Patterns of condom use among men who have sex with men in China: a systematic review and meta-analysis.

HIV is rapidly spreading among men who have sex with men (MSM) in China. We estimate and compare rates of condom use among MSM in different regions of China through a systematic literature review. Meta-analyses were conducted over a final set of 66 studies to estimate national and regional condom use rates among MSM with different types of male sex partners. Country-wide, there has been a modest increase in reported condom use at last sex among MSM, from 56.1% (95% CI: 53.4-58.7%) in 2003-2005 to 61.6% (95% CI: 58.4-64.8%) in 2006-2008. Consistent condom use has also increased, from 32.5% (95% CI: 28.6-36.7%) in 2003-2005 to 36.3% (95% CI: 33.7-38.9%) in 2006-2008. Condom use was greatest and increasing among commercial sex partners, from 49.8 to 75.2% at last anal sex. Further condom promotion is still required to reduce the incidence of HIV infection among MSM in China.