Epidemiological Profile of Men Who Have Sex with Men: First Data about Male Sex Workers in Central African Republic (CAR)

Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex workers (SW) among them, as well as the proportion of MSM who have been victims of gender-based violence (GBV). Material and Methods: A cross-sectional study coordinated by the Direction de la Médecine du Travail was carried out at the headquarters of the association ALTERNATIVES in Bangui Bangui from July 1 to October 31, 2021. Consenting MSM present during the study period were systematically included. Sociodemographic variables, those relating to the future vision of the activity and to GBV were collected and analyzed using Epi-Info version 7 software. Results: Forty MSM with an average age of 23 years and mainly secondary education (75.0%) were included. The vast majority of MSM were unemployed (85.0%). 45.0% had been victims of GBV and wanted to stop working as an MSM (47.5%), and almost 2/3 (65.0%) would accept another income-generating activity in exchange for the MSM. Violence was sexual (32.5%), economic (22.5%), physical (20.0%), verbal (12.5%) and psychological (12.5%). Conclusion: The MSM were mainly young, poorly educated, unemployed, and almost half were victims of GBV. The desire to change MSM activity to another income-generating activity alongside that of MSM shows that many of them are SW, workers in the informal sector. This must be taken into account in prevention activities, even if the data needs to be confirmed on a much larger sample.

Uptake of HIV Self-testing among Men Who have Sex with Men in Beijing, China： a Cross-sectional Study

Objective To examine HIV self-testing uptake and its determinates among men who have sex with men （MSM） in Beijing, China. Methods A cross-sectional online survey was conducted in Beijing, China in 2016. Participants were users of a popular Chinese gay networking application and had an unknown or negative HIV status. Univariate and multivariate logistic regression analyses were conducted to examine factors associated with HIV self-testing based on adjusted odds ratio （AOR） and 95% confidence interval （CI）. Results Among the 5,996 MSM included in the study, 2,383 （39.7%） reported to have used HIV self-testing kits. Willingness to use an HIV self-test kit in the future was expressed by 92% of the participants. High monthly income （AOR = 1.49; CI = 1.10-2.02; P = 0.010）, large number of male sex partners （≥2： AOR = 1.24; CI = 2.09-1.43; P = 0.002）, sexual activity with commercial male sex partners （〉 2： AOR = 1.94; CI = 1.34 -2.82; P = 0.001）, long-term drug use （AOR = 1.42; CI = 1.23-1.62; P 〈 0.001）, and long-term HIV voluntary counseling and testing （VCT） attendance （AOR = 3.62; CI = 3.11-4.22; P 〈 0.001） were all associated with increased odds of HIV self-testing uptake. Conclusion The nearly 40% rate of HIV self-testing uptake among MSM in our sample was high. In addition, an over 90% willingness to use kits in the future was encouraging. HIV self-testing could be an important solution to help China achieve the global target of having 90% of all people living with HIV diagnosed by 2020.

：actors influencing HIV infection in men who have sex with men in China

To identify risk factors for HIV infection among men who have sex with men （MSM） and to provide a theoretical basis for prevention interventions. Between December 2011 and August 2012, a case-control study was conducted among MSM who underwent voluntary counselling and testing for HIV. Confirmed HIV-positive MSM were included in the case group, and HIV-negative MSM were included in the control group. Information on possible risk factors was collected by a survey questionnaire and a qualitative interview. The results of a conditional logistic regression showed that the following were influencing factors for HIV infection： average monthly income between 2001 and 3000 Yuan （odds ratio （0R）=6.341, 95% Ch 1.714-12.544）, only sometimes using condoms when having anal sex with men in the last 6 months （0R=7.601, 95% Ch 1.359-23.083）, having HIV-positive sex partners （0R=5.273, 95% Ch 1.572- 17.691）, rectal trauma with bleeding in the last 6 months （0R=2.947, 95% Ch 1.308-6.638）, not using condoms at last sexual encounter （OR-- 1.278, 95% Ch 1.012-5.595）, engaging in commercial sex （0R=5.925, 95% Ch 1.923-13.890） and having more than 16 sex partners in the last 6 months （0R=1.175, 95% Ch 1.021-1.353）. These seven factors were the risk factors of HIV infection （OR〉l）. However, having anal sex less than 10 times in the previous 1 month （OR=O.O02, 95% CI： 0.000-0.287） was a protective factor against HIV infection among MSM （OR〈l）, and insertive （0R=0.116, 95% Ch 0.000-0.236） （OR〈l） anal intercourse influenced HIV infection. Interventions should be targeted at MSM whose average monthly income is between 2001 and 3000 Yuan, and who engage in commercial sex. In addition, the importance of using condoms at every sexual encounter should be emphasised in health education, as should the treatment of rectal trauma with bleeding. Finally, MSM should decrease the number of sex partners and frequency of anal sex to decrease the rate of HIV infection.

