The influence of social and sexual networks in the spread of HIV and syphilis among men who have sex with men in Shanghai, China

J Acquir Immune Defic Syndr. 2007 May 1;45(1):77-84. doi: 10.1097/QAI.0b013e3180415dd7.


Objectives: To analyze characteristics of social and sexual networks and their role as risk factors for HIV and syphilis among men who have sex with men (MSM) in Shanghai, China.

Design: : A cross-sectional study.

Methods: We recruited 477 participants using a snowball sampling method. We administered a face-to-face questionnaire and provided testing and counseling for HIV and syphilis.

Results: The prevalences of HIV and markers for syphilis were 1.47% (95% confidence interval [CI]: 0.59 to 3.01) and 13.47% (95% CI: 10.53 to 16.88), respectively. The independent factors associated with lower risk for syphilis infection were having a contact network, overlap of social and sexual networks, meeting other MSM at the gym or through the Internet, having 3 to 5 lifetime male anal sex partners, and having a female steady sex partner. A larger male sexual network size, having been married, being more knowledgeable about HIV, having 6 or more lifetime male anal sex partners, and having steady male or female sex partners were independently associated with having unprotected anal or vaginal intercourse.

Conclusions: Significant associations were found between network characteristics and syphilis infection and unprotected sex. Network-based interventions should be developed to reduce this HIV risk among MSM in China.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / analysis
  • China / epidemiology
  • Cities*
  • Cross-Sectional Studies
  • Female
  • HIV Infections / epidemiology
  • HIV Infections / transmission*
  • Homosexuality, Male*
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Sexual Behavior
  • Sexual Partners
  • Sexually Transmitted Diseases / epidemiology
  • Social Support*
  • Surveys and Questionnaires
  • Syphilis / epidemiology
  • Syphilis / transmission*
  • Urban Population


  • Biomarkers