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Sun S, Yang C, Zaller N, Zhang Z, Zhang H, Operario D. PrEP Willingness and Adherence Self-Efficacy Among Men Who have Sex with Men with Recent Condomless Anal Sex in Urban China. AIDS Behav 2021; 25:3482-3493. [PMID: 33932186 PMCID: PMC8558112 DOI: 10.1007/s10461-021-03274-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 12/23/2022]
Abstract
This study investigates PrEP willingness, adherence self-efficacy and potential impact of PrEP among HIV-negative, Chinese men who have sex with men (MSM; n = 622) with recent condomless anal sex. Facilitative factors of PrEP willingness included migrant status, sexual risk, and prior PrEP use, whereas barriers included concerns over being treated as an HIV/AIDS patient, recent HIV testing, identity concealment, and HIV prevention service usage. Adherence self-efficacy was associated with PrEP knowledge and confidence in PrEP efficacy of HIV prevention. A total of 39.3% anticipated increase in sex partners, 25.6% anticipated decrease in condom use, and 38.0% anticipated increased HIV testing following PrEP uptake. Results suggest a two-step approach to (1) promote PrEP acceptance among Chinese MSM and (2) enhance adherence and risk monitoring among PrEP-willing MSM. Efforts to reduce stigma, incorporate PrEP in the HIV prevention continuum, and increase PrEP knowledge will be crucial to optimize PrEP implementation.
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Affiliation(s)
- Shufang Sun
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main St, Providence, RI, 02903, USA.
| | - Cui Yang
- Johns Hopkins University, Baltimore, USA
| | - Nickolas Zaller
- University of Arkansas for Medical Sciences, Little Rock, USA
| | | | | | - Don Operario
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main St, Providence, RI, 02903, USA
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HIV Prevalence and Factors Related to HIV Infection Among Transgender Women in Vietnam: A Respondent Driven Sampling Approach. AIDS Behav 2020; 24:3132-3141. [PMID: 32297068 PMCID: PMC7223453 DOI: 10.1007/s10461-020-02867-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Transgender women are at higher risk of HIV infection, however, there is a lack of information about HIV infection and related factors among transgender women in Vietnam. From February 2018 to June 2018, 456 transgender women were recruited in the study using Respondent-Driven Sampling technique. Participants completed the computer-based questionnaire and were tested for HIV serostatus. Multivariable logistic regression was used to identify factors related to HIV infection. The prevalence of HIV infection was 77 (16.5%), of which 19 (24.7%) were not aware of their HIV-positive status prior to the study. Factors associated with HIV infection included popper use (aOR 2.01, p = 0.044) and having regular male partner(s) (aOR 0.42, p = 0.006). More efforts are needed to reduce the high prevalence of HIV infection, such as expanding the reach of HIV screening and prevention programs to the transgender women population, particularly for substance users.
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Chu JH, Huang JH. Psychosociobehavioral characteristics associated with high condomless anal intercourse intention: a comparison of receptive, versatile, and insertive MSM in Taiwan. AIDS Care 2019; 32:770-778. [PMID: 31422670 DOI: 10.1080/09540121.2019.1653433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In Taiwan, men who have sex with men (MSM) continue to be disproportionately affected by HIV, and the main route of HIV transmission is condomless anal intercourse (CAI). This study examined the associations between psychosociobehavioral characteristics and CAI intention among MSM in Taiwan who had ever engaged in anal intercourse with men, and compared the differences across three sexual roles (receptive, versatile, and insertive) using online survey data (N = 563). For all MSM, those that were in a relationship (AOR = 2.55; 95% CI: 1.61-4.03), had three or more steady partners (AOR = 2.58; 95% CI: 1.19-5.58), did not use a condom during last anal intercourse (AOR = 6.81; 95% CI: 4.36-10.63), perceived high HIV risk (AOR = 2.13; 95% CI: 1.26-3.60), and had high sexual sensation seeking (AOR = 2.80; 95% CI: 1.82-4.30) were more likely to have high CAI intention. After stratification, the significant characteristics differed depending on sexual role, except for no condom use during last anal intercourse remaining significant in all models (AOR = 5.09-20.30; 95% CI: 2.49-66.69, depending on sexual role). Tailoring the programs for MSM of different sexual roles may improve the effectiveness of future prevention efforts.
