Unprotected sex among HIV-positive treatment-seeking opioid-dependent adults in China: a cross-sectional study.

Zhenghong Zhang, Zunyou Wu, Katharine E Poundstone, Wenyuan Yin, Lin Pang, Keming Rou, Wei Luo, Xiaobin Cao, Changhe Wang, China’s National Working Group on Methadone Maintenance Treatment

National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.

Sexually transmitted diseases 2012 Dec

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We set out to identify factors associated with unprotected sex among HIV-positive patients on methadone maintenance therapy (MMT) in China. We conducted a cross-sectional study in 60 MMT clinics in Yunnan, Sichuan, Guizhou, Guangxi, and Xinjiang provinces, China, with a total of 2742 participants. The median age of participants was 35 years (range, 19-63 years), and 78.3% were male. More than half (1471/2742; 53.6%) were married, 6.4% (176/2742) had a regular sex partner, and 3.5% (95/2742) had 1 or more occasional sex partners. Among married participants, 64.6% (950/1471) had a spouse who was HIV negative or of unknown HIV status. Among them, 62.8% (597/950) reported sex in the past 30 days, and 31.0% (185/597) reported unprotected sex in the past 30 days. Multivariate logistic regression identified 3 factors associated with an increased risk of unprotected sex: receiving MMT in Guangxi (odds ratio [OR], 3.72 [2.05-6.75]; P < 0.001) or Xinjiang (OR, 2.23 [1.33-3.73]; P < 0.01), having a spouse that is a current or former drug user (OR, 1.80 [1.12-2.90]; P < 0.05), and having dropped out of MMT in the past 6 months (OR, 3.05 [1.63-5.71]; P < 0.001); it also identified 2 factors associated with a decreased risk of unprotected sex: being male (OR, 0.46 [0.26-0.79]; P < 0.01) and being aware of one's own HIV serostatus (OR, 0.16 [0.10-0.27]; P < 0.001). Many HIV-positive opioid-dependent individuals attending MMT continue to engage in high-risk sexual behaviors. Future efforts should focus on increasing awareness of HIV serostatus, retaining patients in MMT, and addressing the specific needs of female patients on MMT.

Citation

Zhenghong Zhang, Zunyou Wu, Katharine E Poundstone, Wenyuan Yin, Lin Pang, Keming Rou, Wei Luo, Xiaobin Cao, Changhe Wang, China’s National Working Group on Methadone Maintenance Treatment. Unprotected sex among HIV-positive treatment-seeking opioid-dependent adults in China: a cross-sectional study. Sexually transmitted diseases. 2012 Dec;39(12):930-7