Background Knowing the HIV incidence is essential for providing timely intervention among key populations. However, HIV incidence data from men who have sex with men (MSM) in China are limited. In this study, we aim to measure HIV incidence among MSM in eight cities and investigate correlates with incidence.

Methods This study is a secondary analysis of a stepped-wedged randomized control trial focusing on promoting HIV testing among Chinese MSM. MSM from eight cities in Guangdong and Shandong Province were recruited and followed from July 2016 to August 2017. Sexual behaviors and HIV testing activity were measured at baseline and during follow-up survey every three months. Participants who reported to have tested HIV at least twice during different follow-up periods were included in this analysis. We defined the seroconversion as a negative HIV testing result followed by a positive result during any of the follow up. We used Cox regression to examine correlates with HIV seroconversion.

Results Of the 1381 participants recruited at baseline, 360 MSM had HIV tests at least twice. At baseline, 87.5% (315/360) were never married and 32.8% (118/360) never disclosed their sexual orientation to anyone other than their sexual partners. During the 12-month follow-up period, 56.67% (204/360) had multiple male partners, 15.3% (55/360) had female partners and 14.7% (53/360) had bisexual behaviors. Overall, 25 men had seroconversion, and the HIV incidence rate was 15.0/100 person-year. The Cox regression model showed higher seroconversion risk was associated with a higher number of female sexual partners (HR=3.59, 95%CI: 1.32–9.80). The association between seroconversion and bisexual behavior was marginally significant (HR=2.05, 95%CI: 0.98–4.29).

Conclusion HIV incidence is very high among MSM in our study based in China. It was associated with multiple sexual partners, as well as bisexual behaviors. Interventions to prevent HIV transmission, targeting on sexual behavior change are needed.

Disclosure No significant relationships.