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Ossa-Giraldo AC, Correa JS, Moreno CL, Blanquiceth Y, Flórez-Álvarez L, Contreras-Ramírez K, Higuita-Gutérrez LF, Hernández JC, Zapata W. Sexual Behaviors and Factors Associated with Condomless Sexual Practice in Colombian Men Who Have Sex with Men at High Risk of HIV Transmission. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:3175-3190. [PMID: 33829332 DOI: 10.1007/s10508-020-01856-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 06/12/2023]
Abstract
Men who have sex with men (MSM) have a disproportionate burden of HIV infection worldwide. In Colombia, the prevalence of HIV in MSM is ~ 43 times higher than in the general population (17% vs. 0.4%). This study determined the sexual behaviors, HIV serostatus, and associated factors with condomless sexual practice with both regular and casual partners in 92 MSM from Medellín, Colombia. The subjects were recruited through a community-based approach, and the data were collected by a structured survey and in-depth interviews. Participants were classified into three groups according to the number of sexual partners in the last three months, to compare the sociodemographic conditions and sexual behaviors. Univariate analysis was described by absolute and relative frequencies; bivariate analysis and multivariate logistic regression were used to compare the groups and to explore the associated factors with condomless sexual practice. The overall HIV estimated prevalence was 4.3%, while the estimated prevalence for MSM with > 10 sexual partners in the last three months was 14.8%. This last group showed higher average age, higher percentage of subjects who have had sex with people living with HIV, and increased frequency of previous sexually transmitted infections. Having condomless sex with casual partners was associated with the number of sexual partners in the last three months. This study demonstrates that Colombian MSM continue to have a high risk of HIV infection/transmission and reinforce the need to implement adequate prevention programs, PrEP and guarantee access to treatment for people living with HIV.
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Affiliation(s)
- Ana Claudia Ossa-Giraldo
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia.
| | - John Sebastián Correa
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia
| | - Cristhian Leonardo Moreno
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia
| | - Yurany Blanquiceth
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia, UdeA, Medellín, Colombia
| | - Lizdany Flórez-Álvarez
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia, UdeA, Medellín, Colombia
| | - Katherin Contreras-Ramírez
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia, UdeA, Medellín, Colombia
| | - Luis Felipe Higuita-Gutérrez
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia
| | - Juan Carlos Hernández
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia, UdeA, Medellín, Colombia
| | - Wildeman Zapata
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia, UdeA, Medellín, Colombia
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Ofreneo MAP, Gamalinda TB, Canoy NA. Culture-embedded drivers and barriers to (non) condom use among Filipino MSM: a critical realist inquiry. AIDS Care 2020; 33:1430-1435. [PMID: 32741207 DOI: 10.1080/09540121.2020.1801979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This qualitative study examines the drivers and barriers of condom use among Filipino men who have sex with men (MSM) using a critical realist inquiry (i.e., shared meanings, norms, and practices related to condom use). Thematic analysis was used to analyze interviews of 105 MSM participants across 21 cities in the Philippines. Key findings showed three social structures that shape how participants view sexual partners as safe (linked to non-condom use) or unsafe (linked to condom use). First, classism is linked to relative economic social position of sexual partner (lower socio-economic class as unsafe; higher socio-economic class as safe). Second, heteronormativity is linked to relationship arrangements (multiple partner as unsafe; exclusive partner as safe) and identity categories (bisexuals as unsafe; straight men are safe). Third, body-ism is linked with notions of health (looks sick as unsafe; looks healthy as safe) and appearance (not good looking as unsafe). Sexual partners perceived as good looking can be construed as either safe or unsafe. Discussion points highlight importance of understanding the cultural and material contexts of looking and sounding educated, looking healthy, looking physically attractive vis-à-vis promoting condom use.
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Affiliation(s)
| | - Tristan B Gamalinda
- Department of Psychology, Ateneo de Manila University, Quezon City, Philippines
| | - Nico A Canoy
- Department of Psychology, Ateneo de Manila University, Quezon City, Philippines
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Wu AMS, Lau JTF, Wang Z, Ma L. Prevalence and Factors of Concurrent Multiple Male Sex Partnership Among Men Who Have Sex With Men With Regular Sex Partners in Beijing, China. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:247-258. [PMID: 30672392 DOI: 10.1080/0092623x.2018.1518883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study was to test whether the cognitive factors of the theory of planned behavior were associated with concurrent multiple male sex partnership (CMMSP) status (past three months) and intention to have CMMSP (next six months) among 251 men who have male regular sex partners in Beijing, China. The prevalence of having had CMMSP and intention to do so was 48.2% and 28.7%, respectively. Positive attitudes toward CMMSP, injunctive norm for not having CMMSP, and behavioral control for not having CMMSP were significantly associated with behavioral intention. Descriptive norm and perceived behavioral control were significant factors for CMMSP status.
