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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. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. The HIV prevalence among men who have sex with men (MSM) is increasing sharply in China. Many MSM have female sexual partners, representing a bridge of transmitting HIV to the general population. Circumcision reduces the risk of HIV prevention via heterosexual intercourse. Aim. The study investigated the prevalence and factors related to willingness to undergo circumcision when MSM were informed that circumcision could reduce risk of heterosexual HIV transmission. Methods. An anonymous cross-sectional survey was conducted in Jiangsu, China. A total of 157 MSM with bisexual behaviors in the last six months were recruited using snowball sampling. Main Outcome Measures. Self-reported circumcision status and foreskin conditions were recorded. HIV-related knowledge, risk perceptions, risky sexual behaviors, cognitive and behavioral intention factors regarding circumcision were assessed. Results. Among all respondents, 5.7% were circumcised. In the uncircumcised subsample, the willingness to be circumcised increased from 8.1% to 35.1% after they were informed about the 50% risk reduction effect of circumcision regarding heterosexual HIV transmission. Risk behaviors, uncertainty about the prevalence of HIV among MSM, perception of overly long foreskin, peer's suggestion, disagreement with the statements 'MSM in general are not willing to be circumcised' and 'circumcisions are for children, not for adults' and self-efficacy for circumcision were significantly associated with willingness for circumcision given the hypothetical risk reduction effect (OR = 2.37 and 3.11, respectively, P < 0.05). Perception of overly long foreskin, self-efficacy, and having used a condom in the last episode of sex with a woman remained significantly associated with the conditional willingness for circumcision in the multivariate analysis (OR = 3.03, 2.84 and 2.42, respectively, P < 0.05). Conclusions. Interventions promoting circumcision among bisexual MSM, based on the risk reduction effect on heterosexual HIV transmission, are likely to be successful. Such programs should focus on increasing self-efficacy and may consider utilizing a peer educator approach. Lau JTF, Yan H, Lin C, Zhang J, Choi K-C, Wang Z, Hao C, Huan X, and Yang H. How willing are men who have sex with men in China to be circumcised for the sake of protecting his female sex partner? J Sex Med 2012;9:1921-1929. [ABSTRACT FROM AUTHOR]