Gay Saunas and the Risks of HIV and Syphilis Transmissions in China--results of a Meta-analysis

Overview

Journal J Sex Med

Publisher Oxford University Press

Specialties Gynecology & Obstetrics
Reproductive Medicine
Urology

Date 2013 Mar 6

PMID 23458215

Citations 12

Authors

Joseph T F Lau

Jin-Kou Zhao

Xiao-Bing Wu

Jing Gu

Chun Hao

Affiliations

Soon will be listed here.

Abstract

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. However, very few studies have systematically compared HIV/sexually transmitted disease (STD) prevalence among MSM according to key venue type for sourcing sex partners.

Aims: The aim of this study was to investigate the associations between HIV/syphilis prevalence and the types of venues, namely saunas, parks, gay bars, and the Internet, which are mostly used for sourcing male sex partners by MSM in China.

Methods: Meta-analyses using fixed-effect and random-effect methods were conducted. Secondary data were obtained from 10 concurrent surveys conducted in 10 cities basing on a common protocol. Pairwise comparisons (e.g., "saunas" vs. "parks") were made.

Main Outcomes Measures: Odds ratios (OR) for HIV/syphilis infection in relations to venue type for partner sourcing.

Results: The distribution of the most commonly used source to recruit male sex partner was 59.32% (Internet), 18.47% (gay bars), 14.18% (gay saunas), and 8.02% (parks). The median prevalence of HIV/syphilis was 10.49% and 19.38% (gay saunas), 2.12% and 16.25% (parks), 6.06% and 15.45% (Internet), and 4.41% and 11.90% (gay bars). We found significant between-group differences when comparing "sauna" against "Internet" (HIV: OR= 2.27, 95% confidence interval [CI] = 1.65-3.12; syphilis: OR = 1.61, 95% CI= 1.07-2.41), "sauna" against "bars" (HIV: OR= 1.65, 95% CI= 1.14-2.39; syphilis: OR= 1.35, 95% CI= 1.02-1.78), and "parks" against "Internet" (syphilis: OR= 1.55, 95% CI= 1.12-2.15) as the main source to recruit male sex partners. Other pairwise comparisons were not statistically significant.

Conclusions: The results of this study suggest that those sourcing partners mainly from gay saunas have higher prevalence of HIV/syphilis when compared with those doing so via the Internet or gay bars. Venue based (sauna-based) interventions using socio-ecological approaches are greatly warranted in order to reduce HIV and syphilis prevalence among MSM in China.

Citing Articles

HIV risk and influence factors among MSM who had sought sexual partners in core venues: a continuous sentinel surveillance in 2010-2022.

Yang Z, Wei L, Xu Z, Li S, Xing Y, Zhang Y Front Public Health. 2024; 12:1476642.

PMID: 39737462 PMC: 11683098. DOI: 10.3389/fpubh.2024.1476642.

High Prevalence of Syphilis and Syphilis/HIV Coinfection among Men Who Have Sex with Men Who Attend Meeting Places in Mexico.

Vergara-Ortega D, Tapia-Maltos A, Herrera-Ortiz A, Garcia-Cisneros S, Olamendi-Portugal M, Sanchez-Aleman M Pathogens. 2023; 12(3).

PMID: 36986278 PMC: 10055729. DOI: 10.3390/pathogens12030356.

Willingness to use HIV pre-exposure prophylaxis and associated factors among men who have sex with men in Liuzhou, China.

Fu Y, Ashuro A, Feng X, Wang T, Zhang S, Ye D AIDS Res Ther. 2021; 18(1):46.

PMID: 34330300 PMC: 8325278. DOI: 10.1186/s12981-021-00374-8.

A scoping review of HIV epidemiologic, sociocultural and programmatic studies related to transgender women and men who have sex with men in Cambodia, 1999-2019.

de Lind van Wijngaarden J, van Griensven F, Sun L, Wignall S PLoS One. 2021; 16(7):e0254490.

PMID: 34270600 PMC: 8284612. DOI: 10.1371/journal.pone.0254490.

Do the same socio-demographic variables predict testing uptake and sero-status? HIV and syphilis among an observational sample of Chinese men who have sex with men in Shanghai, China.

Hall C, Luu M, Nehl E, He N, Zheng T, Haardorfer R Int J STD AIDS. 2020; 31(10):939-949.

PMID: 32772687 PMC: 8323858. DOI: 10.1177/0956462420909733.