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Affiliation(s)
- Anise M S Wu
- a Department of Psychology, Faculty of Social Sciences , University of Macau , Macao , China
| | - Joseph T F Lau
- b Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong , Shatin , Hong Kong
| | - Zixin Wang
- b Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong , Shatin , Hong Kong
- c Shenzhen Research Institute, The Chinese University of Hong Kong , Shenzhen , China
| | - Lu Ma
- b Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong , Shatin , Hong Kong
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4
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Wang C, Tucker JD, Liu C, Zheng H, Tang W, Ling L. Condom use social norms and self-efficacy with different kinds of male partners among Chinese men who have sex with men: results from an online survey. BMC Public Health 2018; 18:1175. [PMID: 30326880 PMCID: PMC6192108 DOI: 10.1186/s12889-018-6090-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 10/04/2018] [Indexed: 01/09/2023] Open
Abstract
Background Social norms and self-efficacy play important roles in promoting consistent condom use among men who have sex with men (MSM). Few studies have investigated the association between social norms, self-efficacy and consistent condom use with different kinds of male partners among MSM. We conducted an online survey of MSM to evaluate this in China. Methods A cross-sectional online survey was conducted in 2015. Participants completed a validated questionnaire covering socio-demographic information, consistent condom use, condom use social norms and self-efficacy. Eligible participants were 16 or older, born biologically as a male, engaged in anal sex with a man at least once during their lifetime, engaged in condomless anal or vaginal sex in the last three months. In this study, we further restricted to people who had sex with male partners in the last three months. Participants were classified into three groups: engaged in sex only with regular partners, engaged in sex only with casual partners and engaged in sex with both regular partners and casual partners. Results Participants were recruited from 32 provinces in China. Among 1057 participants, 451(42.7%), 217(20.5%), and 389(36.8%) engaged in sex with regular partners only, casual partners only and both types in the last three months, respectively. Men engaged in sex only with regular partners in the last three months had a higher condom use self-efficacy than with other two types of partners (P < 0.01). Both social norms (regular partners: adjusted OR:1.59, 95% CI: 0.97–2.60; casual partners: adjusted OR: 1.58, 95% CI: 1.19–2.09; both types: adjusted OR: 1.48, 95% CI: 1.13–1.95) and self-efficacy (regular partners: adjusted OR: 2.88, 95% CI: 1.59–5.22; casual partners: adjusted OR: 2.35, 95% CI: 1.69–3.26; both types: adjusted OR: 2.45, 95% CI: 1.81–3.32) were positively associated with consistent condom use. No interaction effect was detected between condom social norms and self-efficacy on consistent condom use among Chinese MSM (p > 0.05). Conclusions Both social norms and self-efficacy were positively correlated with consistent condom use with any types of partners among Chinese MSM. Tailored interventions that aimed to improve social norms and self-efficacy has the potential to improve overall condom use among Chinese MSM. Trial registration ClinicalTrials.gov: NCT02516930. August 6, 2015. Electronic supplementary material The online version of this article (10.1186/s12889-018-6090-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cheng Wang
- Dermatology Hospital, Southern Medical University, Guangzhou, China.,Guangdong Center for Skin Diseases and STI Control, Guangzhou, China
| | - Joseph D Tucker
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China.,SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China.,School of Medicine of University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Chuncheng Liu
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China.,SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China
| | - Heping Zheng
- Dermatology Hospital, Southern Medical University, Guangzhou, China.,Guangdong Center for Skin Diseases and STI Control, Guangzhou, China
| | - Weiming Tang
- Dermatology Hospital, Southern Medical University, Guangzhou, China. .,Guangdong Center for Skin Diseases and STI Control, Guangzhou, China. .,University of North Carolina at Chapel Hill Project-China, Guangzhou, China. .,SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China. .,School of Medicine of University of North Carolina at Chapel Hill, Chapel Hill, USA.
