Wang et al. BMC Public Health 2011, 11:955 http://www.biomedcentral.com/1471-2458/11/955 R E S E A R C H A R T I C L E Open Access HIV/STD pattern and its associated risk factors among male STD clinic attendees in China: a foci for HIV intervention Qian-Qiu Wang1*, Xiang-Sheng Chen1, Yue-Ping Yin1, Guo-Jun Liang1, Ning Jiang1, Ting Dai1, Xi-Ping Huan2, Bing Yang3, Qiao Liu4, Yu-Jiao Zhou5 and Bao-Xi Wang1 Abstract Background: Previous studies suggested a high prevalence of STDs including HIV among female sex workers and men who have sex with men in China, but little was known about the prevalence in male patients attending public STD clinics. The aim of this study was to investigate STD patterns and HIV prevalence among male STD clinic attendees in different areas in China and the associated risk factors. The feasibility of Provider-initiated HIV testing and counseling (PITC) was evaluated as well. Methods: A cross-sectional study was conducted at 46 public STD clinics in 4 provinces in China. Between July 2009 and September 2009, a total of 3243 eligible subjects were invited to participate in an interview with a structured-questionnaire for collecting socio-demographic characteristics and sexual behavioral information. They also were asked to provide venous blood samples for serological determinations of HIV and syphilis infection, and first void urine specimens for detecting Chlamydia trachomatis and Neisseria gonorrhoeae infections, Results: Out of the 3243 eligible patients, 2951(91%) men agreed to take part in the HIV and syphilis testing. The overall prevalence rate of HIV infection was 0.7% while the rates of syphilis, N. gonorrhoeae, C. trachomatis infections were 10.7%, 4.3% and 6.9%, respectively, with the highest syphilis and N. gonorrhoeae rates in Jiangsu Province. Patients from Guangxi province, homosexual/bisexual practices and intravenous drug use were significantly associated with HIV infection in multivariate logistic regression analyses. Provider-initiated HIV testing and counseling (PITC) was well accepted by attendees, with 91% of eligible attendees agreeing to undergo HIV testing and counseling. All HIV positive patients were properly managed accordingly. Conclusions: A modest prevalence of HIV infection and substantial prevalence of other STD infections were found among male patients attending public STD clinics in China. The findings further support the introduction of HIV and syphilis PITC strategy into this important setting. Background Sexually Transmitted Diseases (STDs) are a group of communicable diseases that are transmitted predomi- nantly via sexual contact and caused by different etiolo- gies. STDs were nearly eliminated in the 1960s in China [1]. The situation changed rapidly with the initiation of economic reform in the 1980s and STDs again became a major public health problem [2,3]. In 2005, a total of * Correspondence: wangqianqiu@sina.com 1National Center for STD Control and Prevention, China Centers for Diseases Control and Prevention, Nanjing 210042, China Full list of author information is available at the end of the article 703,001 new STD cases (including gonorrhea, syphilis, non-gonococcal urethritis, genital herpes, genital warts, chancroid and lymphogranuloma venereum) were reported. Reported syphilis cases increased sharply from 88,311 in 2004 to 358,534 in 2010. Interestingly, reported gonorrhea cases decreased significantly from 228,294 in 2004 to 105,544 in 2010 (unpublished data from National Center for STD Control, China CDC). STD screening is useful to decrease HIV transmission because it allows identification of patients with ongoing high-risk sexual behavior and enables the treatment of © 2011 Wang et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.