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Disparities and Risks of Sexually Transmissible Infections among Men Who Have Sex with Men in China: A Meta-Analysis and Data Synthesis

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  • Eric P F Chow
  • Joseph D Tucker
  • Frank Y Wong
  • Eric J Nehl
  • Yanjie Wang
  • Xun Zhuang
  • Lei Zhang

Abstract

Background: Sexually transmitted infections (STIs), including Hepatitis B and C virus, are emerging public health risks in China, especially among men who have sex with men (MSM). This study aims to assess the magnitude and risks of STIs among Chinese MSM. Methods: Chinese and English peer-reviewed articles were searched in five electronic databases from January 2000 to February 2013. Pooled prevalence estimates for each STI infection were calculated using meta-analysis. Infection risks of STIs in MSM, HIV-positive MSM and male sex workers (MSW) were obtained. This review followed the PRISMA guidelines and was registered in PROSPERO. Results: Eighty-eight articles (11 in English and 77 in Chinese) investigating 35,203 MSM in 28 provinces were included in this review. The prevalence levels of STIs among MSM were 6.3% (95% CI: 3.5–11.0%) for chlamydia, 1.5% (0.7–2.9%) for genital wart, 1.9% (1.3–2.7%) for gonorrhoea, 8.9% (7.8–10.2%) for hepatitis B (HBV), 1.2% (1.0–1.6%) for hepatitis C (HCV), 66.3% (57.4–74.1%) for human papillomavirus (HPV), 10.6% (6.2–17.6%) for herpes simplex virus (HSV-2) and 4.3% (3.2–5.8%) for Ureaplasma urealyticum. HIV-positive MSM have consistently higher odds of all these infections than the broader MSM population. As a subgroup of MSM, MSW were 2.5 (1.4–4.7), 5.7 (2.7–12.3), and 2.2 (1.4–3.7) times more likely to be infected with chlamydia, gonorrhoea and HCV than the broader MSM population, respectively. Conclusion: Prevalence levels of STIs among MSW were significantly higher than the broader MSM population. Co-infection of HIV and STIs were prevalent among Chinese MSM. Integration of HIV and STIs healthcare and surveillance systems is essential in providing effective HIV/STIs preventive measures and treatments. Trial Registration: PROSPERO No: CRD42013003721

Suggested Citation

  • Eric P F Chow & Joseph D Tucker & Frank Y Wong & Eric J Nehl & Yanjie Wang & Xun Zhuang & Lei Zhang, 2014. "Disparities and Risks of Sexually Transmissible Infections among Men Who Have Sex with Men in China: A Meta-Analysis and Data Synthesis," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-13, February.
    • Handle: RePEc:plo:pone00:0089959
    DOI: 10.1371/journal.pone.0089959
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    References listed on IDEAS

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    1. Eric P F Chow & Ka I Iu & Xiaoxing Fu & David P Wilson & Lei Zhang, 2012. "HIV and Sexually Transmissible Infections among Money Boys in China: A Data Synthesis and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 7(11), pages 1-16, November.
    2. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
    3. Remis, R.S. & Dufour, A. & Alary, M. & Vincelette, J. & Otis, J. & Masse, B. & Turmel, B. & LeClerc, R. & Parent, R. & Lavoie, R., 2000. "Association of hepatitis B virus infection with other sexually transmitted infections in homosexual men," American Journal of Public Health, American Public Health Association, vol. 90(10), pages 1570-1574.
    4. Singer, Merrill C. & Erickson, Pamela I. & Badiane, Louise & Diaz, Rosemary & Ortiz, Dugeidy & Abraham, Traci & Nicolaysen, Anna Marie, 2006. "Syndemics, sex and the city: Understanding sexually transmitted diseases in social and cultural context," Social Science & Medicine, Elsevier, vol. 63(8), pages 2010-2021, October.
    5. Eric P F Chow & David P Wilson & Lei Zhang, 2011. "HIV and Syphilis Co-Infection Increasing among Men Who Have Sex with Men in China: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 6(8), pages 1-1, August.
    6. Hong Shang & Junjie Xu & Xiaoxu Han & Jessica Spero Li & Kelly C. Arledge & Linqi Zhang, 2012. "Bring safe sex to China," Nature, Nature, vol. 485(7400), pages 576-577, May.
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