| | - Li Ling
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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He J, Xu HF, Cheng WB, Zhang SJ, Gu J, Hao YT, Hao C. Intimate relationship characteristics as determinants of HIV risk among men who have sex with regular male sex partners: a cross-sectional study in Guangzhou, China. BMC Infect Dis 2018; 18:150. [PMID: 29606100 PMCID: PMC5879993 DOI: 10.1186/s12879-018-3044-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 03/12/2018] [Indexed: 11/10/2022] Open
Abstract
Background China faces a serious HIV epidemic among men who have sex with men (MSM), and a large proportion of new infections are attributed to their regular male sex partners (RP). The objective of this study was to investigate the association between intimate relationship characteristics and HIV-related behaviors among MSM with RP in Guangzhou, China. Methods A convenience-sampling method was used in data collection. A total of 608 MSM were screened, of whom 406 HIV negative MSM with at least one RP in the past six months were used for data analysis. Three-step logistic regressions were used to analyze the data. Results The prevalence of unprotected anal intercourse (UAI) with regular male sex partners, non-regular male sex partners, and concurrent UAI in the past six months was 53.9%, 23.6%, 20.7%, respectively. Variables associated with UAI with regular male sex partners included expectations for this relationship (adjusted odds ratio in multiple forward stepwise logistic regression, ORm = 1.66) and open communication about the sexual relationship (ORm = 1.79), while expectations for the relationship (ORm = 0.46 to 0.54) and conflicts of interest (ORm = 5.46 to 5.97) were associated with concurrent UAI and UAI with non-regular male sex partners. Conclusion Intimate relationship characteristics were related to HIV-related risk behaviors. Future HIV prevention interventions should take MSM couples into consideration, include a focus on the quality of their intimate relationships, and encourage open communication about their sexual relationships. Electronic supplementary material The online version of this article (10.1186/s12879-018-3044-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Juan He
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China
| | - Hui-Fang Xu
- Department of HIV/AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, 510440, People's Republic of China
| | - Wei-Bin Cheng
- Department of HIV/AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, 510440, People's Republic of China
| | - Sheng-Jie Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China.,Current address: Medical Research & Biometrics Center, National Center for Cardiovascular Disease, Chinese Academy of Medical Science & Peking Union Medical College, A105, Xishan Institute of Fuwai Hospital, Fengcunxili, Mentougou Dist, Beijing, 102300, China
| | - Jing Gu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China.,Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, Guangdong, 510080, People's Republic of China.,Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, People's Republic of China
| | - Yuan-Tao Hao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China.,Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, Guangdong, 510080, People's Republic of China.,Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, People's Republic of China
| | - Chun Hao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China. .,Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, Guangdong, 510080, People's Republic of China. .,Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, People's Republic of China.
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Hickson DA, Mena LA, Wilton L, Tieu HV, Koblin BA, Cummings V, Latkin C, Mayer KH. Sexual Networks, Dyadic Characteristics, and HIV Acquisition and Transmission Behaviors Among Black Men Who Have Sex With Men in 6 US Cities. Am J Epidemiol 2017; 185:786-800. [PMID: 28402405 DOI: 10.1093/aje/kww144] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 03/15/2016] [Indexed: 12/24/2022] Open
Abstract
The role of sexual networks in the epidemiology of human immunodeficiency virus (HIV) among black men who have sex with men (MSM) is poorly understood. Using data from 1,306 black MSM in the BROTHERS Study (2009-2010) in the United States, we examined the relationships between multiple sexual dyadic characteristics and serodiscordant/serostatus-unknown condomless sex (SDCS). HIV-infected participants had higher odds of SDCS when having sex at least weekly (odds ratio (OR) = 2.41, 95% confidence interval (CI): 1.37, 4.23) or monthly (OR = 1.94, 95% CI: 1.17, 3.24) versus once to a few times a year. HIV-uninfected participants had higher odds of SDCS with partners met offline at sex-focused venues (OR = 1.79, 95% CI: 1.15, 2.78) versus partners met online. In addition, having sex upon first meeting was associated with higher odds of SDCS (OR = 1.49, 95% CI: 1.21, 1.83) than was not having sex on first meeting, while living/continued communication with sexual partner(s) was associated with lower odds of SDCS (weekly: OR = 0.64, 95% CI: 0.47, 0.85; monthly: OR = 0.60, 95% CI: 0.44, 0.81; yearly: OR = 0.58, 95% CI: 0.39, 0.85) versus discontinued communication. Persons with primary/steady nonprimary partners versus commercial partners had lower odds of SDCS regardless of HIV serostatus. This suggests the need for culturally relevant HIV prevention efforts for black MSM that facilitate communication with sexual partners especially about risk reduction strategies, including preexposure prophylaxis.
