Public health challenges of the emerging HIV epidemic among men who have sex with men in China
Public health challenges of the emerging HIV epidemic among men who have sex with men in China
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DOI：
10.1016/j.puhe.2011.01.007
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发表时间：
2011-05-01
期刊：
影响因子：
5.2
通讯作者：
Gu, J.
中科院分区：
文献类型：
--
作者：
Lau, J. T. F.;Lin, C.;Gu, J.
2008年，中国在61个城市开展了一项大规模的全国性调查，覆盖了18,000多名男男性行为者(MSM)。人类免疫缺陷病毒(HIV)感染率为4.9%，发病率为2.6~5.4/百人年。中国不同地区男男性接触者性病患病率在2.0%~29.9%之间。梅毒状况、主要从男同性恋桑拿房招募性伴、MSM经历的持续时间、与常规男性性伴侣和多个男性性伴侣发生无保护措施的性行为可以预测HIV血清转换。肛交期间坚持使用安全套的比例较低，为29.4%~37.3%。在此背景下，本文考虑了围绕艾滋病毒预防活动的因素，并确定了一些公共卫生挑战，如果要取得最佳结果，就需要考虑这些挑战。以男男性接触者为目标的艾滋病毒预防是一种延迟反应。与同性恋桑拿浴相关的高风险以及这些场所需要稳定的避孕套供应，需要紧急考虑。此外，中国约三分之一的男男性接触者有双性恋行为，这可能是由于社会文化原因和对男男性接触者的耻辱。男男性接触者的女性性伴很少意识到她们暴露在艾滋病毒传播的高风险中。最后，非政府组织预防艾滋病毒的原始性质及其可持续性问题，对中国男男性接触者艾滋病毒预防运动的未来构成了另一个严峻的挑战。(C)2011年皇家公共卫生学会。爱思唯尔有限公司出版。保留所有权利。
A large-scale national survey was conducted in 2008 across 61 cities throughout China, covering over 18,000 men who have sex with men (MSM). The prevalence of human immunodeficiency virus (HIV) was 4.9% and incidence ranged from 2.6 to 5.4 per 100 person-years. The prevalence of sexually transmitted diseases ranged from 2.0% to 29.9% among MSM in different parts of China. Syphilis status, recruitment of sexual partners mainly from gay saunas, duration of MSM experience, and unprotected sex with regular male sex partners and multiple male sex partners predicted HIV seroconversion. The prevalence of consistent condom use was low during anal sex, ranging from 29.4% to 37.3%. Within this context, this paper considers the factors surrounding HIV prevention activity, and identifies a number of public health challenges which need to be considered if optimum outcomes are to be achieved. HIV prevention targeting MSM is a delayed response. The high risk associated with gay saunas and the need for steady condom supply at these venues needs urgent consideration. In addition, approximately one-third of MSM in China reported bisexual behavior, which may be attributed to sociocultural reasons and stigma against MSM. Female sex partners of MSM are seldom aware of their exposure to high risk of HIV transmission. Finally, the primitive nature of non-government organizations for HIV prevention and issues around their sustainability pose another serious challenge for the future of HIV prevention campaigns targeting MSM in China. (C) 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.