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Affiliation(s)
- Jen-Hao Chu
- Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jiun-Hau Huang
- Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei, Taiwan.,Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
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Yang J, Xu H, Li S, Cheng W, Gu Y, Xu P, Yu Q, Lv F. The characteristics of mixing patterns of sexual dyads and factors correlated with condomless anal intercourse among men who have sex with men in Guangzhou, China. BMC Public Health 2019; 19:722. [PMID: 31182070 PMCID: PMC6558892 DOI: 10.1186/s12889-019-7082-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 05/31/2019] [Indexed: 11/19/2022] Open
Abstract
Background The HIV prevalence among men who have sex with men (MSM) in China has increased yearly. This study aimed to explore the association between the characteristics of social communication and condomless anal intercourse (CAI) among MSM and the implications for prevention and control of HIV among MSM in China using an egocentric network framework. Methods The data were collected in Guangzhou between November 2016 and May 2017 through standardized face-to-face interviews. The participants were recruited among MSM who received voluntary counselling and testing services (VCT) provided by nongovernmental organizations (NGOs) and the local Centers for Disease Control and Prevention (CDC). We used the framework of the egocentric network analysis, the odd ratios of CAI were analyzed using generalized estimating equations (GEE). Results In total, 1073 MSM who nominated 2667 sexual partners were sampled. MSM who were approximately 30 years old and chose sexual partners of different age category were more likely to engage in CAI. Participants with high level education who were in partnerships with individuals with lower education levels had a higher risk of CAI. Participants who reported having a strong relationship with their sexual partners(AOR = 1.31) were associated with a higher probability of experiencing CAI during sex; while having sexual partners who were unmarried (OR = 0.56), and participants who reported meeting sexual partners online (AOR = 0.74) or, having sex with an occasional partner (AOR = 0.44)were less likely to engage in CAI. Conclusion Our study indicates that the strength of sexual dyadic relational ties and different social communication mixing patterns across ages, educational categories, and marital status were associated with CAI. Electronic supplementary material The online version of this article (10.1186/s12889-019-7082-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Juan Yang
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155th Changbai Road, Changping District, Beijing, China
| | - Huifang Xu
- Department of HIV/AIDS Control and Prevention, Center for Disease Control and Prevention, Guangzhou, China
| | - Shuo Li
- United Nations Entity for Gender Equality and the Empowerment of Woman, China Office, Beijing, China
| | - Weibin Cheng
- Department of HIV/AIDS Control and Prevention, Center for Disease Control and Prevention, Guangzhou, China
| | - Yuzhou Gu
- Department of HIV/AIDS Control and Prevention, Center for Disease Control and Prevention, Guangzhou, China
| | - Peng Xu
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155th Changbai Road, Changping District, Beijing, China
| | - Qiuyan Yu
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155th Changbai Road, Changping District, Beijing, China
| | - Fan Lv
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155th Changbai Road, Changping District, Beijing, China.
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Su X, Zhou AN, Li J, Shi LE, Huan X, Yan H, Wei C. Depression, Loneliness, and Sexual Risk-Taking Among HIV-Negative/Unknown Men Who Have Sex with Men in China. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1959-1968. [PMID: 29147806 PMCID: PMC5955768 DOI: 10.1007/s10508-017-1061-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 06/20/2017] [Accepted: 08/11/2017] [Indexed: 05/09/2023]
Abstract
Research conducted among men who have sex with men (MSM) in high-income countries has demonstrated that negative mental health is one of the significant drivers of HIV infection, and few studies have examined the status of mental health among MSM in China. We sought to describe depression and loneliness and identify their correlates among Chinese MSM. A cross-sectional study was conducted among HIV-negative or unknown status MSM in 2014. Time-location sampling and online convenience sampling methods were employed. Depression was measured via a short version of CES-D (CES-D 10). Loneliness was measured from a single item in CES-D 10. Multivariable logistic regressions were conducted to identify independent correlates of depression and loneliness. A total of 507 individuals participated in the study. Of them, 26.8 and 35.5% reported moderate-to-severe symptoms of depression and feeling lonely, respectively. Depressed participants were more likely to have a sense of hopelessness for the future (AOR 3.20, 95% CI 1.90, 5.20) and report higher levels of internalized homophobia (AOR 2.32, 95% CI 1.47, 3.67). Participants who reported feeling lonely were more likely to have had condomless receptive anal intercourse in the past 6 months (AOR 1.67, 95% CI 1.08, 2.58) and feel hopeless for the future (AOR 2.40, 95% CI 1.60, 3.70). MSM in China have significant rates of depression and loneliness. HIV prevention efforts should address the mental health needs of Chinese MSM such as providing safe environments for social support and role models.