A survey of HIV infection and related high-risk factors among men who have sex with men in Suzhou,Jiangsu,China

A cross-sectional study using the snowball sampling method was conducted in May 2008 to investigate human immunodeficiency virus （HIV） infection status and related high risk factors among men who have sex with men （MSM） in Suzhou city of Jiangsu province. The researchers carried out a face-to-face questionnaire interview among MSM, and collected their blood samples to test for HIV and other sexually transmitted diseases （STDs）. Among the 280 respondents, 91.1% had homosexual acts in the past 6 months and 87.5% had multiple homosex- ual partners; 46.4% had heterosexual sex in the past 6 months and 33.1% had multiple heterosexual partners. The rate of continued condom use was 44.3% in homosexual sex in the past 6 months, while the rate in heterosexual sex was 33.9%. Laboratory test results showed that the prevalences of HIV and syphilis were 7.1% （20/280） and 15.0% （42/280）, respectively, but no HCV-positive person was found. In the multivariate logistic regression model, subjects with a monthly income of more than RMB $ 1,000 （OR=4.83,95% CI=1.44-16.22）, subjects who often went to bars for sexual partners （OR=2.25, 95%CI=1.21-4.20）, and subjects who had more than one sexual partner in the past 6 months （OR=0.49, 95%CI=0.25-0.97） and had sex with fixed sexual partners in the past 6 months （OR=0.42, 95%CI=0.25-0.75） were significantly associated with the rate of continued condom use in homosexual sex in the past 6 months. Unprotected sex and multiple sexual partners were more common among MSM in Suzhou city; furthermore, the prevalences of HIV infection and syphilis were relatively high. HIV preventive measures should be designed to address these risk factors and control the spread of HIV among MSM.

Prevalence and risk factors of HIV and syphilis,and knowledge and risk behaviors related to HIV/AIDS among men who have sex with men in Chongqing,China

High HIV prevalence and incidence burdens have been reported in men who have sex with men（MSM）in Chongqing,China.We aimed to estimate the prevalence of HIV and other sexually transmitted infections（STIs）,to appraise the knowledge and risk behaviors related to HIV/AIDS among MSM,and to analyze the possible causes of deviation between behavior and knowledge to make better strategies.We recruited 617 MSM from February to July in 2008 by using a respondent-driven sampling（RDS） method in Chongqing,China.Through the collection of questionnaire-based data and biological testing results from all objects,we launched a crosssectional survey.STATA/SE was used for data analysis by frequency,ANOVA,rank sum test and logistic regression models.MSM with syphilis（OR=4.16,95%CI：2.35-7.33,P〈0.0001） were more likely to be HIV infected.Being a company employee（OR=3.64,95%CI：1.22-10.08,P〈0.0001） and having bought male for sex（OR=3.52,95%CI：1.10-11.32,P〈0.034） were associated with a higher probability of syphilis.MSM with younger age,higher education and greater monthly income had a higher mean knowledge score.MSM who had HIV testing had a higher mean knowledge score than those who never had.Students,venues for finding sex partners by Internet and homosexuals in MSM had a higher mean knowledge score compared to other occupations,venues for finding sex partners and sexual orientation.There is an urgent need for delivery of barrier and biomedical interventions with coordinated behavioral and structural strategies to improve the effect of HIV interventions among MSM.

