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

描述（由申请人提供）：虽然艾滋病病毒在中国的传播主要集中在注射吸毒者、商业性工作者和前血浆献血者中，但中国政府现在也将男男性行为者（MSM）视为高危人群。最新的统计数据显示，男同性恋者占中国所有艾滋病病例的7%。越来越多的研究记录了男男性接触者的高危行为，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艾滋病毒感染率为3.1%（基于艾滋病毒检测），其中大多数样本都有高危行为，如无保护的肛交。考虑到许多中国男同性恋者也结婚了，这些发现尤其令人担忧。此外，还有一部分男同性恋者从事性交易，在当地被称为“金钱男孩”。研究表明，几乎所有的“钱男”都是移民。各种研究发现，与非移民相比，移民感染和传播艾滋病毒的风险更大。鉴于MSM（包括金钱男孩作为一个亚群体）成为艾滋病毒传播的高危人群，本研究拟进行为期5年的研究：(1)确定上海MSM人群中艾滋病毒和三种性传播疾病（淋病、单纯疱疹II型和梅毒）的流行情况；(2)检查和描述非金钱男孩男同性恋者和金钱男孩男同性恋者的艾滋病毒风险（包括性风险和药物使用/滥用）；(3)调查并描述这两类男男性行为者的艾滋病毒和性传播感染检测意愿；(4)考察和描述三种招募方法的效用——(a)社区民意领袖；(b)以场地为基础的办法；(c)受访者驱动的抽样——在研究这两类男男性行为者中与艾滋病毒相关的风险。除了对中国男男性接触者的艾滋病风险进行系统调查外，本研究还测试了一个概念模型对高危男男性接触者亚人群（即中国的钱男）艾滋病风险的启发式价值。吸取的经验教训对印度等其他发展中国家也有影响，印度正在经历日益严重的艾滋病毒流行，并且有大量地下男同性恋者人口。

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.