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Affiliation(s)
- Xiaoyou Su
- School of Public Health, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - A Ning Zhou
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Jianjun Li
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Ling-En Shi
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Xiping Huan
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Hongjing Yan
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Chongyi Wei
- Department of Epidemiology and Biostatistics & Global Health Sciences, University of California, 50 Beale St., Suite 1300, San Francisco, CA, 94105, USA.
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Chu JH, Huang JH. A Theory-Based Exploration of Condomless Anal Intercourse Intention Among Young Men Who Have Sex with Men of Different Sexual Roles in Taiwan. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:2041-2050. [PMID: 29185094 DOI: 10.1007/s10508-017-1081-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 09/07/2017] [Accepted: 09/11/2017] [Indexed: 06/07/2023]
Abstract
In recent years, men who have sex with men (MSM) have accounted for over 80% of all new HIV cases in Taiwan. More than 70% of new cases have occurred in those aged 15-34 years. Condomless anal intercourse (CAI) has been identified as the main route of HIV transmission among MSM. To systematically examine CAI intention and associated factors among young MSM in Taiwan, an anonymous online survey based on the Theory of Planned Behavior (TPB) was conducted. Data from 694 MSM aged 15-39 years were included in the analysis. This study found that, overall, all five TPB factors (i.e., attitudes toward positive and negative outcomes regarding CAI, perceived support for CAI from important others, and perceived behavioral control of CAI under facilitating and constraining conditions) were significantly associated with CAI intention. When data were stratified by sexual role (i.e., receptive, versatile, and insertive), the associations between TPB factors and CAI intention varied. Of the five TPB factors, positive attitudes toward positive outcomes regarding CAI were most strongly associated with high CAI intention (AOR 5.68 for all young MSM; AOR 3.80-15.93, depending on sexual role). Findings from this study could inform the development of theory-driven HIV prevention programs as well as future research and practice. These results also highlight the importance of tailoring HIV prevention initiatives for young MSM of different sexual roles to optimize the program effectiveness.
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Affiliation(s)
- Jen-Hao Chu
- Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jiun-Hau Huang
- Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei, Taiwan.
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei, 10055, Taiwan.
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
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Goedel WC, Schneider JA, Hambrick HR, Kreski NT, Morganstein JG, Park SH, Mgbako O, Duncan DT. Are Anal Sex Roles Associated with Preferences for Pre-Exposure Prophylaxis Administration Modalities Among Men Who Have Sex with Men? ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:2123-2133. [PMID: 29192368 PMCID: PMC6008239 DOI: 10.1007/s10508-017-1083-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 09/05/2017] [Accepted: 09/12/2017] [Indexed: 05/27/2023]
Abstract
The current study sought to examine awareness of, willingness to use, and preferences for available and theoretical administration modalities for HIV pre-exposure prophylaxis (PrEP) and the association of anal sex roles with these concepts among a sample of men who have sex with men (MSM) in Paris, France. Broadcast advertisements were placed on a popular geosocial-networking smartphone application for MSM to direct users to complete a Web-based survey. MSM answered questions on their recent engagement in condomless anal intercourse and awareness of and willingness to use PrEP in the form of once daily and event-driven pill regimens, long-acting injections, and penile and rectal microbicides as well as sexual roles. Multinomial regression models were fit to assess the association between behaviorally classified anal sexual role and preferences for one of these biomedical prevention modalities. A total of 482 HIV-uninfected MSM completed the survey, 48.1% of whom engaged in some form of condomless anal intercourse in the preceding 3 months. Most respondents (85.3%) had heard of once daily PrEP, but fewer respondents had heard of other prevention strategies. Assuming equal effectiveness, long-acting injections were the most commonly preferred (21.8%). Behaviorally defined "bottom" and "versatile" MSM more frequently preferred long-acting injections (32.9% of "bottoms" and 25.3% of "versatiles"). The development of long-acting injections to deliver antiretroviral drugs and topical microbicides may offer more convenient and acceptable options for HIV prevention among MSM, as MSM in this sample were willing to use them and would prefer to use them over currently available pill regimens.
