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Muessig K.E.,University of North Carolina at Chapel Hill | Bien C.H.,Mount Sinai School of Medicine | Wei C.,University of California at San Francisco | Lo E.J.,University of North Carolina at Chapel Hill | And 5 more authors.
Journal of Medical Internet Research

Background: Human immunodeficiency virus (HIV) infection disproportionately affects men who have sex with men (MSM). Over half of all HIV-positive MSM in China may not know their HIV status. Mobile phones and Web interventions (eHealth) are underutilized resources that show promise for supporting HIV education, testing, and linkage to care. Objective: This mixed-methods study among MSM in China assessed technology utilization and eHealth acceptability for sexual health care. Methods: We conducted in-depth interviews and an online survey. Qualitative analyses informed the development of the Internet survey, which was administered through two popular MSM websites. Bivariate and multivariate analysis assessed characteristics of MSM interested in eHealth for sexual health care. Results: The qualitative sample included MSM across a range of ages, education, marital status, sexuality, and HIV testing experience. Qualitative findings included the importance of the Internet as the primary source of information about sexual health, HIV and other sexually transmitted diseases (STDs), use of the Internet to enable HIV testing opportunities by facilitating connections with both the gay community and health care providers, and mixed perceptions regarding the confidentiality of eHealth tools for sexual health. Among the Internet sample (N=1342), the average age was 30.6 years old, 82.81% (1098/1342) were single, and 53.42% (711/1331) had completed college. In the past 3 months, 38.66% (382/988) had condomless sex and 60.53% (805/1330) self-reported having ever tested for HIV. The majority of men owned computers (94.14%, 1220/1296) and mobile phones (92.32%, 1239/1342), which many had used to search for HIV/STD information and testing sites. In multivariate analysis, interest in using computers or mobile phones to support their sexual health care was associated with being a student, prior use of computers or mobile phones to search for general health information, prior use of computers or mobile phones to search for HIV/STD information, and confidentiality concerns. Conclusions: MSM in this sample had high utilization of technology and interest in eHealth despite confidentiality concerns. Future eHealth interventions can thoughtfully and creatively address these concerns as a priority for successful implementation. ©Kathryn E Muessig, Cedric H Bien, Chongyi Wei, Elaine J Lo, Min Yang, Joseph D Tucker, Ligang Yang, Gang Meng, Lisa B Hightow-Weidman. Source

Best J.,North University of China | Best J.,University of California at San Francisco | Tang W.,North University of China | Tang W.,Guangdong Provincial Center for Skin Diseases and Control and Prevention | And 7 more authors.
Sexually Transmitted Diseases

Background HIV and syphilis are disproportionately common among transgender individuals globally, yet few studies have investigated transgender HIV/syphilis risk and testing in low- and middle-income nations. We conducted an online survey of men who have sex with men (MSM) and transgender individuals to examine sexual behaviors and HIV/syphilis testing in China. Methods We recruited MSM and transgender individuals from 2 major Chinese lesbian, gay, bisexual, and transgender Web platforms. χ 2 Test and logistic regression were used to compare risk behaviors, HIV and syphilis testing history, and prevalence between transgender individuals and other MSM. Results Among the 1320 participants, 52 (3.9%) self-identified as transgender. Demographics, including education, employment, and marital status, were similar between both groups, whereas transgender individuals were older. Condomless anal intercourse rate was comparable between the groups. Transgender individuals were less likely to report ever testing for HIV (34.6% vs. 62.0%) and syphilis (15.7% vs. 31.2%) with adjusted odds ratios of 0.36 (95% confidence interval, 0.20-0.65) and 0.42 (95% confidence interval, 0.20-0.91), respectively. We found a trend toward a higher HIV prevalence among transgender individuals (11.1% vs. 5.7%, P = 0.12). Conclusions Transgender individuals have suboptimal HIV and syphilis testing rates in China. Given the substantial risk behaviors and burden of HIV/STI in the general Chinese MSM population and a lack of knowledge about transgender individuals, enhanced HIV/syphilis testing programs for transgender individuals in China are needed. © 2015 American Sexually Transmitted Diseases Association. Source

Han L.,North University of China | Han L.,University of North Carolina at Chapel Hill | Bien C.H.,North University of China | Bien C.H.,Mount Sinai School of Medicine | And 11 more authors.
Journal of Acquired Immune Deficiency Syndromes

HIV self-testing offers an alternative to facility-based testing that could expand HIV testing among men who have sex with men (MSM). We organized an online survey of MSM in China to better understand the frequency and correlates of HIV self-testing. A total of 1342 individuals completed the survey. About 20.3% of MSM reported previous HIV self-testing. Self-testing was correlated with being married, having 6 or greater male anal sex partners in the past 3 months, and having HIV tested within 12 months in the multivariable analysis. Our study suggests that HIV self-testing may be able to reach subgroups of high-risk MSM and enable more frequent HIV testing. Copyright © 2014 by Lippincott Williams & Wilkins. Source

Yang B.,Guangdong Provincial Center for Skin Diseases and Control and Prevention | Yang B.,Central South University | Zheng H.-P.,Guangdong Provincial Center for Skin Diseases and Control and Prevention | Feng Z.-Q.,Guangdong Provincial Center for Skin Diseases and Control and Prevention | And 5 more authors.
Japanese Journal of Infectious Diseases

This study was designed to determine the prevalence and distribution of Chlamydia trachomatis genotypes from clinical specimens in Guangzhou, China, obtained in the period 2005-2008. One hundred and ninety-four urogenital C. trachomatis samples were collected from sexually transmitted disease clinic patients, and the VS1-VS2 of OmpA gene wasamplifiedby nestedPCR andsequenced using an ABI-prism 3730 sequencer. Clinical C. trachomatis strains were genotyped and analyzed for a mutation with respect to the reference VS1-VS2 sequence. VS1-VS2 fragments with 453 bp were amplified from 194 clinical samples. Upon alignment with the sequences of the reference strains, 189 strains with discernible sequences were typed into 9 genotypes, while 5 with ambiguous sequences were considered to be mixed-serovar samples. The most prevalent genotypes were E (50, 26%), F (46, 24%), J (35, 19%), and D (24, 13%). There was no significant difference in the distribution of any of the genotypes detected during the study period, except for genotype K (P < 0.01). A total of 16 (8%, 16/189) genetic variants of the OmpA VS1-VS2 of the reference strains were identified. Mutations occurred frequently for genotypes D (2/24, 8%), E (6/50, 12%), F (2/46, 4%), G (1/8, 13%), H (1/12, 8%), and K (4/11, 36%), with most of these being sense mutations that may result in amino acid substitution. Sequencing the OmpA VS1-VS2 enabled the genotype and sequence variations within each genotype to be analyzed. Genotypes E, F, J, and D continued to dominate among urogenital C. trachomatis, whereas genotype K increased significantly in Guangzhou between 2005 and 2008. Source

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