HIV infection among young men who have sex with men in China: comparison of risks among students and non-students

Abstract Background The human immunodeficiency virus (HIV) epidemic has been drastically increasing among men who have sex with men (MSM) in China over the past decade. More so, the number of HIV infections among young adults in the country has also been on the rise, highlighting a unique sub-population, which may lead to increased incidence and transmission of the disease. This study aimed to determine the HIV infection rate amongst student and non-student young men who have sex with men (YMSM) in three regions in China and factors associated with their HIV infection. Methods A cross-sectional study was conducted from 1 September to 6 September 2017 in Beijing, Sichuan, and Guangzhou). Participants were recruited through a popular Chinese gay social networking application, as well as several college-based youth associations. Univariate and multivariate logistic regression analyses were conducted to assess factors associated with HIV infection. Results The HIV infection rate among non-student YMSM was significantly higher than that of student YMSM (10.3% versus 5.3%, χ2trend=17.34, P<0.001). The multivariate logistic regression analysis showed that YMSM self-identifying as homosexual (AOR=2.81, 95%CI=1.40-5.66, P=0.004) and perceived themselves at risk for HIV (AOR=3.08, 95:CI:1.33-7.15, P=0.009) had a 3 times increased odds of being HIV positive. Additionally, participants whom reported not always using condoms with sex partners in the past six months (AOR=1.69, 95%CI=1.17-2.44, P=0.006) were at increased odds of HIV infection. Conclusions Young men who have sex with men, particularly those identifying as homosexual and not always using condoms during intercourse, are at increased odds of HIV infection in China. Promoting comprehensive sexual education to youth and other measures aimed at improving HIV knowledge could help control HIV transmission among this key sub-population.