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Affiliation(s)
- William C Goedel
- Department of Population Health, Spatial Epidemiology Lab, New York University School of Medicine, 227 East 30th Street, 6th Floor, New York, NY, 10016, USA.
| | - John A Schneider
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - H Rhodes Hambrick
- Department of Population Health, Spatial Epidemiology Lab, New York University School of Medicine, 227 East 30th Street, 6th Floor, New York, NY, 10016, USA
| | - Noah T Kreski
- Department of Population Health, Spatial Epidemiology Lab, New York University School of Medicine, 227 East 30th Street, 6th Floor, New York, NY, 10016, USA
| | - Jace G Morganstein
- Department of Population Health, Spatial Epidemiology Lab, New York University School of Medicine, 227 East 30th Street, 6th Floor, New York, NY, 10016, USA
| | - Su Hyun Park
- Department of Population Health, Spatial Epidemiology Lab, New York University School of Medicine, 227 East 30th Street, 6th Floor, New York, NY, 10016, USA
| | - Ofole Mgbako
- Department of Population Health, Spatial Epidemiology Lab, New York University School of Medicine, 227 East 30th Street, 6th Floor, New York, NY, 10016, USA
- Department of Internal Medicine, New York University School of Medicine, New York, NY, USA
| | - Dustin T Duncan
- Department of Population Health, Spatial Epidemiology Lab, New York University School of Medicine, 227 East 30th Street, 6th Floor, New York, NY, 10016, USA
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Liu J, Yi Z, Zhao Y, Qu B, Zhu Y. The psychological health and associated factors of men who have sex with men in China: A cross-sectional survey. PLoS One 2018; 13:e0197481. [PMID: 29813076 PMCID: PMC5973584 DOI: 10.1371/journal.pone.0197481] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 05/03/2018] [Indexed: 11/18/2022] Open
Abstract
Objectives The psychological health of men who have sex with men (MSM) has received increased attention in recent years. We thus investigated the psychological status and associated factors among MSM in China. Methods A cross-sectional survey of 248 MSM was conducted from April to September 2015 using Symptom Checklist 90 (SCL-90) in Huludao and Zhengzhou, China. Statistical analyses utilized SPSS version 19.0 for Windows. Results All Cronbach’s α coefficients of the SCL-90 subscales exceeded 0.7, suggesting acceptable reliability. The coefficient range of the collective validity for all the subscales was >0.4. For the divisional validity, each item correlated better with the hypothetical subscale than with other subscales. Collective validity and divisional validity were both acceptable. The four most frequent types of psychological distress among MSM were depression, obsessive-compulsive behavior, interpersonal sensitivity, and anxiety. Results of the univariate analysis revealed that the following groups had significantly higher SCL-90 scores (P < 0.05): peasantry, married MSM, respondents who reported condomless anal intercourse and a greater number of male partners, and respondents who had not undergone psychosocial counseling and whose family or friends did not know about their sexual identity. In a multivariate logistic regression model, the following parameters were independently associated with higher SCL-90 scores: being married (AOR [adjusted odds ratio] = 3.19; 95% CI [confidence interval]: 1.96 to 5.93), condomless anal intercourse (AOR = 1.16; 95% CI: 1.02 to 1.31), number of male partners (AOR = 1.66 and 1.81; 95% CI: 1.08 to 2.34 and 1.32 to 2.69), family or friends not knowing about sexual identity (AOR = 2.13; 95% CI: 1.17 to 4.92), and lack of psychosocial counseling (AOR = 2.09; 95% CI: 1.06 to 4.09). Conclusions Our results indicate that psychological health problems among MSM in China are of concern. It is thus necessary to strengthen intervention efforts, with more emphasis on intervention programs to improve psychological health among Chinese MSM.
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Affiliation(s)
- Jie Liu
- Department of Health Statistics, School of public health, China Medical University, Shenyang, Liaoning Province, P.R. China
| | - Zhe Yi
- Department of Prothodontics, School of Stomatology, China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Yang Zhao
- Department of Health Statistics, School of public health, China Medical University, Shenyang, Liaoning Province, P.R. China
| | - Bo Qu
- Department of Health Statistics, School of public health, China Medical University, Shenyang, Liaoning Province, P.R. China
- * E-mail:
| | - Yaxin Zhu
- Department of Health Statistics, School of public health, China Medical University, Shenyang, Liaoning Province, P.R. China
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Zhou N, Bauermeister J, Guo W, Yu M, Yang J, Zheng M, Guo Y, Gong H, Gao Y, Jiang G. Condomless Anal Intercourse by Partner Type Among Chinese Men Who Have Sex With Men in Tianjin. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2018; 30:63-71. [PMID: 29481303 DOI: 10.1521/aeap.2018.30.1.63] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
HIV prevalence and incidence is high among men who have sex with men (MSM) in China, underscoring the need to support and optimize HIV risk reduction strategies for this population. We sought to estimate the prevalence of condomless anal sex among MSM living in Tianjin, China. We recruited 595 HIV-negative MSM living in Tianjin to participate in a HIV study between 2013 and 2014. Data were collected after a voluntary counseling and testing session through a face-to-face survey. We used multivariable logistic regressions to examine the association between sociodemographic characteristics and HIV risk correlates and MSM's likelihood of engaging in condomless anal intercourse with main and casual partners in the prior 6 months. Results are presented. HIV risk reduction efforts should be developed to be sensitive and responsive to the unique experiences of Chinese MSM. We discuss opportunities for future work, including the development HIV risk reduction interventions.