Perceptions of Reducing HIV-Preventive Behaviors among Men Who Have Sex with Men Living with HIV in Japan

Sexual health and behavior among HIV-positive men who have sex with men (MSM) have attracted attention in Japan and elsewhere. It has been reported that perceptions about sex are one factor leading to a reduction in HIV-preventive behaviors. This study investigated types of perceptions, termed self-talk, which allow HIV-positive Japanese MSM to permit themselves to participate in unprotected anal intercourse (UAI). A package of internet surveys for MSM including 20 items assessing self-talk on UAI and condom usage in anal intercourse was administered in 2014. Data from 479 HIV-positive Japanese MSM were analyzed. Exploratory factor analysis was conducted to reveal the factor structure of the self-talk. In addition, using the Kruskal-Wallis test, we examined the relationship between the types of self-talk and the tendency to have UAI. Factor analysis of 20 items assessing self-talk on UAI produced four dimensions: “Diversion/Desire for Stimulation,” “Optimism/Defiant Attitude,” “Denial of Concern of Transmitting,” and “Concern about Relationships.” The score of the subscale “Diversion/Desire for Stimulation” was significantly higher than the other three subscales. It was shown that there was a tendency for the self-talk assessed to be associated with the UAI frequency. The types of perceptions permitting UAI and the psychological stress of being an HIV-positive MSM in Japan were discussed. This study was the first to reveal the factorial structure of perceptions in reducing HIV-preventive behaviors among HIV-positive MSM in Japan. We found positive associations between certain types of self-talk and risky sexual behaviors. We provided recommendations for psychosocial support and HIV risk-reduction intervention for HIV-positive MSM.

Acceptance to Use Daily Oral Pre-Exposure Prophylaxis (PrEP) as an HIV Prevention Method and Ability to Pay for PrEP among Men Who Have Sex with Men in Ho Chi Minh City, Vietnam

Background: Men who have sex with men (MSM) are disproportionately affected by HIV in Vietnam. Regardless of international and national agencies’ efforts, the HIV epidemic in MSM has been increasing in recent years. Novel and evidence-based HIV antiretroviral pre-exposure prophylaxis (PrEP) maybe needed to combat the HIV epidemic among this population in Vietnam. This study aims to identify how MSM accept the use of PrEP as an HIV prevention method and their ability to pay for it. Method: This is a cross-sectional study of 373 MSM seeking HIV testing in a community-based HIV clinic in Ho Chi Minh City, Vietnam from January to April 2016. Potential participants were briefly informed about ethical considerations, screened for eligibility, and signed an informed consent form when selected. Face-to-face interviews were conducted by the clinic’s staff. Descriptive and analytical analysis was performed by STATA 13.0. Results: Of 373 participants, only 92 men (24.7%) reported having known about PrEP. Out of 360 men who were questioned about their acceptance of PrEP as an HIV prevention method, 274 (76.1%) embraced the use of PrEP. The median maximum affordable monthly PrEP cost was one million Vietnam Dong (VND) (equivalent to US$43) and the median average affordable monthly PrEP cost was 0.5 million VND (approximately $21.7). The majority of men (68.8%) could afford an average of less than $43 a month for PrEP. Conclusion: There is a relatively high level of PrEP acceptance among MSM in Ho Chi Minh City, Vietnam. To increase PrEP acceptance, raising awareness and understanding of PrEP is recommended. To expand PrEP interventions in Vietnam, the target population’s ability to pay should be a key focus.

