Nationality Difference in Behavioral Risks and HIV Testing of Men Having Sex with Men (MSM) in Shanghai, China

Background/Objectives: An estimated 2-5% of Chinese males are homosexual or bisexual. Increasing numbers of gay bars have permitted widespread interaction with foreign tourists and expatriates. This pilot survey assessed HIV testing, knowledge, and condom use among gay clubgoers.

Methods: Participants were identified via venue-based sampling at five popular gay clubs in Shanghai. Self-identified MSMs were surveyed for demographics, utilization of health care, HIV knowledge, and high-risk sexual behaviors. Data were evaluated via bivariate analysis and multiple logistic regression.

Results: 112 local Chinese and 24 international MSMs were enrolled. Over 1/3 participants had 4 to 10+ partners last year. 41% of all participants reported condom use with every sexual encounter. Chinese men had an OR of 0.287 (95% CI, 0.11, 0.72) to use condoms, relative to foreign men. Participants with a perfect HIV knowledge score were 2.03 times as likely to use condoms with every sexual encounter (p = 0.110).

Clubgoers reported significant international sexual encounters. 7 out of 24 foreigners reported 4 to 10+ Chinese partners last year. 30 out of 112 Chinese men reported sexual encounters with foreign men, 5 of them claiming 10+ partners.

39% of participants claimed to have been tested for HIV. Chinese men were 8.97 times as likely as foreigners to be tested (95% CI, 2.01, 39.89). This finding persisted after adjustment for possible confounders.

Conclusion: Although the pilot study did not sample all subtypes of MSMs in China, it demonstrated the need for increased condom use in the high-risk gay clubgoer population.