Open Access Highly Accessed Research article

Risk Factors for HIV-1 seroconversion among Taiwanese men visiting gay saunas who have sex with men

Yen-Ju Chen1, Yu-Ting Lin1, Marcelo Chen23, Szu-Wei Huang14, Su-Fen Lai1, Wing-Wai Wong15, Hung-Chin Tsai16, Yu-Huei Lin17, Hsin-Fu Liu18, Shu-Yu Lyu19* and Yi-Ming A Chen14*

Author Affiliations

1 AIDS Prevention and Research Center, National Yang-Ming University, Taipei, Taiwan

2 Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan

3 Mackay Medicine, Nursing and Management College, New Taipei City, Taiwan

4 Institute of Microbiology and Immunology, National Yang-Ming University, Taipei, Taiwan

5 Taipei Veterans' General Hospital, Taipei, Taiwan

6 Kaohsiung Veterans' General Hospital, Kaohsiung, Taiwan

7 Taichung Veterans' General Hospital, Taichung, Taiwan

8 Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan

9 School of Public Health, Taipei Medical University, Taipei, Taiwan

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BMC Infectious Diseases 2011, 11:334  doi:10.1186/1471-2334-11-334

Published: 5 December 2011



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 infection.