China MACS: An Exploratory Study

描述（由申请人提供）：中国艾滋病监测数据显示，中国的海洛因使用者和性工作者正在迅速将艾滋病病毒传播给普通人群，但迄今为止，同性恋传播一直被忽视。据估计，中国有3000万男性与男性发生性关系（MSM），这一人群可能因特定的风险行为而极易感染艾滋病毒/艾滋病。目前，关于艾滋病毒的流行程度、发病率以及影响男男性行为人群感染的社会、行为和环境因素的信息缺乏。大约70%的男同性恋者已经或将在社会或家庭压力下结婚，因此增加了感染男性将感染传播给配偶或子女的可能性。由于大多数男同性恋者倾向于保守同性恋的秘密，没有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程度和发病率及其相关因素。本R21申请拟在中国5个城市招募750名年龄在18至40岁的男男性行为者进行流行病学研究。本研究的具体目的是评估中国5个城市的男男性行为者招募和保留的可行性和方法，并估计中国5个城市的男男性行为者中HIV感染和性传播疾病的患病率和发病率。为达到这一目标，建议进行为期两年的研究。这个项目可能相当具有挑战性，但它可能会导致中国艾滋病相关研究的突破。这项研究可能会对HIV相关的生物学、行为学和临床研究产生重大影响，这些研究将扩展到中国以外的所有HIV感染风险人群。

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.