Impact of HIV/sexually transmitted infection testing on risky sexual behaviors among men who have sex with men in Langfang, China

Background Men who have sex with men (MSM) in China remain at high risk for HIV infection, the proportion of reported HIV/AIDS cases that occurred among MSM rose greatly from 2005 to 2011. HIV testing and counseling is a critical HIV prevention strategy among HIV related high-risk population, including MSM in China. This article aimed to assess the association between receiving HIV testing and high-risk sexual behaviors among MSM in Langfang, Hebei Province, China. Methods Between September and November 2007, 233 MSM were recruited to receive an HIV testing intervention. Face-to-face interviews were conducted before HIV testing and 3 months later HIV-related risk behaviors were assessed. Serological testing for HIV and other sexually transmitted infections (STIs) was performed. Results Of the recruited 233 MSM, 200 completed follow-up. Baseline prevalence was 7.8% for HIV, 21.0% for syphilis, 15.8% for gonorrhea, and 5.0% for chlamydia. Multivariate analysis indicated that inconsistent condom use (OR=7.9, 95% CI: 0.9-66.7, P=0.059) and bleeding during anal sex (OR=5.9, 95% CI: 1.3-26.2, P=0.019) were risk factors for HIV infection, and group sex (OR=6.6, 95% CI: 2.2-19.7, P=0.001) was a risk factor for syphilis infection at baseline. At 3 months follow-up, among STI-positive MSM, self-reported anal sex fell from 73.1% to 38.5% (P <0.001); group sex fell from 19.2% to 5.8% (P <0.001); and bleeding during anal sex fell from 23.1% to 5.8% (P <0.001). Among STI-negative MSM, the frequency of one-night stands fell from 32.5% to 17.2% (P <0.001), and oral sex rose from 57% to 78.5% (P <0.001). STI-positive MSM were less likely to engage in anal sex compared to STI-negative MSM (chi(2)=5.189, P=0.023). Conclusions HIV testing is an important intervention strategy among MSM. HIV testing services among MSM need to be scaled up, along with comprehensive, tailored interventions including condom promotion and STI treatment.