Casual Sex, Sex Work and Unprotected Sex among Men Who Have Sex with Men in the Human Papilloma Virus (HPV) Clinical Trial —North-West Region of Tshwane, South Africa

Background: The gap in the understanding of the context of the sexually transmitted infections (STIs) and risky behaviours among men who have sex with men (MSM) could lead to the development and implementation of inappropriate interventions, which could exacerbate the rapid spread of STIs, especially HIV, among MSM. The aim of the study was to qualitatively assess the understanding of the STIs and the risky sexual behaviours of men who have sex with men in the North-West region of Tshwane. Methods: An exploratory qualitative design was employed to assess the STIs and the risky sexual behaviour of the MSM population. The study participants were enrolled in an HPV clinical trial at MECRU, which is a clinical research unit at the Sefako Makgatho Health Sciences University. Data collection occurred from September 2016 to May 2017. A convenience sampling method was used and n = 30 participants were selected. Face-to-face in-depth interviews were conducted on MSM 18 years and older, using a semi-structured interview guide. Thematic content analysis was used for data analysis, using NVivo version 10 software. Results: The mean age of the sample was 26 years, and the age range was 18 to 44 years. All were unmarried, and all of them came from townships, rural villages and informal settlements in the vicinity of the clinical research unit. The high-risk behaviours noted among the majority of the MSM in this study were having multiple sexual partners and exchanging partners, alcohol abuse, inconsistent condom-use, having unprotected anal sex, and having transactional sex. There was a high level of knowledge of STIs in the heterosexual population with poor understanding of STIs affecting MSM through anal sex. Most of the MSM played a female or bottom role, which made them vulnerable because they could not successfully negotiate condom use, and they reported that they sometimes accepted gifts or money in exchange for anal sex. Conclusion: The study concludes that the MSM in this study had casual sex, and are involved in sex work without practising safe sex. There is a need for health promotion on STIs and risky behaviours among MSM in communities as well as in health facilities for MSM in the North-West region of Tshwane.

Demographic and Sexual Behavior Characteristics of Men Who Have Sex with Men (MSM) Registered in a Targeted Intervention (TI) Program in India

Background: Men who have sex with men (MSM) contribute substantially to HIV prevalence in India. The targeted intervention (TI) program is the most important link between MSM and the public health system. Hence, we studied the demographic and sexual behavior characteristics of MSM registered in TI program in India. Methods: We used information maintained at TI sites under the program catering exclusively to MSM in India. Demographic characteristics and sexual behavior of MSM over the past two decades were also studied. Risk behaviors included type of partners, alcohol use, sexual acts per week, years of sex work and age at initiation of sex work. Bivariate analysis was carried out to understand the demographic determinants of sexual behavior. Results: In total, data of 6037 MSMs from 14 TI sites were analyzed. Of these 4655 (73.8%) were young adults (<35 years) and 2565 (40.8%) had completed their matriculation. More than half (55.4%) were married. Double-decker was identified as the most common sub-typology among MSM. Average age of initiation of sex was 23.0 years and average number of sexual acts per week was 6.8 (95% CI: 6.8 - 7.0). Irregular partners and alcohol use were observed in 30.5% and 52.8% of MSM respectively. Cohort analysis revealed a statistically significant declining trend in average age of initiation of sex over the past two decades. The sexual behavior of MSM varied significantly by employment status, education, marital status, state of residence, alcohol use and type of sex partner. Conclusion: MSMs registered with the TI program in India were mostly young, educated, and employed. Many MSM also had a history of heterosexual relationships, and thus had the potential of transmitting HIV infection to the otherwise low risk general population. This analysis supports the use of TI program data for understanding the demographic and sexual behavior characteristics of hard to reach and stigmatized population in society.

Effectiveness of a Training Program for Improving Public Health Nurses’ Attitudes and Confidence in Dealing with Men Who Have Sex with Men

