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First, condom use in MSWs was increased. Therefore, the risk of HIV infection was reduced by this protective behavior. Second, because the sole aim of sex for most MSWs was to earn money rather than pursuit of sexual gratification, MSWs were more likely to adopt protective behavior compared with ncMSM, thus protecting their health and decreasing their risk of infection.
MSWs engaged in high-risk work. Due to self-protection awareness and were more likely to be knowledgeable about AIDS [ 13 ], these workers were more willing to undergo frequent HIV testing.
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However, the study showed that repeat testers are more likely to engage in high-risk sexual behavior than non-repeat testers [ 13 ]. So for MSWs, frequent testing might be associated with risky behaviors sex work. This is a significant problem, as non-testers may not be aware of their HIV infection status, and infected non-testers can unknowingly transmit the disease to their partners [ 14 ], thereby leading to a high rate of HIV infection.
Many ncMSM in our study have been infected elsewhere but were tested and found to be positive in Shenzhen. For one thing, most MSM are not Shenzhen natives in our study, NcMSM usually have male-male sex elsewhere and then possibly continue homosexual activities in Shenzhen.
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Additionally, most ncMSM do not stay in Shenzhen for a long time. Due to high liquidity of the population and the difficulty in identification of ncMSM due to social stigma , there are few effective intervention strategies to target this population. We found that the syphilis positive rate in ncMSM decreased from The prevalence of syphilis was Therefore, the syphilis infection rate in Shenzhen maintains at a stable level, but shows a general tendency of decline. Because of the shared transmission routes of the 2 infections and because of adverse interactions—syphilis facilitates both HIV transmission and acquisition [ 19 ]—the co-infection rate of syphilis and HIV is high.
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HIV can alter the clinical manifestations of syphilis and, in turn, syphilis induces immune activation and favors viral replication, so it may accelerate HIV transmission [ 20 , 21 ]. There are limitations of this study. Our study was not a cohort study, but two cross-sectional studies. The included population may vary between the two studies, precluding direct comparison of HIV infection rate and behavioral changes.
However, due to the high liquidity and instability of the MSWs and ncMSM populations in Shenzhen, performing a cohort study was impossible.
Chaozhou people have historically had a great deal of contact with the Hakka people, but Hakka has had little, if any, influence on Chaozhou. A portrait might appear as a romantic overture, but then there is a turn. In Ancient Fujian , the region had developed a sexual culture isolated from that of the rest of the Chinese empire. Access to sterile injecting equipment is more important than awareness of HCV status for injection risk behaviors among drug users. Households headed by same-sex couples are not permitted to adopt children and do not have the same privileges as heterosexual married couples. The syphilis-positive rate in MSWs significantly decreased [ Conclusions: This study reports the seroepidemiology of drug users in the monitored Detoxification Center in Southeast China.
Therefore, a series of cross-sectional studies was a reasonable alternative. In summary, compared with the data from the previous survey in , both the HIV-infection and syphilis-positive rates were decreased in MSWs. Additionally, the syphilis-positive rate in ncMSM was also decreased.
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The rising rate of HIV in ncMSM show targeted interventions for this group still need to be strengthened and improved to combat this public health problem. Conceptualization: JZ KL. Data curation: YH YZ. Formal analysis: YH YZ. Funding acquisition: JZ. Investigation: YH YZ. Project administration: JZ KL. Resources: JZ. Supervision: JZ KL. Writing — original draft: YH YZ. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field.
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Competing interests: The authors declare no conflict of interest. Data collection The parallel recruitment was conducted from June to November Download: PPT. Table 1.
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Sexual Practices Both similarities and differences in sexual behaviors were observed in the 2 compared groups Table 1. The comparisons with previous survey Table 2 presents the HIV and syphilis infection rate for each group and compares with this data with the previous data collected in Table 3.
Supporting Information. S1 Table. The survey questions in Chinese. S2 Table. The survey questions in English. S3 Table. The dataset for analysis. References 1.
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Estimating HIV incidence among key affected populations in China from serial cross-sectional surveys in — HIV prevalence in China: integration of surveillance data and a systematic review. The Lancet Infectious diseases. AIDS and behavior. HIV prevalence and related risk factors among male sex workers in Shenzhen, China: results from a time-location sampling survey. Sexually transmitted infections. A comparison of HIV infection and related risks among male sex workers in different venues in Shenzhen, China.
AIDS research and therapy. HIV risks among two types of male migrants in Shanghai, China: money boys vs. View Article Google Scholar 8. Sexual risk behaviours and HIV seroprevalence among male sex workers who have sex with men and non-sex workers in Campinas, Brazil. PloS one.
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