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Affiliation(s)
- DeMarc A Hickson
- Department of Epidemiology and Biostatistics, Jackson State University, School of Public Health, Jackson, MS
| | - Leandro A Mena
- Department of Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39213, USA
| | - Leo Wilton
- Department of Human Development, State University of New York at Binghamton, Binghamton, NY, USA
- Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Hong-Van Tieu
- New York Blood Center and Columbia University Medical Center, New York, NY, USA
| | - Beryl A Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States
| | - Vanessa Cummings
- National Institute of Water and Atmospheric Research (NIWA), Wellington, New Zealand
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kenneth H Mayer
- Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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Liu C, Mao J, Wong T, Tang W, Tso LS, Tang S, Zhang Y, Zhang W, Qin Y, Chen Z, Ma W, Kang D, Li H, Liao M, Mollan K, Hudgens M, Bayus B, Huang S, Yang B, Wei C, Tucker JD. Comparing the effectiveness of a crowdsourced video and a social marketing video in promoting condom use among Chinese men who have sex with men: a study protocol. BMJ Open 2016; 6:e010755. [PMID: 27697868 PMCID: PMC5073617 DOI: 10.1136/bmjopen-2015-010755] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Crowdsourcing has been used to spur innovation and increase community engagement in public health programmes. Crowdsourcing is the process of giving individual tasks to a large group, often involving open contests and enabled through multisectoral partnerships. Here we describe one crowdsourced video intervention in which a video promoting condom use is produced through an open contest. The aim of this study is to determine whether a crowdsourced intervention is as effective as a social marketing intervention in promoting condom use among high-risk men who have sex with men (MSM) and transgender male-to-female (TG) in China. METHOD We evaluate videos developed by crowdsourcing and social marketing. The crowdsourcing contest involved an open call for videos. Entries were judged on capacity to promote condom use, to be shareable or 'go viral' and to give value to the individual. 1170 participants will be recruited for the randomised controlled trial. Participants need to be MSM age 16 and over who have had condomless anal sex in the last 3 months. Recruitment will be through an online banner ad on a popular MSM web page and other social media platforms. After completing an initial survey, participants will be randomly assigned to view either the social marketing video or the crowdsourcing video. Follow-up surveys will be completed at 3 weeks and 3 months after initial intervention to evaluate condomless sex and related secondary outcomes. Secondary outcomes include condom social norms, condom negotiation, condom self-efficacy, HIV/syphilis testing, frequency of sex acts and incremental cost. ETHICS AND DISSEMINATION Approval was obtained from the ethical review boards of the Guangdong Provincial Center for Skin Diseases and STI Control, UNC and UCSF. The results of this trial will be made available through publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT02516930.
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Affiliation(s)
- Chuncheng Liu
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
| | - Jessica Mao
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
| | - Terrence Wong
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
| | - Weiming Tang
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
| | - Lai Sze Tso
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
| | - Songyuan Tang
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
| | - Ye Zhang
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
- Guangdong Provincial Center for Skin Diseases and Sexually Transmitted Infections Control,Guangzhou, China
| | - Wei Zhang
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
| | - Yilu Qin
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
| | | | - Wei Ma
- Shandong University School of Public Health, Jinan, China
| | - Dianming Kang
- Shandong Center for Disease Prevention and Control, Jinan, China
| | - Haochu Li
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
- Shandong University School of Public Health, Jinan, China
| | - Meizhen Liao
- Shandong Center for Disease Prevention and Control, Jinan, China
| | - Katie Mollan
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Michael Hudgens
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Barry Bayus
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shujie Huang
- Guangdong Provincial Center for Skin Diseases and Sexually Transmitted Infections Control,Guangzhou, China
| | - Bin Yang
- Guangdong Provincial Center for Skin Diseases and Sexually Transmitted Infections Control,Guangzhou, China
| | - Chongyi Wei
- University of California, San Francisco, San Francisco, California, USA
| | - Joseph D Tucker
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
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8
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Yeo TED, Fung TH. Between '0' and '1': safer sex and condom use among young gay men in Hong Kong. CULTURE, HEALTH & SEXUALITY 2015; 18:294-307. [PMID: 26389565 DOI: 10.1080/13691058.2015.1080298] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Young men who have sex with men are becoming the most at-risk subgroup for HIV incidence in Hong Kong. To understand how young gay men in Hong Kong interpret and implement safer sex and condom use, focus-group discussions and individual in-depth interviews were held. The 74 participants were nearly all ethnic Chinese gay men aged between 18 and 25 years. Findings indicate that the challenge for health intervention lies in young gay men's inconsistent condom use despite their high level of HIV-related knowledge. Participants described using condoms, testing for HIV and abstaining from anal sex as measures undertaken to prevent HIV infection. However, sociocultural norms and expectations pertaining to '0' (docile, bottom) and '1' (assertive, top) roles and trust between partners complicate the consistent implementation of risk-reduction measures. Influenced by heteronormative and romantic beliefs, sexual behaviours such as condomless anal sex and internal ejaculation hold symbolic meanings - exclusivity, commitment, intimacy, possession - for young gay men in Hong Kong, which override health concerns. These findings support more empowerment-driven HIV programming for young gay men.