References

Ko N, Lee H, Chang J, Lee N, Chang C, Lee M . Condom availability inTaiwanese gay bathhouses: the right things in the wrong places. AIDS Educ Prev. 2008; 20(4):338-46. DOI: 10.1521/aeap.2008.20.4.338. View

Somlai A, Kalichman S, Bagnall A . HIV risk behaviour among men who have sex with men in public sex environments: an ecological evaluation. AIDS Care. 2001; 13(4):503-14. DOI: 10.1080/09540120120058030. View

Gao L, Zhang L, Jin Q . Meta-analysis: prevalence of HIV infection and syphilis among MSM in China. Sex Transm Infect. 2009; 85(5):354-8. DOI: 10.1136/sti.2008.034702. View

Cauchemez S, Ferguson N, Wachtel C, Tegnell A, Saour G, Duncan B . Closure of schools during an influenza pandemic. Lancet Infect Dis. 2009; 9(8):473-81. PMC: 7106429. DOI: 10.1016/S1473-3099(09)70176-8. View

Huebner D, Binson D, Dilworth S, Neilands T, Grinstead O, Woods W . Rapid vs. standard HIV testing in bathhouses: what is gained and lost?. AIDS Behav. 2008; 14(3):688-96. DOI: 10.1007/s10461-008-9442-9. View

Liu H, Feng T, Liu H, Feng H, Cai Y, Rhodes A . Egocentric networks of Chinese men who have sex with men: network components, condom use norms, and safer sex. AIDS Patient Care STDS. 2009; 23(10):885-93. DOI: 10.1089/apc.2009.0043. View

Xiao Y, Ding X, Li C, Liu J, Sun J, Jia Y . Prevalence and correlates of HIV and syphilis infections among men who have sex with men in Chongqing Municipality, China. Sex Transm Dis. 2009; 36(10):647-56. DOI: 10.1097/OLQ.0b013e3181aac23d. View

Reisner S, Mimiaga M, Skeer M, Vanderwarker R, Gaucher M, OConnor C . Differential HIV risk behavior among men who have sex with men seeking health-related mobile van services at diverse gay-specific venues. AIDS Behav. 2008; 13(4):822-31. DOI: 10.1007/s10461-008-9430-0. View

Yang H, Hao C, Huan X, Yan H, Guan W, Xu X . HIV incidence and associated factors in a cohort of men who have sex with men in Nanjing, China. Sex Transm Dis. 2010; 37(4):208-13. DOI: 10.1097/OLQ.0b013e3181d13c59. View

10.

Zhong F, Lin P, Xu H, Wang Y, Wang M, He Q . Possible increase in HIV and syphilis prevalence among men who have sex with men in Guangzhou, China: results from a respondent-driven sampling survey. AIDS Behav. 2009; 15(5):1058-66. DOI: 10.1007/s10461-009-9619-x. View

11.

He Q, Wang Y, Lin P, Raymond H, Li Y, Yang F . High prevalence of risk behaviour concurrent with links to other high-risk populations: a potentially explosive HIV epidemic among men who have sex with men in Guangzhou, China. Sex Transm Infect. 2009; 85(5):383-90. DOI: 10.1136/sti.2009.035808. View

12.

Hong F, Zhou H, Cai Y, Pan P, Feng T, Liu X . Prevalence of syphilis and HIV infections among men who have sex with men from different settings in Shenzhen, China: implications for HIV/STD surveillance. Sex Transm Infect. 2008; 85(1):42-4. DOI: 10.1136/sti.2008.031682. View

13.

Green L, Richard L, Potvin L . Ecological foundations of health promotion. Am J Health Promot. 1996; 10(4):270-81. DOI: 10.4278/0890-1171-10.4.270. View

14.

Fernandez M, Warren J, Varga L, Prado G, Hernandez N, Bowen G . Cruising in cyber space: comparing Internet chat room versus community venues for recruiting Hispanic men who have sex with men to participate in prevention studies. J Ethn Subst Abuse. 2008; 6(2):143-62. DOI: 10.1300/J233v06n02_09. View

15.

Ruan S, Yang H, Zhu Y, Wang M, Ma Y, Zhao J . Rising HIV prevalence among married and unmarried among men who have sex with men: Jinan, China. AIDS Behav. 2009; 13(4):671-6. DOI: 10.1007/s10461-009-9567-5. View

16.

Evans A, Wiggins R, Mercer C, Bolding G, Elford J . Men who have sex with men in Great Britain: comparison of a self-selected internet sample with a national probability sample. Sex Transm Infect. 2006; 83(3):200-5. PMC: 2659092. DOI: 10.1136/sti.2006.023283. View

17.

Lau J, Cai W, Tsui H, Chen L, Cheng J, Lin C . Unprotected anal intercourse behavior and intention among male sex workers in Shenzhen serving cross-boundary male clients coming from Hong Kong, China - prevalence and associated factors. AIDS Care. 2011; 24(1):59-70. DOI: 10.1080/09540121.2011.592813. View

18.

Guevara W, Valladares Cardoza E, Essen B . Sexuality and risk behavior among men who have sex with men in León, Nicaragua: a mixed methods approach. J Sex Med. 2012; 9(6):1634-48. DOI: 10.1111/j.1743-6109.2012.02713.x. View

19.

MacKellar D, Gallagher K, Finlayson T, Sanchez T, Lansky A, Sullivan P . Surveillance of HIV risk and prevention behaviors of men who have sex with men--a national application of venue-based, time-space sampling. Public Health Rep. 2007; 122 Suppl 1:39-47. PMC: 1804106. DOI: 10.1177/00333549071220S107. View

20.

Lau J, Yan H, Lin C, Zhang J, Choi K, Wang Z . How willing are men who have sex with men in China to be circumcised for the sake of protecting his female sex partner?. J Sex Med. 2010; 9(7):1904-12. DOI: 10.1111/j.1743-6109.2010.02050.x. View