China MACS: An Exploratory Study

描述(申请人提供)：中国的艾滋病监测数据显示，中国的吸毒者和性工作者正在将艾滋病病毒感染迅速传播到普通人群，但迄今为止同性恋传播一直被忽视。据估计，中国有3,000万男男性行为者(MSM)，根据具体的危险行为，这一人群极易感染艾滋病毒/艾滋病。目前，关于男男性接触者人群中HIV的流行率、发病率以及哪些社会、行为和背景因素影响感染的信息缺乏。大约70%的男同性恋者在社会或家庭压力下结婚或将结婚，从而增加了感染从受感染的男性传播到他们的配偶或子女的可能性。由于大多数男男性接触者倾向于对他们的同性恋行为保密，因此还没有进行精心设计的流行病学研究来确定这一人群中艾滋病毒感染的流行率和发病率及其相关因素。本次R21申请拟在中国5个城市招募750名18岁至40岁的男男性接触者进行流行病学研究。本研究的具体目的是评估招募和留住男男性接触者的可行性和方法，并估计中国5个城市男男性接触者中HIV感染和性传播疾病的患病率和发病率。为了实现这一目标，建议进行为期两年的研究。这个项目可能具有相当大的挑战性，但它可能会导致中国在艾滋病毒相关研究方面的突破。这项研究可能会对与艾滋病毒相关的生物学、行为和临床研究产生重大影响，该研究不仅限于中国，还包括所有有艾滋病毒感染风险的人群。

DESCRIPTION (provided by applicant): China HIV surveillance data have shown that heroin users and sex workers in China are rapidly spreading HIV infection to the general population, but so far homosexual transmission has been ignored. There are an estimated 30 million men who have sex with men (MSM) in China, a population that can be extremely vulnerable to HIV/AIDS depending on specific risk behaviors. Currently, information is lacking about the prevalence of HIV, its incidence and which social, behavioral and contextual factors influencing the infection in the MSM population. About 70% of gay men are married or will marry under social or family pressure, thus raising the possibility of spread of infection from infected men to their spouses or children. Because most MSM tend to keep their homosexuality secret, no well-designed epidemiological studies have been conducted to determine the prevalence and incidence of HIV infection and its associated factors in this population. This R21 application proposes to conduct an epidemiologic study that will recruit 750 MSM aged 18 to 40 years old, in 5 cities in China. The specific aim of this study is to assess the feasibility of, and methods for recruitment and retention of MSM, and to estimate the prevalence and incidence of HIV infection and sexually transmitted diseases in MSM in 5 cities in China. A 2-year study is proposed to achieve this aim. This project may be considerably challenging, but it could lead to a breakthrough in HIVrelated research in China. The study could have major impact on a HIV-related biological, behavioral, and clinical research that extends beyond China to include all populations at risk for HIV infection.