amfAR, The Foundation for AIDS Research

HIV and Syphilis Among MSM in China

July 2010 - A recent study including cross-sectional surveys conducted in seven provinces in China has revealed high prevalences of both syphilis and HIV in men who have sex with men (MSM). Although these findings have been previously documented among urban MSM in China, most studies focused on men living in large urban centers, including Beijing, Shanghai, and Guangzhou. This new study was conducted across 20 large and mid-size cities and districts in regions with low overall HIV prevalence.

The surveys showed that the average HIV prevalence among MSM was 2.9%, although in one district it was as high as 15.1%. Syphilis prevalence was also high, ranging from 1.3% to 29.3%, with an average rate of 9.8%. The study also documented behavioral information, including sexual practice, health-seeking behavior, and understanding of HIV transmission.1 Knowledge of how HIV was transmitted was high at 72.9%. However, knowledge does not necessarily translate into safe sexual practice or health-seeking behavior, as was demonstrated by the finding that only 18% of participants reported having had an HIV test. Twenty-seven percent reported always using condoms during anal sex with men.1 

Although efforts have been made to scale up the response to HIV among MSM in China, less than 15% of this population is reported to be receiving comprehensive HIV prevention interventions or is covered by current health surveillance.2  The rates of both HIV and syphilis among MSM in China highlight the risk of sexually transmitted infections among MSM and underline concerns about the relationship between HIV and syphilis because sexually transmitted infections that cause skin ulcers, like syphilis, have been shown to increase the risk of acquiring and transmitting HIV.3 

This study, along with other research emerging from China, emphasizes the need to include information regarding a range of sexually transmitted infections and their impact on HIV transmission in standard health information and education targeted to MSM.

1. Xiao Y et al. Prevalence and correlates of HIV and syphilis infections among men who have sex with men in seven provinces in China with historically low HIV prevalence. Journal of Acquired Immune Deficiency Syndrome. 2010; 53: S66-S73.

2. Muessig KE et al. HIV and syphilis among men who have sex with men in China: the time to act is now. Sexually Transmitted Diseases. 2010; 37:214-216.

3. Yuhua R et al. Relationship between syphilis and HIV infections among men who have sex with men in Beijing, China. Sexually Transmitted Diseases. 2007; 34:592-597.