A Follow-up Study Of The Impacts Of VCT Services On HIV Related High-risk Behaviors Among Men Who Have Sex With Men In Langfang, Hebei Province

Background:Men who have sex with men(MSM) seldom attend VCT clinics in China although they are one of the populations at high risk of HIV and sexually transmitted diseases(STDs).Objective:To understand the policy and strategy situation and challenges of HIV prevention for MSM population at the local level,analyze the risk factors of HIV/STD infection and evaluate the impacts of VCT services on HIV related high-risk behaviors among MSM.Methods:Face-to-face interviews were conducted to understand the usage of local HIV prevention resources by MSM and their HIV related high-risk behaviors. Laboratory testing was also conducted on MSM at the baseline and three months later. Baseline and follow-up data were compared to analyze the behavioral changes before and after HIV/STDs testing among MSM in Langfang,Hebei Province.Chi-square test was performed to measure the association between categorical variables,and odds ratio were calculated to estimated protential risk factors of HIV/STDs infection.Results:Qualitative study showed that MSM lacked of HIV testing and hardly any knew about VCT services though policy situation was improved since 2003.233 MSM were enrolled in a three months cohort.This population had energetic sex and high prevalence of unprotected sex,the condom use rate is 46.6%during anal intercourse.Condom usage in anal intercourse,bleeding during sex and experience of group sex were related with HIV infection,odds ratios of these risk factors were 6.286 (P=0.027),8.944(P=0.001) and 7.353(P=0.002) respectively.After receiving VCT services,MSM changed their high risk behaviors,such as reducing the number of their sexual partners and anal intercourses,avoiding casual sex and bewaring bleeding during sex,the effects of VCT services on HIV related risk behaviors were associated with HIV/STDs status.Although they changed their behaviors,MSM continued to expose themselves to a high risk of HIV infection.The incidence of syphilis and gonorrhea in the last three months were 5%and 6.47%among MSM cohort.Conclusions:The utilization of HIV prevention resources was low at local level,the comprehenssive coordination of multi-departments and the optimization of resources should be enhanced in HIV prevention.MSM were in the high risk of HIV infection and had a high prevalence of HIV/STDs,health education and behavioral intervention should be conducted on them urgently.VCT services had significant effects on the reducing of HIV related behaviors among MSM,HIV/STDs counseling and testing should be promoted to slow down the rising prevalence of HIV and STD among MSM.