Guodong Mi1, Baoli Ma2, Nora Kleinman3, Zhijun Li4, Serena Fuller3, Marc Bulterys5, Wolfgang Hladik6, Zunyou Wu7. 1. Global AIDS Program, China Office, US Centers for Disease Control and Prevention (CDC) National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention. 2. Blue Brother, Beijing, China. 3. Global AIDS Program, China Office, US Centers for Disease Control and Prevention (CDC) Association of Schools of Public Health, Washington D.C. 4. Global AIDS Program, China Office, US Centers for Disease Control and Prevention (CDC). 5. Global AIDS Program, China Office, US Centers for Disease Control and Prevention (CDC) Naval Health Research Center, San Diego, California. 6. Division of Global HIV and TB, Center for Global Health, CDC, Atlanta, Georgia. 7. National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention.
Abstract
BACKGROUND: Men who have sex with men (MSM) are highly vulnerable to human immunodeficiency virus (HIV) infection and more likely to migrate due to widespread stigma and discrimination in China. Their mobility complicates estimation of local MSM population sizes and the provision of HIV services, and may also contribute to the spread of HIV. METHODS: Between 1 January 2008 and 31 December 2012, the visits of all individuals to the largest Chinese MSM dating website were recorded. After a predesigned de-identification procedure by the website, we analyzed Internet Protocol addresses for migration patterns. Migrants were defined as individuals who were away from their registered residence for >6 months in the last 12 months. RESULTS: The website contained data on 794 912 MSM eligible for the study, of which 34.5% were migrants. The median age was 26 years (range, 18-61 years), and 85.5% were unmarried. Compared with nonmigrant MSM, migrants were less likely to be married to a woman (8.6% vs 13.5%; P < .001). The 5 provinces with the highest migrant inflow ratios were Guangdong, Shanghai, Beijing, Tianjin, and Zhejiang. Eastern coastal cities were the primary destination of MSM from southwestern China. CONCLUSIONS: Preferential MSM migration may influence MSM population sizes in both originating and destination provinces, particularly for provinces with uneven inflow and outflow. MSM migration from southwestern China, which has the highest HIV prevalence in this population, to coastal cities with lower prevalence may have implications for the spread of the HIV epidemic as well as HIV care services.
BACKGROUND:Men who have sex with men (MSM) are highly vulnerable to humanimmunodeficiency virus (HIV) infection and more likely to migrate due to widespread stigma and discrimination in China. Their mobility complicates estimation of local MSM population sizes and the provision of HIV services, and may also contribute to the spread of HIV. METHODS: Between 1 January 2008 and 31 December 2012, the visits of all individuals to the largest Chinese MSM dating website were recorded. After a predesigned de-identification procedure by the website, we analyzed Internet Protocol addresses for migration patterns. Migrants were defined as individuals who were away from their registered residence for >6 months in the last 12 months. RESULTS: The website contained data on 794 912 MSM eligible for the study, of which 34.5% were migrants. The median age was 26 years (range, 18-61 years), and 85.5% were unmarried. Compared with nonmigrant MSM, migrants were less likely to be married to a woman (8.6% vs 13.5%; P < .001). The 5 provinces with the highest migrant inflow ratios were Guangdong, Shanghai, Beijing, Tianjin, and Zhejiang. Eastern coastal cities were the primary destination of MSM from southwestern China. CONCLUSIONS: Preferential MSM migration may influence MSM population sizes in both originating and destination provinces, particularly for provinces with uneven inflow and outflow. MSM migration from southwestern China, which has the highest HIV prevalence in this population, to coastal cities with lower prevalence may have implications for the spread of the HIV epidemic as well as HIV care services.
Authors: Zunyou Wu; Jie Xu; Enwu Liu; Yurong Mao; Yan Xiao; Xinhua Sun; Yufen Liu; Yan Jiang; Jennifer M McGoogan; Zhi Dou; Guodong Mi; Ning Wang; Jiangping Sun; Zhongfu Liu; Lu Wang; Keming Rou; Lin Pang; Wenge Xing; Juan Xu; Shuo Wang; Yan Cui; Zhijun Li; Marc Bulterys; Wen Lin; Jinkou Zhao; Ray Yip; You Wu; Yang Hao; Yu Wang Journal: Clin Infect Dis Date: 2013-04-11 Impact factor: 9.079
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