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Affiliation(s)
- Ning Zhou
- Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | | | - Wei Guo
- National Centre for AIDS/STD Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Maohe Yu
- Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Jie Yang
- Tianjin Dark Blue Working Group, Tianjin, China
| | - Minna Zheng
- Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Yan Guo
- Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Hui Gong
- Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Yongjun Gao
- Tianjin Hongqiao District Center for Disease Control and Prevention, Tianjin, China
| | - Gueohong Jiang
- Tianjin Centers for Disease Control and Prevention, Tianjin, China
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Lei Y, Zhang K, Xiao X, Tang C, Li X, Wang H. Sexual Roles, Risk Sexual Behaviours, and HIV Prevalence among Men who Have Sex with Men Seeking HIV Testing in Changsha, China. Curr HIV Res 2018; 16:174-181. [PMID: 29992887 PMCID: PMC6182933 DOI: 10.2174/1570162x16666180711101643] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/11/2018] [Accepted: 07/02/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND HIV infection is prevalent among men who have sex with men (MSM), and sexual roles may be important factors related to it. This study aims to describe the sexual roles, risky sexual behaviors and HIV prevalence among MSM, and to determine associated factors for HIV prevalence. METHODS A convenient sampling method was used to recruit participants in a non-government organization in Changsha, China. The participants were asked to complete a 38-item self-administered questionnaire regarding demographic characteristics and risky sexual behaviours before collecting blood samples for HIV testing. Chi-square tests and logistic regression analysis were conducted with the Statistical Package for the Social Sciences Version 18.0 and other indexes were statistically described. RESULTS A total of 601 MSMs who came to a local non-government organization for voluntary counseling and testing completed a pencil-and-paper survey and were tested for HIV. The overall HIV prevalence of this sample was 13.3%, and that of the bottoms (16.3%) was similar to the versatiles (15.9%) but higher than the tops (6.1%). Bivariate analyses showed that there were significant differences in age, marital status, monthly income, sexual orientation, age at first sex, sex of the first sex partner, sex with a woman in the last 6 months, oral sex with a man in the last 6 months and role of oral sex among 3 subgroups of MSM (p < 0.05). Multivariate analyses indicated that MSMs who played the role of either the bottoms or the versatiles were more likely to be HIV positive than the tops. While MSMs who used condoms in anal sex in the last 6 months, had sex with a woman in the last 6 months or had oral sex with a man in the last 6 months were less likely to be HIV positive. CONCLUSION Different sexual roles are associated with high-risk sexual behaviors among MSMs and their HIV infection status. Further research should target preventive interventions, and improve the effectiveness of the intervention according to the characteristics of the subgroups to reduce the HIV transmission among Chinese MSM.
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Affiliation(s)
| | | | | | | | | | - Honghong Wang
- Address correspondence to this author at Xiangya School of Nursing of Central South University, 172 Tong Zi Po Road, Changsha 410013, Hunan, China; Tel: 86-731-82650270; Fax: 86-731-82650266; E-mail:
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11
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Card KG, Lachowsky NJ, Cui Z, Carter A, Armstrong H, Shurgold S, Moore D, Hogg RS, Roth EA. A Latent Class Analysis of Seroadaptation Among Gay and Bisexual Men. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:95-106. [PMID: 27987086 PMCID: PMC5474217 DOI: 10.1007/s10508-016-0879-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 09/16/2016] [Accepted: 10/08/2016] [Indexed: 05/30/2023]
Abstract
Initial research into seroadaptive strategies suggests that, individually, they are potentially effective behavioral methods to reduce risk of HIV transmission. Combining strategies, therefore, has the potential to increase risk reduction. The aim of this study was to determine how gay and bisexual men (GBM) combine strategies. To this end, a total of 774 sexually active GBM, aged ≥16 years, in Metro Vancouver, Canada, were recruited. Grouped by self-reported HIV status, latent class analysis of self-reported condom use, strategic positioning, anal sex avoidance, serosorting, viral-load sorting, and withdrawal were conducted. Multinomial logistical regression identified explanatory variables of class membership (i.e., sensation seeking, treatment optimism, sexual altruism, relationship status, number of partners, anal sex preference). Four latent classes were identified: Condom Users, Multiple Prevention Users, Viral-Load Sorters, and Serosorters. The majority of HIV-negative/unknown men (72 %) and a large proportion of HIV-positive men (42 %) belonged to the Condom Users class. Class membership was associated with age, relationship status, treatment optimism, sexual altruism, sensation seeking, number of recent male anal sex partners, and recent condomless anal sex with a serodiscordant or unknown-status partner. Understanding these distinct patterns allows for tailored interventions addressing GBM's sexual health needs.
