Risks for HIV/STIs and Their Psychological Correlates among Chinese MSM

描述(申请人提供)：虽然中国的艾滋病毒传播主要集中在注射吸毒者、商业性工作者和前献浆者，但中国政府现在也将男男性行为者视为高危群体。最新统计数据显示，男男性接触者占中国所有艾滋病病例的7%。越来越多的研究记录了MSM之间的高危行为，如无保护的肛交。例如，Choi和他的同事发现，北京男男性接触者的HIV流行率为3.1%(基于HIV检测)，样本中的大多数人都有高危行为，如无保护的肛交。考虑到许多中国男男性接触者也已婚，这些调查结果尤其令人担忧。此外，还有一群男男性同性恋者从事交易性行为，在当地被称为“金钱男孩”。研究显示，几乎所有的摇钱树都是移民。各种研究发现，相对于非移民，移民感染和传播艾滋病毒的风险更大。鉴于男男性接触者(包括钱仔为亚人群)已成为HIV传播的高危人群，建议进行为期5年的研究：(1)确定上海市男男性接触者中HIV和三种性传播疾病--淋病、单纯疱疹和梅毒的流行情况；(2)检查和描述非金钱男童和金钱男童之间的HIV风险(包括性风险和药物使用/滥用)；(3)检查和描述这两种类型MSM中HIV和STI检测的意愿；以及(4)审查和描述三种招募方法的效用--(A)社区舆论领袖；(B)基于地点的方法；以及(C)受访者驱动的抽样--在研究这两类男男性接触者中与艾滋病毒相关的风险方面。除了对中国地区男男性接触者艾滋病病毒风险进行系统调查外，这项研究还测试了艾滋病病毒感染风险概念模型在高危男男性接触者群体中的启发式价值。吸取的经验教训对印度等其他发展中国家有影响，印度正在经历艾滋病毒流行的日益严重，并有大量地下男男性接触者人口。

DESCRIPTION (provided by applicant): Although HIV transmission in China has been largely concentrated among injection drug users, commercial sex workers, and former blood plasma donors, the Chinese Government now also considers men who have sex with men (MSM) to be a high-risk group. The latest statistics show that MSM account for 7% of all HIV/AIDS cases in China. A growing number of studies document high-risk behaviors such as unprotected anal intercourse among MSM. Choi and colleagues, for example, found an HIV prevalence rate of 3.1% (based on HIV testing) among Beijing MSM, with a majority of the sample practicing high-risk behaviors such as unprotected anal intercourse. Considering that many Chinese MSM are also married, these findings are especially alarming. In addition, there is a subpopulation of MSM who engage in transactional sex, known locally as "money boys." Research reveals that virtually all of money boys are migrants. Various studies have found that relative to non-migrants, migrants are at greater risk of contracting and transmitting HIV. Given the emergence of MSM (including money boys as a subpopulation) as a high-risk group for the spread for HIV, the proposed 5-year study is to: (1) establish the prevalence of HIV and three sexually transmitted infections -gonorrhea, herpes simplex II, and syphilis - among MSM in Shanghai; (2) examine and describe HIV risks (including sexual risks and substance use/abuse) among non-money-boy MSM and money-boy MSM; (3) examine and describe the willingness to test for HIV and STIs among these two types of MSM; and (4) examine and describe the utility of three recruitment approaches - (a) community popular opinion leader; (b) venue-based approaches; and (c) respondent-driven sampling - in studying HIV-related risks among these two types of MSM. In addition to a systematic investigation of HIV risks among MSM in China, the proposed study also tests the heuristic value of a conceptual model on HIV risks among a high-risk MSM subpopulation, namely the Chinese money boys. Lessons learned have implications for other developing countries such as India, which is experiencing a growing HIV epidemic and has a large, underground MSM population.