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Affiliation(s)
- Tien Ee Dominic Yeo
- a Department of Communication Studies , Hong Kong Baptist University , Hong Kong
| | - Tsz Hin Fung
- a Department of Communication Studies , Hong Kong Baptist University , Hong Kong
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9
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Cuervo M, Whyte J. The Effect of Relationship Characteristics on HIV Risk Behaviors and Prevention Strategies in Young Gay and Bisexual Men. J Assoc Nurses AIDS Care 2015; 26:399-410. [PMID: 26066694 DOI: 10.1016/j.jana.2015.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 03/30/2015] [Indexed: 10/23/2022]
Abstract
We examined whether relationship status, relationship ideation, and sexual agreements affected HIV/sexually transmitted disease (STD) prevention strategies and high-risk behaviors in young men who have sex with men (MSM). Using an online survey, we found that partnered MSM more commonly used condoms with casual partners and knew the reported HIV status of all their partners, compared to single MSM (p < .05). Men scoring high in relationship exclusivity reported higher condom use with casual partners compared to men scoring lower (p < .05). Of partnered MSM, 58% reported a sexual agreement. MSM reporting restricted sexual agreements more commonly used condoms during oral and anal intercourse with their main partners and casual partners compared to MSM reporting unrestricted sexual agreements. The data suggest that relationship status should be considered by health care providers when counseling MSM and that behavioral interventions should target sexual agreements as a mechanism to reduce HIV/STD transmission.
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10
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Li D, Li C, Wang Z, Lau JTF. Prevalence and associated factors of unprotected anal intercourse with regular male sex partners among HIV negative men who have sex with men in China: a cross-sectional survey. PLoS One 2015; 10:e0119977. [PMID: 25816292 PMCID: PMC4376721 DOI: 10.1371/journal.pone.0119977] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 02/03/2015] [Indexed: 11/18/2022] Open
Abstract
The HIV prevalence and incidence among men who have sex with men (MSM) in China are high. Unprotected anal intercourse (UAI) with a regular male sex partner (RP), a significant predictor of HIV sero-conversion, was high yet under-emphasized among MSM having RP (MSMRP). The present cross-sectional survey interviewed 307 HIV negative MSMRP recruited through convenient sampling from multiple sources, including venue-based outreaching, online recruitment, and referrals made by peers, in Beijing and Chengdu, China. Among MSMRP, the prevalence of UAI with RP in the last three months was 52.4%. The results of the multivariate analysis showed that trust and intimacy within the relationship with RP and presence of clinical depression symptoms were positively associated with UAI with RP in the last three months. Other associated scalar factors derived from the Theory of Planned Behavior were related to perceptions on condom use, including positive attitudes toward condom use (a negative association), subjective norm of the perception that MSM do not usually use condoms during anal intercourse with RP (a positive association), perceived behavioral control over condom use with RP (a negative association), and behavioral intention to use condoms with RP in the coming three months (a negative association). It is seen that MSMRP were at high risk of HIV/STD transmission. The associated factors hence involved those related to perceptions about condom use, mental health, and interpersonal relationship. Future interventions should take these multi-dimensional factors into account. In particular, future research to test the efficacy of couple-based interventions that include mental health elements needs to be conducted, as trust and intimacy within the relationship were associated with UAI among MSMRP, and mental health problems may exist for both the MSMRP and their RP.
