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Scheadler TR, Rao S, Shuper PA, Beer OWJ, Curtis T, McInroy LB, Eaton AD. Recruiting and Engaging Heterosexual-Identified Men Who have Sex with Men: A Brief Report of Considerations for Sex Researchers. JOURNAL OF SEX RESEARCH 2024:1-9. [PMID: 39037807 DOI: 10.1080/00224499.2024.2380017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
Heterosexual-identified men who have sex with men (H-MSM) are a unique population difficult to identify and recruit for research and practice. Yet, engaging H-MSM remains a top research priority to learn more about this population's health needs. A scoping review was conducted to develop a stronger understanding of recruitment patterns involving H-MSM in research. The search and screening procedures yielded 160 total articles included in the present study. Most studies relied on venue-based and internet-based recruitment strategies. Thematic analysis was then used to identify three themes. Locations of H-MSM's sexual encounters related to where sex researchers may recruit participants; sociocultural backgrounds of H-MSM related to important characteristics researchers should acknowledge and consider when working with H-MSM; and engagement with health services related to how H-MSM interact with or avoid HIV/STI testing and treatment and other public health services. Findings suggest H-MSM have sex with other men in a variety of venues (e.g. bathhouses, saunas) but tend to avoid gay-centric venues. H-MSM also are diverse, and these unique identities should be accounted for when engaging them. Finally, H-MSM are less likely to access healthcare services than other MSM, highlighting the need for targeted advertisements and interventions specific for H-MSM.
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Affiliation(s)
| | - Salem Rao
- Department of Psychology, University of Toronto Mississauga
| | - Paul A Shuper
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health
- Department of Psychiatry and Dalla Lana School of Public Health, University of Toronto, Toronto
| | - Oliver W J Beer
- Social Work & The Centre for Health Technology, University of Plymouth
| | - Tyrone Curtis
- School of Public Health and Social Policy, Faculty of Human and Social Development, University of Victoria
| | | | - Andrew D Eaton
- Faculty of Social Work - Saskatoon Campus, University of Regina
- Factor-Inwentash Faculty of Social Work, University of Toronto
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Smith MK, Wei C, Liu C, Pan SW, Ong JJ, Tucker JD. Gender Identity and Sexual Orientation in Chinese Men Who Have Sex with Men: A Latent Class Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:721-731. [PMID: 31571020 PMCID: PMC7035172 DOI: 10.1007/s10508-019-01481-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 05/24/2019] [Accepted: 06/01/2019] [Indexed: 06/10/2023]
Abstract
Men who have sex with men (MSM) are a diverse population yet are often treated as a monolithic risk group. In China, MSM have long been characterized as a "bridge population" of closeted men who are married to (or will marry) women due to sociocultural expectations. Latent class models can inform a more nuanced yet empirical characterization of this population. In total, 1424 eligible respondents recruited online provided self-reported behavioral data. Nine items related to constructs including sexual behaviors, sexual orientation, and gender identity informed the latent class model. Logistic regression was used to measure associations between latent class membership and HIV-related sexual and health-seeking behaviors. Model fit indicated a population structure made up of four classes that we characterized as "Gender nonconforming" (4.3%), "Closeted-unmarried" (29.9%), "Closeted-married" (24.6%), and "Out" (41.2%). Members of the "gender nonconforming" class were more likely to report HIV-related risk behaviors, and "Closeted-unmarried" class members were less likely to report health-seeking behaviors, both relative to "Out" members. The largest latent class was made up of members of the "Out" class, an enlightening revision of a population traditionally viewed as largely closeted men. Two types of "closeted" classes emerged, distinguished by divergent tendencies regarding marriage and health seeking. Findings suggest that current understandings of Chinese MSM are simplistic (regarding closeted behaviors) and too narrow (in its definition of MSM as cisgender men). A more nuanced understanding of MSM subgroups and their heterogeneous risk behaviors will be critical for provision of more meaningful prevention services.
