Factors Affecting Antiretroviral Therapy Initiation among Chinese Men Having Sex with Men

Starting the antiretroviral therapy (ART) initiation early is key in reducing the risk of HIV transmission. According to studies done, HIV-infected Chinese men having sex with men (MSM) were found to be less likely to initiate ART when compared to other HIV-infected individuals.

A group of researchers conducted a study that was published in the International Journal of Infectious Diseases to assess predictors of ART initiation among Chinese MSM. The researchers conducted a cross-sectional study from 2010 to 2011 involving MSM in Beijing, China who were diagnosed with HIV infection before participation in the study.

Characteristics of the Participants

The main objective of the study was to assess the link between male circumcision and HIV risk among MSM in Beijing. The participants in the study were recruited from HIV/STD clinics, the community and through peer referral. The participants had to be male, living in Beijing, report to ever having sex with men, willing to provide blood samples for HIV and syphilis tests and swab specimens for HPV testing. Eligible participants completed a questionnaire, undertook genital examinations and provided blood samples for required tests.

Important information sort from the participants included age, marital status, ethnicity, occupation, education, duration of living in Beijing and sexual orientation. The researchers also sort to find out participants’ behavioral risk factors such as unprotected anal sex, most recent CD4+ count and history of STDs such as Gonorrhea, Syphilis, Chlamydia and herpes. Participants diagnosed with HIV infection before participating in the study were asked about AIDS clinical symptoms, their experience using ART and HIV care and counseling.

290 participants were confirmed to be HIV positive, out of these 48 men were newly diagnosed upon enrolling in the current and 242 had been previously diagnosed. The 48 newly diagnosed HIV cases were excluded from the study. The median age among the participants was 31 years and median time from HIV diagnosis to participation in the study was 15 months. 94.1% of the participants were Han ethnics, 71.4% were currently unmarried and 74.8 % employed, 53.8 % had college education. Over a quarter (26.1 %) of the HIV+ participants had started ART. Those who had started ART were more likely to be older, married to a woman and have lived longer in Beijing. These men were also more likely to have had the HIV infection longer, experience adverse clinical symptoms and have had an STD compared to those who have not started ART. On the other hand, those who had started ART were less likely to be engaged in unprotected anal sex.

ART Initiation Motivation

The study found a close link between age, adverse clinical symptoms, marital status and initiating ART. According to the study findings, the older the men and the more the adverse clinical symptoms the more likely the MSM is to start ART. The study also found that married MSMs were more likely to start ART than unmarried MSM mainly because married men are thought to have more sense of responsibility and care not only about their health but that of their wives too and therefore, more likely to start ART.


The original paper can be found here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4696158/