The Threshold at Which Elderly Men from Rural China Who Visit Female Sex Workers Are Significantly More at Risk of Becoming HIV-Positive

Abstract

Background:HIV prevalence of elderly (≥50 years old) men in China has been steadily increasing, mainly through the sexual transmission route, but sexual behaviors of elderly men in China are far from well-studied.

Objectives:In order to make clear how many sexual partners (SPs) are too many for elderly (≥50 years old) men from rural China becoming HIV-positive. 

Methods: We conducted a case-control study: 99 newly HIV (+) vs. 88 HIV (-) elderly men with similar age who visited female sex workers (FSW). Receiver-operating characteristics (ROC) curves and backward binary logistic regression was applied. 

Results:We found out cases had more SPs (315.66±401.33) than controls(14.63±25.63)in their lifetime, mainly commercial SPs(313.98±401.38 vs. 12.81±25.85), similarly in the last three years. AUCs for HIV infection at number of accumulated SPs and of commercial SPs were 0.89 and 0.90, and correspondingly 0.79 and 0.81 in the last three years. Cut-off values were identified as 51.5, 52.5, 5.5 and 4.5 based on Youden’s indexes (0.715, 0.705, 0.612 and 0.601). Risky factors for HIV infection among elderly men who visit FSW were having 52-2002 SPs in their lifetime (AOR (95%CI): 56.33(11.36-279.25)), having 5-289 commercial SPs in the last three years (11.55(2.78-47.94)), and having 3000 YUAN and above (9.02(2.04-39.96)) and 2000-2999 YUAN (4.21(1.05-16.85)) monthly income, not receiving HIV-related health education (3.57(1.1-11.64)).

Conclusions:In conclusion, ≥52 SPs in their lifetime and ≥5 FSW in the last three years are too many for elderly men from rural China becoming HIV-positive.

Keywords: Sex, Elderly men, Case-control study，HIV,   Receiver-operating characteristics(ROC)