Prevalence of bisexual behaviour among bridge population of men who have sex with men in China: a meta-analysis of observational studies
- 1Key Laboratory of AIDS Immunology of Ministry of Health, Department of Laboratory Medicine, No 1 Hospital of China Medical University, Shenyang, China
- 2National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention (CDC), Xuanwu District, Beijing, China
- 3Tulane University Health Sciences Center, School of Public Health and Tropical Medicine, New Orleans, Los Angeles, California, USA
- Correspondence to Shang Hong, Key Laboratory of AIDS Immunology of Ministry of Health, Department of Laboratory Medicine, No 1 Hospital of China Medical University, 155 Nanjing North Street, ShenYang 110001, China;
Contributors The work presented here was carried out in collaboration between all authors. All authors read and approved the final manuscript. The first two authors contributed equally to the work. JJX defined the research theme. KY and JZ worked on data collection and data abstraction. KY and JJX analysed the data, interpreted the results and wrote the paper. KHR revised the language. YJJ, NW and HS supplied comments and helped with interpretation of the results.
- Accepted 31 August 2011
- Published Online First 27 September 2011
Objective To integrate the empirical estimates of bisexual behaviour among the bridge population of men who have sex with men (MSM) in China and their HIV and syphilis prevalences stratified by sexual behaviour.
Methods The Pubmed, Chinese Biomedical, Chinese National Knowledge Infrastructure, VIP, Wanfang and Google Scholar databases were searched to January 2011 to identify relevant articles. Data of eligible citations were extracted by two reviewers. All analyses were performed using Stata 10.0.
Results Forty-nine articles (including 28 739 MSM subjects) met the selection criteria. Aggregated findings indicated that the estimated prevalence of bisexual behaviour among MSM in China is 31.2% (95% CI 28.1% to 34.5%). HIV and syphilis prevalences were 5.4% and 11.4%, respectively, among MSM engaging in bisexual behaviour and 3.8% and 9.3% among MSM only having sex with men. HIV prevalence among MSM engaging in sex with both men and women was significantly higher than in those who only have sex with men (OR 1.30; 95% CI 1.04 to 1.62; p=0.02).
Conclusion There is a high prevalence of bisexual behaviour among MSM in China and bisexual behaviour is significantly associated with increased HIV infection risk. The results of this meta-analysis highlight a critical pattern of HIV transmission among MSM in China and indicate that targeted interventions aimed at encouraging safe sex practices and promoting societal and family acceptance of MSM are urgently needed.
- Bisexual behaviour
- epidemiology (general)
- gay men
- men who have sex with men
- sexual behaviour
Funding This work was supported by the mega-projects of national science research for the 11th Five-Year Plan (2008ZX10001–001); National Nature Science Foundation of China (81001291); Shenyang Science and Technology Plan (F10-149-9-50).
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The data are free to sharing with related studies.