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Affiliation(s)
- Kiffer G Card
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada.
- Faculty of Health Science, Simon Fraser University, Vancouver, BC, Canada.
| | - Nathan J Lachowsky
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Zishan Cui
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada
| | - Allison Carter
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada
- Faculty of Health Science, Simon Fraser University, Vancouver, BC, Canada
| | - Heather Armstrong
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada
| | - Susan Shurgold
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada
| | - David Moore
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Robert S Hogg
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada
- Faculty of Health Science, Simon Fraser University, Vancouver, BC, Canada
| | - Eric A Roth
- Department of Anthropology, University of Victoria, Victoria, BC, Canada
- Centre for Addiction Research of British Columbia, University of Victoria, Victoria, BC, Canada
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Duan C, Wei L, Cai Y, Chen L, Yang Z, Tan W, Gan Y, Au WW, Zhao J. Recreational drug use and risk of HIV infection among men who have sex with men: A cross-sectional study in Shenzhen, China. Drug Alcohol Depend 2017; 181:30-36. [PMID: 29031090 DOI: 10.1016/j.drugalcdep.2017.09.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 09/03/2017] [Accepted: 09/06/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Recreational drug use has increased in recent years, especially among MSM, and has been found to be associated with higher risk of HIV infection. However, there is limited information about current recreational drug use among MSM in Shenzhen which is an international gateway city to China with a rapidly expanding MSM population. METHODS A cross-sectional survey among MSM in Shenzhen was conducted and was used to collected information on demographics, sexual behavior and drug use via questionnaires. Serologic results on HIV and syphilis were obtained from laboratory assays. We performed logistic regression analysis to evaluate correlates with drug use. RESULTS Among the 1935 MSM surveyed, 12.7% reported use of recreational drugs in the past six months. Rush poppers had become the most frequently used drug (10.6%). Risk factors associated with the use of recreational drugs included being unmarried, non-Han ethnicity, having high education level, seeking male sex partners via the internet, having multiple male sex partners, performing receptive role during anal sex, and having unprotected anal intercourse. Recreational drug use was significantly associated with higher risk of both HIV and syphilis infections (aOR:1.89, 95% CI:1.28-2.79; aOR:1.79, 95% CI:1.25-2.60, respectively). CONCLUSIONS Recreational drug use is associated with increased risk of HIV and syphilis infections among MSM in Shenzhen. Rush poppers were the most popular recreational drug. This finding suggests the need for targeted prevention and behavioral intervention programs to control the recreational drug use, and to reduce HIV and other sexually transmitted diseases among MSM in Shenzhen and internationally.
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Affiliation(s)
- Chenlin Duan
- Department of Preventive Medicine and MPH Education Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Lan Wei
- Shenzhen Center for Disease Control and Prevention, Guangdong, China
| | - Yitian Cai
- Shenzhen Center for Disease Control and Prevention, Guangdong, China
| | - Lin Chen
- Shenzhen Center for Disease Control and Prevention, Guangdong, China
| | - Zhengrong Yang
- Shenzhen Center for Disease Control and Prevention, Guangdong, China
| | - Wei Tan
- Shenzhen Center for Disease Control and Prevention, Guangdong, China
| | - Yongxia Gan
- Shenzhen Center for Disease Control and Prevention, Guangdong, China
| | - William W Au
- Department of Preventive Medicine and MPH Education Center, Shantou University Medical College, Shantou, Guangdong, China; University of Medicine and Pharmacy, Tirgu Mures, Romania
| | - Jin Zhao
- Shenzhen Center for Disease Control and Prevention, Guangdong, China
