HIV-1 infection and influencing factors in MSM in sentinel surveillance, Shanghai, 2012–2019

  Objective  To investigate the infection status of human immunodeficiency virus-1 (HIV-1) and related behaviors in men who have sex with men (MSM) in Shanghai, identify the influencing factors, and provide evidence for HIV prevention and control.

  Methods  Consecutive sentinel surveillance in MSM were conducted from 2012 to 2019. Blood samples were collected from the MSM and tested for HIV, syphilis and hepatitis C virus (HCV) antibodies. Logistics regression analysis was used to identify the influencing factors.

  Results  A total of 3207 MSM were investigated from 2012 to 2019, they were mainly aged 25–34 years, unmarried and non-local population, and lived in Shanghai for more than 2 years. Most of them had college education or above. The median of coverage rate of AIDS prevention service was 86.3%, and the median of awareness rate of AIDS related knowledge was 94.6%. The median of HIV antibody positive rate was 6.5%, which showed an overall upward trend (P<0.001). Up to 85.2% of MSM reported that they had anal homosexual behaviors in the past six months, among these MSM, 79.3% used condom at each anal sex. In the past six months, the proportions of condom use in homosexual, commercial homosexual and heterosexual behaviors all increased (P<0.05). Multivariate logistic regression analysis showed, education level of senior high school or lower (OR=1.506, 95% CI: 1.067–2.126, P=0.020), non-consistent condom use in anal sex (OR=1.379, 95% CI: 1.005–1.891, P=0.047), drug use (OR=3.688, 95% CI: 1.412–9.634, P=0.008) and syphilis status (OR=5.872, 95% CI: 3.784–9.111, P<0.001) were risk factors for HIV infection.

  Conclusion  The positive rate of HIV antibody in MSM in Shanghai is still high, and HIV related risk behaviors are still common. It is necessary to further explore a comprehensive prevention and control intervention model to reduce the HIV infection in MSM.