HIV risk among migrant men who have sex with men (MSM) in China: Does it differ by origin of residence and venue of employment

Background and objective: China's HIV epidemic has been shifting towards predominantly sexual transmission and emerging data suggest potential increases in HIV prevalence among men who have sex with men (MSM). Few studies have examined possible roles of origin of residence and venue of employment in HIV risk among MSM.

Methods: A community sample of 307 migrant MSM 18-29 years of age was recruited in Beijing, China. Self-administered survey was conducted to collect information on demographics, sexual and other risk behaviors. Blood specimens were collected to test for HIV and syphilis infections. Multiple logistic regression analyses were performed.

Results: HIV and syphilis prevalence rates were 5.9% and 20.2%, respectively. The median number of lifetime male sexual partners was 15. Approximately 60% of the MSM self-identified as gay. Nearly half grew up in rural areas. One-third worked at entertainment establishment, 45.6% at factories or construction sites, 22% were self-employed. MSM who grew up in rural areas were more likely to be infected with syphilis than MSM grew up in urban areas (OR=2.56, 95%CI: 1.33-4.94). Self-employed MSM and MSM worked at entertainment establishments were more likely to have three or more sexual partners in the last week, and to sell sex to men. Higher proportion of MSM who worked at entertainment establishments used condoms consistently in anal sexual intercourse.

Conclusion: MSM who grew up in rural areas or self-employed MSM and MSM who work at entertainment establishments are at increased risk for HIV/STI. Future HIV prevention efforts should target these subgroups of MSM.