Men having sex with men (MSM) accounts for 33.6% of all reported cases of HIV-1
infection in Taiwan. The aim of this study was to investigate the epidemiology of
HIV-1 infection among MSM in gay saunas in Taiwan.
Patrons of 5 gay saunas were recruited for a weekly volunteer counseling and testing
program from 2001 to 2005. Questionnaires were collected for a risk factor analysis.
HIV-1 subtypes were determined using DNA sequencing and phylogenetic analyses.
HIV-1 prevalence rates among MSM in gay saunas in 2001 through 2005 were 3.4%,
5.1%, 8.9%, 8.5%, and 8.3%, respectively. In total, 81 of 1,093 (7.4%) MSM had
HIV-1 infection. Fifty-two HIV-1 strains were genotyped, and all of them were
subtype B. HIV-seropositive men were significantly younger than the seronegatives.
Only 37.1% used condoms every time during sexual intercourse. A multivariate
logistic regression analysis showed that the risk factors for HIV-1 were being
uncircumcised (odds ratio (OR) = 2.19; 95% confidence interval (CI), 1.08~4.45);
having sexual intercourse with at least 2 partners during each sauna visit (≥ 2 vs. ≤ 1,
OR = 1.71; 95% CI, 1.02~2.89); and the role played during anal intercourse (versatile
vs. an exclusively insertive role, OR = 2.76; 95% CI, 1.42~5.36).
Overall, 7.4% Taiwanese MSM participating in this study had HIV-1 subtype B
infection. Uncircumcised, being versatile role during anal intercourse, and having sex
with more than one person during each sauna visit were main risk factors for HIV-1
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