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Copy Copied. Read Next. China tech TikTok harvested and sent data to China, lawsuit claims. China tech Besieged app TikTok hires lobbyists. International relations Japan excluded from new US foreign investment whitelist. Sponsored Content. B Prevalence of syphilis among saunas and bars. The results of this study suggest that those sourcing male sex partners mostly from saunas in the 10 cities in China were at higher risk of contracting HIV and syphilis, as compared with those from gay bars or the Internet.
In most of the pairwise comparisons, the tests for heterogeneity were not statistically different, suggesting that the associations of the individual cities follow a consistent direction. The findings have important policy and programming implications. Many of associations within individual cities did not reach statistical significance, possibly due to the small sample sizes. Methodologically speaking, it is a reminder that statistically negative results obtained from HIV and STD prevalence surveys targeting MSM in China should be interpreted with extreme caution, as the usual sample size of — 5 , 27 might not have an adequate power for detecting significant differences.
Previous studies reported that participants recruited from the Internet have higher HIV prevalence as compared with those recruited from other sources. Our study gives a clarification to that conclusion. Therefore, data comparing recruitment via different types of venues may not represent the risk levels associated with male sex partners being recruited from different types of venues, and conclusions from such studies comparing sources of respondent recruitment should be interpreted with care.
Although only Patrons of gay saunas may visit gay saunas frequently and they may visit multiple saunas within the same time period—large, intensive, and overlapping sexual networks are therefore created by sauna goers. Some of these sauna goers may also source sex partners from other venues, further extending their sexual networks. Studies investigating the structure of sexual networks among MSM are warranted in China 4 , There are reasons why gay saunas in China are conducive to HIV transmissions. Previous studies showed that factors including condom availability, lack of communication, and physical settings were associated with UAI within gay saunas 24 , 32 , Ecology is an important element of health promotion 34 , Saunas, unlike hotels or private rooms, do not provide a reasonable setting for practicing protected sex.
For instance, sex actions may take place spontaneously in shower rooms where MSM are naked, making it harder for them to practice protected sex. Detailed research about detailed ecological, social, and cognitive factors contributing to UAI in saunas in China is urgently required. Sourcing partners from parks were also at higher risk of syphilis infection than sourcing partners from the Internet. Parks may fall between saunas and bars or the Internet in terms of risk. The environments e. Ensuring condom availability is a logical step to strengthen HIV prevention in China. Condoms found in the saunas might be used as evidence in police prosecution; hence, vending machines are hence not installed in gay saunas in China.
A study found that Coordination between HIV prevention workers and the public security forces need to be enhanced. In public health, removal of the source of infection is a commonly used method for controlling emerging infectious diseases. Animals were removed from wet markets to control severe acute respiratory syndrome SARS and avian flu [37] , and schools were closed to control human swine flu [38]. It is arguable whether gay saunas in China should be shut down. Such a measure would damage the relationship between HIV workers and stakeholders such as gatekeepers and MSM clients.
Therefore, even high coverage of testing may not be able to stop HIV transmission in gay saunas. Previous studies have, however, compared the HIV prevalence of the participants sampled from different venues 3 , 40 , Some of these reported that participants sampled from gay saunas have higher HIV prevalence as compared with those sampled from other venues such as gay bars and gay clubs 21 , No direct comparisons are possible as this study is unique in considering the key venue for sourcing male sex partners, rather than venues for the recruitment of the study participants.
The findings are subject to some limitations. Because we are comparing different combinations, the results may be subjected to multiple comparison effects. Applying Bonferroni adjustment to the data would mean that we should reject the null hypothesis of no difference only when the P value is lower than about 0. The significant results from the comparisons of HIV prevalence between the cases of saunas vs.
Internet remained significant, although the comparisons of syphilis prevalence would not meet this stringent adjustment. Another important limitation of the study was related to the way of asking the question about venues of sourcing male sex partners. Participants were requested to give a single answer of the most frequently used venue for sourcing male sex partners.
For some participants, there might be two equally frequently used venues. Furthermore, the 10 cities did not cover the whole of China although efforts have been made to cover different parts of China. We need to pay attention to the representativeness of the 10 cities when interpreting the results. Gay saunas exist in almost all 61 cities and are important venues for sourcing male sex partners among MSM all over China.
Even the 61 cities could not truly represent the entire China, especially the smaller cities and towns. The results are hence important but they may overrepresent the larger cities in China. In sum, attention should be paid to those MSM sourcing male partners from gay saunas. We would like to thank the staffs from the 10 cities for sharing the data with us. Read article at publisher's site DOI : PLoS One , 12 1 :e, 20 Jan Cited by: 9 articles PMID: Biomed Res Int , , 20 Jul To arrive at the top five similar articles we use a word-weighted algorithm to compare words from the Title and Abstract of each citation.
PLoS One , 7 2 :e, 10 Feb Sex Transm Dis , 40 12 , 01 Dec Cited by: 4 articles PMID: Cited by: 82 articles PMID: Sex Transm Infect , 90 4 , 11 Feb Cited by: 48 articles PMID: Coronavirus: Find the latest articles and preprints. Europe PMC requires Javascript to function effectively.
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Share this article Share with email Share with twitter Share with linkedin Share with facebook. Venue based sauna-based interventions using socio-ecological approaches are greatly warranted in order to reduce HIV and syphilis prevalence among MSM in China.
Free full text. J Sex Med. Published online Dec PMID: Author information Copyright and License information Disclaimer. Lau: kh. Tel: ; Fax: ; kh. Published by Elsevier Inc. All rights reserved. Elsevier hereby grants permission to make all its COVIDrelated research that is available on the COVID resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source.
This article has been cited by other articles in PMC. Go to:. Introduction Previous studies suggest the risk of human immunodeficiency virus HIV transmission among men who have sex with men MSM is associated with characteristics of venues. Results The distribution of the most commonly used source to recruit male sex partner was Open in a separate window. The Surveys The survey methodology of the individual surveys has been described in detail in some published reports 27 , Figure 1.
Figure 2. Category 1 a Conception and Design Joseph T. Lau b. Category 2 a. Category 3 a. Gao L. Sex Transm Infect. Beijing, China. Yang H. HIV incidence and associated factors in a cohort of men who have sex with men in Nanjing, China. Sex Transm Dis. Choi K. The influence of social and sexual networks in the spread of HIV and syphilis among men who have sex with men in Shanghai, China. J Acquir Immune Defic Syndr. Guo H. High prevalence of risk behavior concurrent with links to other high risk populations: A potentially explosive HIV epidemic among men who have sex with men in Guangzhou, China.