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Semple SJ, Pitpitan EV, Goodman-Meza D, Strathdee SA, Chavarin CV, Rangel G, Torres K, Patterson TL. Correlates of condomless anal sex among men who have sex with men (MSM) in Tijuana, Mexico: The role of public sex venues. PLoS One 2017; 12:e0186814. [PMID: 29065132 PMCID: PMC5655432 DOI: 10.1371/journal.pone.0186814] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/09/2017] [Indexed: 11/17/2022] Open
Abstract
Condomless anal sex between male partners is the primary risk factor for HIV transmission among men who have sex with men (MSM). Correlates of condomless anal sex have been well-studied in developed countries, but they have received less attention in lower-to-middle income countries (LMIC), where MSM are often subject to stigma, discrimination, intolerance, and even the criminalization of same sex behavior. In Mexico, a LMIC where traditional views on homosexuality are common, HIV prevalence among MSM is high (16.9%), yet little research has been conducted on the correlates of condomless anal sex in this high-risk population. The present study examined correlates of condomless anal sex among 201 MSM recruited in Tijuana, Mexico, with a focus on the role of public sex venues in relation to sexual risk behavior. Eligibility requirements were: biologically male, 18 years of age or older, resident of Tijuana, and self-reported anal or oral sex with a male partner in the past year. Participants completed an interviewer-administered, demographic and psychosocial survey, and were tested for HIV and syphilis. A hierarchical multiple linear regression model was tested to identify correlates of condomless anal sex. Thirty-eight percent of participants (N = 76) reported condomless anal sex with a male partner in the past 2 months. Higher levels of condomless anal sex were associated with higher levels of depressive symptoms, greater sexual compulsivity, and more frequent seeking out of sex partners in a public venue in the past 2 months. In view of these findings, we recommend the development of multi-level, “combination” interventions, which in the Mexican context should include enhanced condom promotion and distribution, improved availability and access to mental health treatment and counseling services, and expanded HIV/STI testing in public venues.
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Affiliation(s)
- Shirley J Semple
- Department of Psychiatry, University of California San Diego, La Jolla, California, United States of America
| | - Eileen V Pitpitan
- Division of Global Public Health, Department of Medicine, University of California San Diego, La Jolla, California, United States of America
| | - David Goodman-Meza
- Division of Infectious Diseases, University of California Los Angeles, Los Angeles, California, United States of America
| | - Steffanie A Strathdee
- Division of Global Public Health, Department of Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Claudia V Chavarin
- Department of Psychiatry, University of California San Diego, La Jolla, California, United States of America
| | | | - Karla Torres
- Agencia Familiar Binacional, A.C., Tijuana, Mexico
| | - Thomas L Patterson
- Department of Psychiatry, University of California San Diego, La Jolla, California, United States of America
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The Relationship Between Methamphetamine Use, Sexual Sensation Seeking and Condomless Anal Intercourse Among Men Who Have Sex With Men in Vietnam: Results of a Community-Based, Cross-Sectional Study. AIDS Behav 2017; 21:1105-1116. [PMID: 27351193 DOI: 10.1007/s10461-016-1467-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study assessed the relationship between methamphetamine use and condomless anal intercourse (CAI) among men who have sex with men (MSM) in Hanoi and Ho Chi Minh City, Vietnam. Of 622 MSM participants, 75.7% reported any CAI in the last three months, 23.2% reported engaging in sex work in the last three months, 21.1% reported group sex in the last twelve months (21.1%) and 14.3% had used methamphetamine for sex in the last three months. CAI was associated with living in Ho Chi Minh City vs. Hanoi, being versatile during anal sex, a greater degree of sexual sensation-seeking, and more strongly agreeing that withdrawal before ejaculation is effective in preventing HIV. Effect-modification analysis showed that recent sex-related methamphetamine use was related to a higher probability of CAI for men with low sexual sensationseeking scores. Methamphetamine assessment and/or interventions should be incorporated into HIV prevention and research with Vietnam's MSM population.