Objective: This study examined the effect of an educational intervention on public health nurses’ attitudes and confidence in dealing with men who have sex with men (MSM). In Japan, HIV is primarily transmitted through sexual contact between men, and free HIV testing and counseling are provided by public health nurses. However, because of a lack of education, public health nurses do not often recognize the existence of MSM in daily life. Thus, improving public health nurses’ understanding of MSM is crucial. Methods: This study used a quasi-experimental design to examine public health nurses’ homophobia, confidence in dealing with MSM, and low awareness of MSM in daily life at pre-test, post-test, and 1 and 3 months follow-ups. The intervention comprised a 3-hour training session conducted between November 2012 and September 2013 in the Kinki region. Results: A total of 124 public health nurses participated in the training, 117 of which were allocated to the intervention group;182 public health nurses who did not participate in the training session were allocated to a control group. Homophobia scores had significantly decreased at post-test, and remained at that low level by the follow-up at 3 months (pre-test to post-test;p = 0.00, post-test to 1 month;p = 0.83, 1 month to 3 months;p = 0.64, pre-test to 3 months;p = 0.00). Confidence in dealing with MSM and recognition of MSM had significantly increased by post-test;these were also maintained by the follow-up at 3 months (pre-test to post-test;p = 0.0, post-test to 1month;p = 0.18, 1 to 3 months;p = 0.44, pre-test to 3 months;p = 0.0). Discussion: While the three-hour training session was short, it was effective for improving attitudes toward MSM and building confidence in dealing with them.

Spread of human immunodeficiency virus 1 among men who have sex with men is emerging as a genuine social concern and affecting the general populace- case reports from Eastern India

Human immunodeficiency virus(HIV) infection among men who have sex with men(MSM) has increased to a drastic proportion throughout India in the last couple of years due to a lack of productive identification and management framework. In apprehension of social disgrace these men attempt to live a normal hetero conjugal life and, in the process, act as a bridge in spreading the virus to their women partners. In this case report we have highlighted two cases which clearly distinguished the adequacy of HIV treatment among MSM when they are diagnosed during early or late phases of infection. An intensive and ample counseling to comprehend the psychology and sexual behavior of these men was found to be critically important in both the cases. Our study, which is actually the first of its kind, recorded and documented evidence of HIV infected MSM from Eastern India and renders a ray of hope among this marginally isolated group to comprehend the challenges and health risks faced by the MSM population. It also provides a format for the medical practitioners here in managing and treating related cases.

Chemsex and its risk factors associated with human immunodeficiency virus among men who have sex with men in Hong Kong

We were intrigued by Hanum et al,who published a study on the prevalence of human immunodeficiency virus(HIV)in homosexual,bisexual,and other men who have sex with men at sexual health clinics in England and the relationship between baseline variables and future HIV occurrence.Chemically-enhanced sexual experience(chemsex)is becoming a global phenomenon.There are increasing medical and academic concerns about chemsex,where substances are used to boost sexual satisfaction,which is prevalent in groups,especially among homosexuals.Lesbians,gays,bisexuals,transgenders,and queers have become increasingly visible,valued,and committed community.However,chemsex requires urgent attention.

Association of Bisphenol A Exposure with Circulating Sex Hormone Concentrations in Men and Postmenopausal Women

A total of 1 116 middle-aged and elderly men and 1 442 postmenopausal women were recruited in this study. Whether bisphenol A exposure was associated with circulating sex hormone concentrations was studied. Univariate analysis revealed that the urinary bisphenol A concentration was negatively correlated with the serum levels of luteinizing hormone （B=-0.061, P〈0.0001） and follicle-stimulating hormone （B=-0.086, P〈0.0001） in men, and with the serum levels of follicle-stimulating hormone （B=-0.037, P=0.018） and sex hormone-binding globulin （B=-0.043, P=0.006） in women. However, no significant association was observed between the serum levels of urinary bisphenol A and circulating sex hormone after adjustment for the potential confounders.

Cardiometabolic risk factors in young Indian men and their association with parameters of insulin resistance and beta-cell function

BACKGROUND There is an unmet need to evaluate the burden of cardiometabolic risk factors in young South Asian adults,who are not preselected for glycaemia.AIM To evaluate young North Indian men(aged 20-50 years)for burden of cardiometabolic risk factors,in relation to parameters of homeostatic model assessment for insulin resistance(HOMA-IR)and beta-cell function(oral disposition index[oDI]).METHODS Study participants were invited in a fasting state.Sociodemographic,anthropometric,and medical data were collected,and 75 g oral glucose tolerance test was performed with serum insulin and plasma glucose estimation at 0,30,and 120 min.Participants were divided into quartiles for HOMA-IR and oDI(category 1:Best HOMA-IR/oDI quartile;category 3:Worst HOMA-IR/oDI quartile)and composite HOMA-IR/oDI phenotypes(phenotype 1:Best quartile for both HOMA-IR and oDI;phenotype 4:Worst quartile for both HOMA-IR and oDI)were derived.RESULTS We evaluated a total of 635 men at a mean(±SD)age of 33.9±5.1 years and body mass index of 26.0±3.9 kg/m^(2).Diabetes and prediabetes were present in 34(5.4%)and 297(46.8%)participants,respectively.Overweight/obesity,metabolic syndrome,and hypertension were present in 388(61.1%),258(40.6%),and 123(19.4%)participants,respectively.The prevalence of dysglycaemia,metabolic syndrome,and hypertension was significantly higher in participants belonging to the worst HOMA-IR and oDI quartiles,either alone(category 3 vs 1)or in combination(phenotype 4 vs 1).The adjusted odds ratios for dysglycaemia(6.5 to 7.0-fold),hypertension(2.9 to 3.6-fold),and metabolic syndrome(4.0 to 12.2-fold)were significantly higher in individuals in the worst quartile of HOMA-IR and oDI(category 3),compared to those in the best quartile(category 1).The adjusted odds ratios further increased to 21.1,5.6,and 13.7,respectively,in individuals with the worst,compared to the best composite HOMA-IR/oDI phenotypes(phenotype 4 vs 1).CONCLUSION The burden of cardiometabolic risk factors is high among young Asian Indian men.Our findings highlight the importance of using parameters of insulin resistance and beta-cell function in phenotyping individuals for cardiometabolic risk.

Total Energy Expenditure of 16 Chinese Young Men Measured by the Doubly Labeled Water Method

Objective Doubly labeled water （DLW） method is the gold standard for measuring total energy expenditure （TEE）. We used this method to measure TEE in Chinese young men. Methods Sixteen healthy young men age 23±1 recruited. TEE was measured by the DLW method, by indirect calorimetry. We also conducted 24-h estimate energy requirements of the subjects. years with body mass index 22.0±1.4 kg/m2 were and basal energy expenditure （BEE） was determined activity, energy balance and factorial approach to Results TEE of subjects by DLW method was 9.45±0.57 M J/day （2258±180 kcal/day）. The 24-h activity was 10.80±0.33 M J/day （2582±136 kcal/day）. The energy requirement, derived from energy balance observations, was 9.93±1.32 M J/day （2373±315 kcal/day）. The BEE of 6.65±0.28 M J/day （1589±67 kcal/day）, calculated by the adjusted Schofield equation, was significantly higher （P〈O.O01） than that measured by indirect calorimetry, 5.99-±0.66 M J/day （1433-±158 kcal/day）. The TEE derived from the factorial approach was 10.31-±0.43 M J/day （2463±104 kcal/day）. Conclusion The TEE of Chinese young men measured by the DLW method was about 10% lower than the current recommended nutrient intake （RNI）, suggesting that the RNI for Chinese men maybe overestimated. Further studies are warranted to determine the value of the estimated energy requirement.

Sexual Risk Behavior and Satisfaction Among Men Who Have Sex With Men Living With Detectable HIV Viral Loads:A Nationwide Online Survey in China

Little is known about sexual behavior and satisfaction among men who have sex with men(MSM)with detectable HIV viral loads(VL)in China.This study aims to investigate sexual risk behavior and sexual satisfaction among MSM living with HIV in China,as well as poten-tial predictors.This cross-sectional study was conducted in February 2021 using an anonymous online survey based on WeChat.Data were collected on sociodemographics,sexual behavior,HIV clinical information,sexual satisfaction and mental health.Descriptive sta-tistics,logistic regression and multivariable logistic regression were performed.MSM with detectable HIV VL(VL+)or VL not sure were more likely to report inconsistent condom use,even with HIV-negative/unknown-status regular male partners.Having an HIV-positive regular partner and recreational drug use were positively associated with inconsistent condom use during anal sex among MSM with undetectable VL(VL-).Alcohol use before or during sexual activities was positively associated with inconsistent condom use during anal sex among VL+or VL not sure MSM.A total of 58.3%of participants reported being sexually satisfied.MSM living with HIV who were currently employed,had experienced anal sex in the prior 6 months,had VL-HIV status,or had more frequent ejaculation during sex/masturbation were more likely to report sexual satisfaction.The development of targeted education and interventions to minimize sexual risk behavior among MSM living with HIV is in dire need.Treating sexual dysfunction and developing a reasonable antiretroviral therapy regimen to achieve viral suppression can help promote sexual satisfaction in MSM living with HIV.

Barriers and facilitators in Pre-exposure Prophylaxis(PrEP)use intention among Chinese homosexual men

Background:Despite strengthened efforts on human immunodeficiency virus(HIV)prevention and control,new HIV infections continue to increase among men who have sex with men(MSM)in China.Pre-exposure prophylaxis(PrEP),a highly effective HIV-prevention tool,has recently been included in China’s Action Plan of HIV Prevention and Control.To promote future PrEP implementation,this study aims to identify the barriers and facilitators in PrEP use intention among MSM in China.Methods:In 2018,a cross-sectional survey was conducted among 300 MSM in Nanjing,Jiangsu Province.Questions on demographics,sexual behavior(including a seven-item high-risk behavior index),PrEP use intention,PrEP-related awareness and accessibility,and a seven-item public HIV stigma scale were included in the questionnaire.Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with PrEP use intention.Results:Overall,44.67%of the participants had more than two male sexual partners and 5.56%had HIV-positive sexual partners.Only 57.00%had heard of PrEP and only four(1.33%)participants had used PrEP.However,75.34%expressed the willingness to use oral PrEP if its efficacy was assured.The beliefs that“PrEP can prevent HIV if taken as prescribed”(adjusted odds ratio(AOR)=4.84,P<0.001)and“PrEP can be scaled up in the community”(AOR=3.24,P<0.001)were positively associated with oral PrEP use intention.Concerns of side effects were negatively associated with oral PrEP use intention(AOR=0.32,P=0.006).Further,77.00%of the participants would choose injectable or implanted PrEP instead of oral PrEP.One of the PrEP stigma items,“Not certain if doctors can prescribe PrEP if I go to the clinic”was positively associated with the intention to use injectable or implanted PrEP(AOR=3.03).The items“Heard of PrEP”(AOR=2.74)and“PrEP can prevent HIV if taken as prescribed”(AOR=2.65)were also positively related to the intention to use injectable or implanted PrEP.The most common concerns regarding PrEP use were efficacy(44.67%)and side effects(38.67%).The most common reasons for using injectable and implanted PrEP were adherence(81.94%and 77.86%,respectively)and privacy concerns(56.48%and 55.00%,respectively).Affordable price and coverage by health insurance were the driving factors for PrEP use.Conclusion:Given the low level of awareness of PrEP-related information in China,it’s necessary to provide interventions for high-risk individuals and communities,in order to increase their awareness and knowledge of PrEP.Furthermore,additional alternatives to HIV prevention,such as long-acting injectable or implanted PrEP,should be investigated to reduce the risk of HIV infection in at-risk MSM.Even if this programme could be approved by the National Medical Products Administration of China and implemented,a supportive social environment for MSM is essential during its implementing.

Trends in the prevalence of obesity among young Thai men and associated factors:From 2009 to 2016

Background:The prevalence of obesity has been increasing in both males and females worldwide.In Thailand,the National Health Examination Surveys reported that the prevalence of obesity(body mass index(BMI)≥30 kg/m^2)among Thai male adults aged 20–59 years increased from 1.7%in 1991 to 6.8%in 2009.Obesity has been confirmed to lead to health problems,including noncommunicable diseases.In the present study,we report trends in the prevalence of obesity among new conscripts from 2009 to 2016.We also investigated the associated factors of obesity.Methods:Serial cross-sectional studies were conducted from 2009 to 2016 among male Royal Thai Army(RTA)conscripts whose weight and height had been measured to determine BMI after being inducted.Each subject completed a detailed risk factor questionnaire.Obesity was defined as BMI≥30 kg/m2.Results:A total of 26,540 young Thai males conscripted into the RTA were included in this study.The prevalence of obesity was 2.2%in 2009,3.4%in 2010,2.5%in 2011,2.9%in 2012,3.4%in 2013,4.4%in 2014,5.0%in 2015,and 4.8%in 2016(P for trend<0.0001).The independent risk factors for obesity were coming from the north central and south regions compared with the northeast,higher education level,indoor occupation and no regular exercise.Conclusions:Our data emphasized that obesity constitutes a serious problem among young Thai men.We could apply these findings in military units to other groups at any age.Regular exercise should be provided to young adults and other age groups to slow the process of obesity,so that associated complications,especially noncommunicable diseases,will cease.

The moderating impact of lifestyle factors on sex steroids, sexual activities and aging in Asian men

The present study sought to evaluate the relative associations of exercise, sleep and other lifestyle habits with aging, sex hormones, percent body fat （%BF） and sexual activities in men living in the community. A better understanding of this complex interrelationship is important in helping the formulation of modalities for a holistic approach to the management of aging men. The results showed that age is a major determinant for many physiological parameters, including sleep, hormonal and metabolic parameters, some lifestyle factors and sexual activities. Testosterone （T）, bioavailable testosterone （BloT） and dehydroepiandrosterone sulphate （DHEAS） concentrations decreased with age, while estradiol （E2）, sex hormone-binding globulin （SHBG） and %BF increased with age. In addition, there exist intricate associations among hormonal and lifestyle factors, %BF and age. High-intensity exercise and longer duration of sleep were associated with higher concentrations of T and BloT. T was shown to be associated positively with men who were engaged in masturbation. DHEAS was associated with men wanting more sex and with good morning penile rigidity. Older Singaporean men tended to sleep for shorter duration, but exercised more intensely than younger men. Coital and masturbation frequencies decreased with age, and a significantly greater number of younger men were engaged in masturbation. Relationship between the partners is a key determinant of sexuality in men. It appears that T may have a limited, while dehydroepiandrosterone （DHEA） have a greater role than previously suggest, as a motivational signal for sexual function in men. Both biological and psychosocial factors interact with each other to influence sexual functions in men. Hence, a biopsychosocial approach may be more appropriate for a more lasting resolution to sexual dysfunctions in men.

Principal Component Analysis on Semen Quality among Chinese Young Men

Objective To understand the current semen quality status among Chinese young men and influential factors in China and to explore its evaluation index. Methods A total of 562 healthy male volunteers were recruited during their premarital examinations in seven provincials and municipal regions' MCH centers; descriptive and principal component analyses were used to analyze data.Results The findings show that semen volume (2. 61± 1. 10 mL), sperm density (64. 47× 34. 59× 106/mL), percentage of sperm forward progression (59. 89%± 17. 11%), percentage of sperm viability (77. 19% ± 11. 87%), and percentage of normal sperm morphology ( 78. 23% ± 9. 15% ). The first principal component function is Z1= -8.512 54 + 0. 001 35X1' + 0. 031 92X2'+0. 043 52X3'+ 0. 039 84X4', which is closely related to percentage of sperm viability (X3), percentage of sperm forward progression (X2), and percentage of normal sperm morphology (X4)The second principal component function is: Z2= 0. 491 92+ 0. 080 80X1- 0. 000 58X2-0. 005 10X3- 0. 018 07X4, which depends on the total sperm count (X1). Conclusion Only 42. 3% subjects meet all the common WHO standard of semen quality. The multiple analysis of Z1 showed that the highest Z1 are among subjects from Guizhou,workers, or town residents. Multiple analysis of Z2 showed that the older age when the subjects had the first sexual impulse, the longer period of sexual abstinence and more quantity of sperm they had; the more sexual activity subjects had, the less amount of sperm they had.