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Gay Saunas and the Risks of HIV and Syphilis Transmissions in China—Results of a Meta-Analysis

Authors

  • Joseph T. F. Lau PhD,

    Corresponding author
    1. Centre for Health Behaviors Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
    2. Centre for Medical Anthropology and Behavioral Health, Sun Yat-sen University, Guangzhou, China
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  • Jin-Kou Zhao MD, PhD,

    1. Monitoring and Evaluation Unit, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
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  • Xiao-Bing Wu MPH,

    1. Centre for Health Behaviors Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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  • Jing Gu PhD,

    1. Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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  • Chun Hao PhD

    1. Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Joseph T.F. Lau, PhD, Centre for Health Behaviors Research, School of Public Health and Primary Care, The Chinese University of Hong Kong, 5/F, School of Public Health and Primary Care, Prince of Wales Hospital, Shatin, NT, Hong Kong Nil, China. Tel: (852) 2637 6606; Fax: (852) 2645 3098; E-mail: jlau@cuhk.edu.hk

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. Lau JTF, Zhao J-K, Wu X-B, Gu J, and Hao C. Gay saunas and the risks of HIV and syphilis transmissions in China—results of a meta-analysis. J Sex Med 2013;10:642–652.

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