Sexual behavior and risks for HIV infection and transmission among male injecting drug users in Yunnan, China

Objectives: To analyze the risk factors, particularly sexual behaviors, associated with HIV infection, and to describe the risks for HIV transmission among male injecting drug users (IDUs) in China. Methods: A cross-sectional study of 314 IDUs in Yunnan Province was conducted. Information on demographics, HIV serostatus, and sexual and drug-using behaviors was collected. Results: HIV prevalence among the study subjects was 59.9%. HIV infection was associated with older age (≥27 years), early drug initiation (at ≤20 years of age), and frequent injection (≥once a day). Thirty-seven percent reported multiple sexual partners. Consistent condom use rates were lowest with regular partners (23.8%), followed by 42.5% with casual partners, and 57.3% with female sex workers. Ninety-eight percent of subjects received high 'HIV knowledge' scores. Few of the subjects who needed medical care sought it out. Conclusions: Despite awareness of HIV, needle sharing and unprotected sex persist in the population, and the HIV prevalence is high. Further interventions should not only seek to educate but also to reduce high-risk behaviors.