Men in a City of Fujian,China , 2010 .

[38]  Zhou Wang.  Epidemiological study on the status of HIV/STD among MSM in Wuhan City , 2010 .

[39]  Shi Xiang-don.  Study on influential factors and characteristics of commercial sex encounters among men having sex with men , 2010 .

[40]  Guo Tian-yin.  Investigation of the sexual behaviors among the MSM in Shaoxing City of Zhejiang Province , 2007 .

[41]  H. Xing,et al.  Relationship Between Syphilis and HIV Infections Among Men Who Have Sex With Men in Beijing, China , 2007, Sexually transmitted diseases.

[42]  Haijiang Lin,et al.  [Human immunodeficiency virus/sexually transmitted infection, risk behavior and sexual networks among men who have sex with men in Taizhou city, Zhejiang province]. , 2008, Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi.

[43]  J. Lau,et al.  The incidence of syphilis, HIV and HCV and associated factors in a cohort of men who have sex with men in Nanjing, China , 2011, Sexually Transmitted Infections.

[44]  Lian-gui Feng,et al.  [HIV prevalence and its associated factors among men who have sex with men in Chongqing]. , 2008, Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine].

[45]  X. Sun,et al.  Estimating the number of people at risk for and living with HIV in China in 2005: methods and results , 2006, Sexually Transmitted Infections.

[46]  Y. Ruan,et al.  Incidence of HIV-1, Syphilis, Hepatitis B, and Hepatitis C Virus Infections and Predictors Associated With Retention in a 12-Month Follow-Up Study Among Men Who Have Sex With Men in Beijing, China , 2009, Journal of acquired immune deficiency syndromes.

[47]  Hongbo Zhang,et al.  STUDY ON THE STATUS OF HIV INFECTION AND SYPHILIS INFECTION AMONG MSM IN HEFEI AND ITS CORRELATION WITH THE SOCIAL AND SEXUAL PARTNER CHARACTERISTICS OF MSM , 2007 .

[48]  Cai Xi.  The Analysis of Risk Behaviors of MSM in Liaocheng and the Serological Detection for Anti-HIV,Anti-TP,and Anti-HCV Antibodies in 2006 , 2007 .

[49]  L. Ying.  Survey of AIDS Knowledge Knowing-rate and Risk Sex Behavior among MSM in Lanzhou , 2007 .

[50]  Jihua Fu,et al.  Analysis of data of behavioral surveillance in men who have sex with men(MSM) in Shandong Province , 2006 .

[51]  H. Fisher Raymond,et al.  Possible Increase in HIV and Syphilis Prevalence Among Men Who Have Sex with Men in Guangzhou, China: Results from a Respondent-Driven Sampling Survey , 2011, AIDS and Behavior.

[52]  Xu Jie.  Sexual behavior and prevalence of HIV and syphilis among young men who have sex with men , 2010 .

[53]  Xu Dan-ge.  An Investigation on the Infection Rate of Syphilis and HIV among MSM Population from Public Bath , 2011 .

[54]  Q. Xia,et al.  High Prevalence of Sexually Transmitted Diseases Among Men Who Have Sex With Men in Jiangsu Province, China , 2006, Sexually transmitted diseases.

[55]  Zhao Ta.  Analysis of the knowledge and infection on AIDS among the MSM in Nanyang City , 2010 .

[56]  H. Jing.  Surveillance of AIDS Related Knowledge Awareness,Risk Behaviors and Biology Among Men Having Sex With Men in Mianyang , 2010 .

[57]  Wu Jian.  A survey on the prevalence of HIV-1 and syphilis infection and characteristics of sexual behaviors in MSM (men who have sex with men) living in Shanghai , 2008 .

[58]  H. Zou,et al.  Condom use in China: prevalence, policies, issues and barriers. , 2012, Sexual health.

[59]  Wen Ming-quan.  INVESTIGATION ON STD AND AIDS PREVALENCE FOR MEN WHO HAVE SEX WITH MEN , 2007 .

[60]  Tan Jing-guang,et al.  A SURVERY OF THE CHARACTERISTICS AND STD/HIV INFECTION OF HOMOSEXUALIFY IN SHENZHEN. , 2005 .

[61]  L. Ju.  Investigation on knowledge of HIV/AIDS and related behaviors character among men who have sex with men in Nanning,Guangxi , 2010 .

[62]  Gao Hong-ru.  Investigation on AIDS Related Knowledge,Behavior and Infection among Men who Have Sex with Men(MSM) in Yancheng City from 2007 to 2008 , 2009 .

[63]  W. Zheng,et al.  HIV infection and mental health of "money boys": a pilot study in Shandong Province, China. , 2010, The Southeast Asian journal of tropical medicine and public health.

[64]  Guangming Qin,et al.  HIV/STD Prevalence Among Men Who Have Sex With Men in Chengdu, China and Associated Risk Factors for HIV Infection , 2010, Journal of acquired immune deficiency syndromes.

[65]  Zhang Guang-gui.  Biological Monitoring and Social Characteristics Investigation of MSM Group in Mianyang City , 2009 .

[66]  Yan Song,et al.  A comparison of four sampling methods among men having sex with men in China: implications for HIV/STD surveillance and prevention , 2011, AIDS care.

[67]  He Qun,et al.  KAP study on AIDS among men who have sex with men in Guangzhou, Guangdong province , 2005 .

[68]  Lian-gui Feng,et al.  [A respondent-driven sampling survey on HIV and risk factors among men who have sex with men in Chongqing]. , 2009, Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi.