Objective To examine the prevalence of heterosexual marriage and the association of the marriage duration with human immunodeficiency virus (HIV)/AIDS related high risk behaviors among the men who have sex with men (MSM) in Mianyang city of Sichuan province.
Methods We carried out a questionnaire survey on heterosexual marriage, sexual behavior and serologic examination among 1 242 MSM recruited with snowball sampling in Mianyang city of Sichuan province between January and October 2017.
Results Of the MSM surveyed, 234 (18.8%) were married to a woman; the married MSM reported an average marriage duration of 14.9 ± 10.579 years and 66.2% of the MSM reported a general marital relationship. An average couple′s sexual activity of 4.1 ± 4.381 times per month was reported by the MSM with heterosexual marriage and 50.7%, 32.4%, 18.7%, and 16.4% of the MSM reported careless, harmonious, disharmonious, and unsatisfactory couple′s sexual activities. There were 78.2% of the married MSM reporting no condom use in couple′s sexual activities and 77.3% denying the necessity of condom use in couple′s sexual activity. The HIV positive rate was 12.6% among the MSM with marriage duration of more than 15 years and was significantly higher than that (4.6%) among those with the duration of ≤ 15 years (χ2 = 4.972, P = 0.029). Multivariate logistic analysis demonstrated that the MSM with the heterosexual marriage duration of more than 15 years were more likely to have occasional homosexual partners and multiple sexual partners during the latest 6 months but less likely to seek sexual partners via internet and to use condom in the latest anal sex.
Conclusion Conjugal relation and sexual life are poor and the condom use is impeded by subjective cognition among the MSM with heterosexual marriage; the MSM's marriage duration associates with HIV-related high risk behaviors and longer marriage duration predicts a higher risk of HIV infection.
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