Sexual Behaviors And Risk Factors Associated With HIV Infection Among Men Who Have Sex With Men Who Use The Internet

BackgroundMen who have sex with men (MSM) are increasingly using the Internet to socialize with their peers. However, the feasibility of recruiting MSM who use the Internet (MSMUI) via the Internet was not yet studied, and their demographic characteristics and risk factors for HIV infection were not well studied.Objectives1. To assess the feasibility of recruiting MSMUI via the Internet;2. To understand the demographic characterstics of MSMUI;3. To explore potential risk factors for HIV infection among MSMUI.MethodsBetween June and August 2007, 429 MSMUI were recruited via the Internet from Beijing and Urumqi, China. Questionnaire and Interview were conducted in a private room. Blood specimen was collected and tested for HIV, syphilis and HCV. Chisq-squared test was used to test if significant difference existed in the proportions of key indexes between the two cities; Logistic regression was used to analyze potential risk factors associated with HIV infection; Atlas.ti 5.0 was used to analyze qualitative data.Results1. Feasibility of recruiting MSM via the Internet:Four staff worked 4 hours a day. 429 MSMUI were recruited within 60 days. 2. Demographic characteristics:Mean age was 27 years. Seventy-two point seven percent had a college education or higher. Seventy point nine percent were homosexual, 18.5% heterosexual and 0.3% bisexual. Ninety point seven percent were Han ethnic. Thirty-three point eight percent had local residency. Sixty-eight point nine percent had a salary of 1000 yuan or more. Ninety-one point two percent ever had Internet sexual partners.3. Sexual behaviors and condom use:Average age of first sex with a male partner was 21. Number of lifetime male sexual partners was 10. Forty-seven point nine had ever tested for HIV. Twenty-six point three percent reported history of STIs infection. The rates of condom use in the last oral sex, receptive anal sex and insertive anal sex were 9.1%, 66.3% and 60.4%, respectively. Forty-one point one percent ever had female sexual partners.4. HFV infection and its impact factors:The infection rates of HIV, syphilis, HIV/syphilis and HCV were 4.8%, 11.4%, 1.7%, and 0.2%, respectively. Factors associated with HIV infection were being 24 years old or younger (OR=4.128, 95% CI: 1.372-12.416), being syphilis positive (OR=4.302, 95% CI: 1.499-12.343), having bleeding gums or oral ulcer during condom-free oral sex (OR=2.946, 95% CI: 1.040-8.342), having used non water-based liquid as substitute for lubricant oil (OR=8.345, 95% CI: 1.061-65.611) and having more than 15 lifetime sexual partners (OR=3.063, 95% CI: 1.058-8.866) were related with HIV infection.5. Factors influencing condom use:Using condom causes pain and cuts down pleasure during anal intercourse; not using a condom is a sign of faithfulness; being fluke-minded and lack of safety awareness; stop using a condom after becoming familiar with a partner; the number of intercourse outnumbers the number of condom; not knowing a condom can cut down HIV/STIs infection; when a good-looking partner refuses to use a condom; a condom is hard to reach; depression and anxiety. Conclusion1. It is feasible to recruit MSM via the Internet;2. MSMUI engages in high risky sexual behaviors for HIV infection and has a high prevalence of HIV infection;3. Under-25s are at higher risk of HIV infection than their older peers.