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Zhang H, Teng T, Lu H, Zhao Y, Liu H, Yin L, Sun Z, He X, Qian HZ, Ruan Y, Shao Y, Vermund SH. Poppers use and risky sexual behaviors among men who have sex with men in Beijing, China. Drug Alcohol Depend 2016; 160:42-8. [PMID: 26796594 PMCID: PMC5321169 DOI: 10.1016/j.drugalcdep.2015.11.037] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 11/23/2015] [Accepted: 11/30/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Although poppers are increasingly popular among MSM in China, little is known about the patterns of poppers use. The objectives of this study were to describe the patterns of poppers use and examine its association with sexual behaviors and HIV infection among MSM in Beijing, China. METHODS As part of a multi-component HIV intervention trial, 3588 MSM were surveyed between March 2013 and March 2014 in Beijing, China. Blood samples were collected and tested for HIV and syphilis. The questionnaire collected information about socio-demographic and behavioral characteristics. Univariate and multivariable logistic regression analyses were performed to evaluate the correlates of poppers use. RESULTS Over a quarter of men (27.5%) reported having used at least one type of drugs in the past three months. Poppers were the most popular one (26.8%). Poppers use was correlated with a higher HIV prevalence [odds ratio (OR): 1.38, 95% confidence interval (CI): 1.11-1.70]. Demographic and sexual behavioral factors associated with poppers use included: younger age [adjusted OR (AOR): 1.56, 95% CI: 1.25-1.94], higher education (AOR: 1.61, 95% CI: 1.33-1.96), alcohol use (AOR: 1.32, 95% CI: 1.10-1.60), seeking male partners mainly via the internet (AOR: 1.60, 95% CI: 1.28-2.00), multiple male sex partnership (AOR: 2.22, 95% CI: 1.90-2.60), and unprotected receptive anal intercourse (AOR: 1.52, 95% CI: 1.28-1.81). CONCLUSIONS In this study, poppers use was positively associated with HIV infection and unprotected anal intercourse. Intervention efforts should be devoted to promote safer sex and HIV testing and counseling among MSM who use poppers.
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Affiliation(s)
- Heng Zhang
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Tao Teng
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Hongyan Lu
- Beijing Center for Disease Control and Prevention, Beijing, China
| | - Yuejuan Zhao
- Beijing Center for Disease Control and Prevention, Beijing, China
| | - Hongjie Liu
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, USA
| | - Lu Yin
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Zheya Sun
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Xiong He
- Beijing Center for Disease Control and Prevention, Beijing, China.
| | - Han-Zhu Qian
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Yuhua Ruan
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Yiming Shao
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Sten H. Vermund
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN, USA
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Yi S, Tuot S, Chhoun P, Pal K, Tith K, Brody C. Factors Associated with Inconsistent Condom Use among Men Who Have Sex with Men in Cambodia. PLoS One 2015; 10:e0136114. [PMID: 26287731 PMCID: PMC4546109 DOI: 10.1371/journal.pone.0136114] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 07/29/2015] [Indexed: 11/29/2022] Open
Abstract
Background Compared to the general population, men who have sex with men (MSM) are at greater risk for HIV and less understood due to their more hidden and stigmatized nature. Moreover, the discrepancy in findings in the literature merits further investigations in MSM populations from different cultures and settings. We therefore conducted this study to explore factors associated with inconsistent condom use among high-risk MSM in Cambodia. Methods This cross-sectional study was conducted in 2014 among 367 MSM randomly selected from Battembang and Siem Reap using a two-stage cluster sampling method. A structured questionnaire was used for face-to-face interviews to collect information on characteristics of respondents, HIV testing history, self-perception of HIV risk, substance use, sexual behaviors, mental disorders, and HIV knowledge. Multivariable logistic regression analysis was performed to identify factors independently associated with inconsistent condom use. Results On average, 62.3% of respondents reported that they always used condoms over the past three months. The rates varied with types of sexual partners; the proportion of respondents who reported always using condoms was 55.1%, 64.2%, 75.9%, 73.0%, 78.1%, and 70.3%, for sexual partners who were girlfriends, boyfriends, female sex workers, male sex workers, female clients, or male clients, respectively. After adjustment, inconsistent condom use was significantly associated with age of ≥25 (AOR = 1.77, 95% CI = 1.09–2.86), self-rated quality of life as good or very good (AOR = 4.37, 95% CI = 1.79–5.67), self-perception of higher HIV risk compared to the general population (AOR = 2.37, 95% CI = 1.35–4.17), illicit drug use in the past three months (AOR = 5.76, 95% CI = 1.65–10.09), and reported consistent lubricant use when selling anal sex to men in the past three months (AOR = 2.85, 95% CI = 1.07–8.12). Conclusions We found risky sexual behaviors to be considerably high among MSM in this study, especially among those who used illicit drugs or were older than 25. HIV education and social marketing should be expanded and specifically designed for MSM to better educate on the increased risk of HIV with unprotected anal sex and illicit drug use as risk factors, and the importance of the use of both condoms and lubricant during anal intercourse.
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Affiliation(s)
- Siyan Yi
- Research Center, KHANA, Phnom Penh, Cambodia
- Center for Global Health Research, Public Health Program, Touro University California, Vallejo, California, United States of America
- * E-mail:
| | | | | | | | - Khimuy Tith
- Research Center, KHANA, Phnom Penh, Cambodia
| | - Carinne Brody
- Center for Global Health Research, Public Health Program, Touro University California, Vallejo, California, United States of America
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