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

描述（申请人提供）：尽管中国的艾滋病病毒传播主要集中在注射吸毒者、商业性工作者和前血浆捐献者中，但中国政府现在也认为男男性行为者（MSM）是高危人群。最新统计显示，中国男男性接触者占艾滋病感染者的7%。越来越多的研究记录了高风险行为，如男男性行为者之间无保护的肛交。例如，Choi及其同事发现，北京男男性行为者中的艾滋病毒感染率为3.1%（基于艾滋病毒检测），大多数样本都有高风险行为，如无保护的肛交。考虑到许多中国男男性接触者也已婚，这些发现尤其令人震惊。此外，还有一部分男男性接触者从事性交易，在当地被称为“金钱男孩”。“研究表明，几乎所有的金钱男孩都是移民。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的出现（1）调查上海市男男性行为人群HIV感染率及淋病、单纯疱疹II型和梅毒三种性传播疾病的流行情况;（2）检查和描述艾滋病毒风险（包括性风险和药物使用/滥用）在非金钱男孩男男性行为者和金钱男孩男男性行为者之间;（3）考察并描述了这两类男男性行为者进行HIV和STI检测的意愿;（4）考察并描述了三种招募方法的效用：（a）社区民意领袖;（B）基于场所的方法;及（c）以受访者为主导的抽样调查-研究这两类男男性接触者的艾滋病毒相关风险。除了对中国男男性接触者的艾滋病风险进行系统调查外，本研究还对一个高危男男性接触者亚群（即中国的金钱男孩）的艾滋病风险概念模型的启发价值进行了检验。所吸取的经验教训对其他发展中国家，如印度，也有影响，印度的艾滋病毒流行病日益严重，有大量的地下男男性行为者。

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.