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The incidence of syphilis, HIV and HCV and associated factors in a cohort of men who have sex with men in Nanjing, China
  1. Chun Hao1,2,
  2. Hongjing Yan3,
  3. Haitao Yang3,
  4. Xiping Huan3,
  5. Wenhui Guan3,
  6. Xiaoqin Xu3,
  7. Min Zhang4,
  8. Weiming Tang5,
  9. Na Wang4,
  10. Jing Gu2,6,
  11. Joseph T F Lau1,2
  1. 1Centre for Health Behaviours Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
  2. 2Centre for Medical Anthropology and Behavioral Health, Sun Yat-sen University, PR China
  3. 3Jiangsu Provincial Central for Disease Control and Prevention, Nanjing, Jiangsu, PR China
  4. 4Nanjing Central for Disease Control and Prevention, Nanjing, Jiangsu, PR China
  5. 5Nanjing Medical University, Nanjing, Jiangsu, PR China
  6. 6School of Public Health, Sun Yat-sen University, PR China
  1. Correspondence to Professor Joseph T F Lau, Centre for Health Behaviors Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, 5/F, School of Public Health and Primary Care, Prince of Wales Hospital, Shatin, NT, Hong Kong Special Administrative Region, PR China; jlau{at}cuhk.edu.hk

Abstract

Objective This study investigated the incidence of syphilis, HIV and hepatitis C virus (HCV), as well as factors associated with syphilis seroconversion among men who have sex with men (MSM) in Nanjing, China.

Methods A cohort of MSM was recruited by respondent-driven sampling methods. Those who were syphilis-, HIV- and HCV-seronegative at the baseline were invited to be retested at month 6. A Poisson regression analysis was performed.

Results Of the 416 participants in the study, 348 participants were HIV-, syphilis- and HCV-negative at the baseline, 250 (71.84%) of whom returned for retesting at month 6. Nine of these 250 participants had seroconverted to syphilis-positive (incidence=7.58 per 100 person-years (PY); 95% CI 2.63 to 12.53 per 100 PY), and five had seroconverted to HIV-positive (incidence=4.17 per 100 PY; 95% CI=0.52 to 7.83 per 100 PY). No HIV and syphilis coinfection and no HCV seroconversion were found. Multivariate analysis identified four statistically significant factors predicting syphilis seroconversion, including currently single marital status (RR=0.32, 95% CI 0.16 to 0.65, p<0.01), monthly income >US$300 (RR=2.68, 95% CI 1.28 to 5.61, p<0.01), self-reported homosexual orientation (RR=0.48, 95% CI 0.24 to 0.96, p<0.05) and recruitment of male sex partners mostly from gay saunas (RR=6.72, 95% CI 2.88 to 15.68, p<0.01).

Conclusions The high incidence of syphilis and HIV reflects the seriousness and urgency of the HIV and sexually transmitted diseases (STD) epidemics among MSM in China. Effective interventions of syphilis treatment and prevention should target MSM with characteristics reflecting the aforementioned risk factors.

  • Sexually transmitted diseases
  • incidence
  • men who have sex with men
  • cohort study
  • China
  • gay men
  • STD

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Footnotes

  • Chun Hao and Hongjing Yan contributed equally to the preparation of the manuscript.

  • Funding This cohort study is financially supported by Jiangsu Provincial Technologies Research Program, No BE2009685.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the The Chinese Centre for Disease Control and Prevention.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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