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Affiliation(s)
- Dongliang Li
- Chaoyang Center for Disease Control and Prevention, Beijing, China
| | - Chunrong Li
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- CUHK Shenzhen Research Institute (SZRI), Shenzhen, China
| | - Joseph T. F. Lau
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- CUHK Shenzhen Research Institute (SZRI), Shenzhen, China
- Centre for Medical Anthropology and Behavioral Health, Sun Yat-sen University, China
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Bui TC, Nyoni JE, Ross MW, Mbwambo J, Markham CM, McCurdy SA. Sexual motivation, sexual transactions and sexual risk behaviors in men who have sex with men in Dar es Salaam, Tanzania. AIDS Behav 2014; 18:2432-41. [PMID: 24890184 DOI: 10.1007/s10461-014-0808-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Understanding the associations between sexual motivation and sexual risk behaviors of men who have sex with men (MSM) is critical for developing effective HIV prevention interventions. To examine these associations, we employed data from a survey of 200 MSM in Dar es Salaam, Tanzania, recruited through respondent driven sampling. Results showed that 44.5 % of surveyed participants most often looked for love/affection when having sex, and 36.5 % most often looked for money. Money-motivated MSM were more likely to identify themselves as bisexual, more likely to have anal sex, and had significantly higher numbers of partners of both sexes. Those who most often looked for love/affection were less likely to ask for condom use, to actually use a condom, and to use lubrication in anal sex. MSM with different sexual motivations had dissimilar sexual risk behaviors. Tailored health interventions for each group to reduce these sexual risks for STIs/HIV prevention are needed.
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Tucker JD, Muessig KE, Cui R, Bien CH, Lo EJ, Lee R, Wang K, Han L, Liu FY, Yang LG, Yang B, Larson H, Peeling RW. Organizational characteristics of HIV/syphilis testing services for men who have sex with men in South China: a social entrepreneurship analysis and implications for creating sustainable service models. BMC Infect Dis 2014; 14:601. [PMID: 25422065 PMCID: PMC4247875 DOI: 10.1186/s12879-014-0601-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Accepted: 10/31/2014] [Indexed: 11/10/2022] Open
Abstract
Background UNAIDS has called for greater HIV/syphilis testing worldwide just as local HIV/syphilis testing programs are cut or altered. New models are needed to make HIV/syphilis testing services sustainable while retaining their essential public health function. Social entrepreneurship, using business principles to promote a social cause, provides a framework to pilot programs that sustainably expand testing. Drawing on fieldwork in two South Chinese cities, we examined organizational and financial characteristics of current HIV/syphilis testing systems for men who have sex with men (MSM) in addition to new pilot programs focused on revenue-generation for sustainability. Methods We undertook a qualitative study to explore organizational and financial characteristics of HIV/syphilis testing for MSM. Data were collected from men who have sex with men and policy stakeholders in Guangzhou and Hong Kong. Framework analysis was used to identify themes and then code the data. Results Our qualitative research study included MSM and policy stakeholders (n = 84). HIV/syphilis testing services were implemented at a wide range of organizations which we grouped broadly as independent community-based organizations (CBOs), independent clinics, and hybrid CBO-clinic sites. From an organizational perspective, hybrid CBO-clinic sites offered the inclusive environment of an MSM CBO linked to the technical capacity and trained staff of a clinic. From a financial perspective, stakeholders expressed concern about the sustainability and effectiveness of sexual health services reliant on external funding. We identified four hybrid CBO-clinic organizations that launched pilot testing programs in order to generate revenue while expanding HIV testing. Conclusion Many MSM CBOs are searching for new organizational models to account for decreased external support. Hybrid CBO-clinic organizations create a strong foundation to increase HIV/syphilis testing using social entrepreneurship models in China. Electronic supplementary material The online version of this article (doi:10.1186/s12879-014-0601-5) contains supplementary material, which is available to authorized users.
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Understanding the meaning of short-term, yiyeqing relationships and how they are formed: implications for condom use in Liuzhou, China. AIDS Behav 2014; 18 Suppl 2:S126-34. [PMID: 23632897 DOI: 10.1007/s10461-013-0489-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Yiyeqing (YYQ) ("one night love", i.e., having sex only once with a non-commercial partner) has increased in China, concomitant with the increase in heterosexual transmission of sexually transmitted infections/human immunodeficiency virus (STI/HIV). Our study explored how participants who had experienced YYQ understood these relationships and characterized YYQ's links to sexual risk behaviors. We conducted in-depth interviews with 45 adults in Liuzhou, a city in southwest China, who had YYQ experience. We analyzed the findings using social construction to interpret the participants' understandings of YYQ. Participants reported that they tend to select YYQ partners whom they trust, which is built through introductions from social connections and within entertainment venues, resulting in the belief that their partners are free of STI/HIV and do not require protected sex. As YYQ relationships become more common, understanding the nature of these relationships is critical for developing public health messages that convey the risks associated with sex in short-term relationships and the need for condoms.
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