MSM ris­ing in China

BioSpectrum (Asia) - - SPECIAL - Source:

HIV preva­lence among men who have sex with men (some­times re­ferred to as MSM) has been ris­ing in China. China’s Health and

Fam­ily Plan­ning Com­mis­sion of­fi­cially es­ti­mates preva­lence among this group to be 7.7 per cent. Men who have sex with men are es­ti­mated to rep­re­sent over a quar­ter of new re­ported in­fec­tions each year.

Ho­mo­sex­ual sex was de­crim­i­nalised in China in 1997 and re­moved from the of­fi­cial list of men­tal dis­or­ders in 2001. How­ever, eco­nomic and cul­tural fac­tors means men who have sex with men of­ten face stigma and dis­crim­i­na­tion and hide their sex­ual iden­tity. This hos­tile en­vi­ron­ment is pre­vent­ing a greater un­der­stand­ing of the epi­demic in China among men who have sex with men.

De­spite this lim­i­ta­tion, some re­search is be­ing con­ducted and pub­lished. For ex­am­ple, a 2015 study in 11 ma­jor Chi­nese cities of more than 8,900 men who have sex with men showed the av­er­age preva­lence of HIV in­fec­tion to be 9.9 per cent, with av­er­age in­ci­dence of 5.5 per 100 peo­ple, which is higher than of­fi­cial fig­ures. In­ci­dence has also been as­sessed by a 2014 study of young men who have sex with men (aged 18- 25) which found in­ci­dence to be as high as 18.9, 10.6 and 5.6 per 100 peo­ple of this age group in Guiyang, Bei­jing and Shang­hai re­spec­tively.

Ig­no­rance of HIV sta­tus is a ma­jor fac­tor in the ris­ing epi­demic amongst men who have sex with men. The 2015 study men­tioned above found high-risk be­hav­iour among men who have sex with men in China to be high. Around 45.7 per cent of re­spon­dents re­ported hav­ing un­pro­tected sex with male part­ners and 10.9 per cent with fe­male part­ners. Around 38 per cent had ex­changed money for sex­ual ac­tiv­i­ties. Data from seven of the 11 cities sug­gests that dis­tricts with high­est rates of il­licit drug use among men who have sex with men also shared the high­est HIV preva­lence.

How­ever, a 2013 study in Chongqing City, which has a high HIV preva­lence among men who have sex with men, found that HIV test­ing was ac­tu­ally higher for men who have sex with men

(58 per cent) than the av­er­age pop­u­la­tions (44 per cent).

Strate­gies such as self-test­ing have also been ex­plored in China amongst men who have sex with men. A 2014 study found 20 per cent had used self-test­ing kits for HIV. The in­creased use of self­test­ing kits greatly cor­re­lated with fac­tors such as the in­di­vid­ual be­ing mar­ried, hav­ing a re­cent HIV test and if they had en­gaged in anal sex. It is clear that the HIV epi­demic among men who have sex with men is con­cern­ing in China but more tar­geted preven­tion strate­gies for this af­fected pop­u­la­tion will en­able a more ef­fec­tive re­sponse that meets this group’s needs.

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