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Affiliation(s)
- M Kumi Smith
- Division of Epidemiology and Community Health, University of Minnesota Twin Cities, 1300 South 2nd St., Suite 300, Minneapolis, MN, 55454, USA.
- University of North Carolina Project-China, Guangzhou, China.
| | - Chongyi Wei
- University of North Carolina Project-China, Guangzhou, China
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, New Brunswick, NJ, USA
| | - Chuncheng Liu
- University of North Carolina Project-China, Guangzhou, China
- Department of Sociology, University of California San Diego, San Diego, CA, USA
| | - Stephen W Pan
- University of North Carolina Project-China, Guangzhou, China
- Xi'an Jiatong-Liverpool University, Suzhou, China
| | - Jason J Ong
- University of North Carolina Project-China, Guangzhou, China
- London School of Hygiene and Tropical Medicine, London, England, UK
| | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China
- Department of Medicine, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
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Liu Y, Yang M, Zhao C, Tan S, Tang K. Self-identified sexual orientations and high-risk sexual behaviours among Chinese youth. BMJ SEXUAL & REPRODUCTIVE HEALTH 2019; 45:bmjsrh-2018-200150. [PMID: 31413158 DOI: 10.1136/bmjsrh-2018-200150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 05/27/2019] [Accepted: 07/21/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE High-risk sexual behaviour is a factor affecting the health of sexual minority students, yet few related studies have been completed among Chinese students. This article explores the distribution of sexual minority groups and its association with high-risk sexual behaviours and symptoms of sexually transmitted infections(STIs) among Chinese college students. METHODS An internet-based questionnaire was applied, and a sample of 17 966 surveys from 130 Chinese colleges was collected. Based on their self-reports, participants were classified into the following groups: homosexual male or female, heterosexual, bisexual, and sexual orientation unknown. High-risk sexual behaviours were defined as having sexual intercourse before the age of 18 years, having one's sexual debut with a non-regular partner, having had more than four sexual partners before investigation, and having mostly had sexual intercourse without using condoms. Logistic regression models were constructed to analyse the associations. RESULTS The proportions of the homosexual males and females, and the bisexual groups were 1.62%, 0.88% and 5.07%, respectively. Homosexual males were more likely to have their sexual debut with a non-regular partner (OR 4.79, 95% CI 3.38 to 6.78), having more than four sexual partners (OR 5.81, 95% CI 4.06 to 8.32), having their sexual debut before the age of 18 years (OR 1.92, 95% CI 1.34 to 2.76), and not using condoms for most episodes of sexual intercourse (OR 1.47, 95% CI 1.00 to 2.17). Similar associations also existed among homosexual females. A positive association between sexual orientation and having symptoms of STIs (OR 1.49, 95% CI 1.02 to 2.18) was found among homosexual males. CONCLUSIONS Sexual minority groups among Chinese college students had a greater risk of engaging in high-risk sexual behaviours and having STI symptoms. Future studies and interventions should focus on this population.
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Affiliation(s)
- Yuning Liu
- Global Health and Population, Harvard T.H Chan School of Public Health, Boston, MA, USA
- Research Center for Public Health, Tsinghua Univeristy, Beijing, China
| | - Minhui Yang
- Research Center for Public Health, Tsinghua Univeristy, Beijing, China
| | - Chunshan Zhao
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Shihui Tan
- School of Basic Medical Scieinces, Peking University, Beijing, China
| | - Kun Tang
- Research Center for Public Health, Tsinghua Univeristy, Beijing, China
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Guo C, Zhang L, Wang Z, Chen G, Zheng X. Prevalence of and disparities in HIV-related sexual risk behaviours among Chinese youth in relation to sexual orientation: a cross-sectional study. Sex Health 2016; 13:SH15190. [PMID: 27248516 DOI: 10.1071/sh15190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 03/08/2016] [Indexed: 12/18/2022]
Abstract
Background: The aim of this study was to calculate the prevalence rate of HIV-related sexual risk behaviours (HSRB) among Chinese youth and determine whether there was an association between sexual orientation and HSRB. Methods: This study used a nationally representative survey of youth aged 15-24 years in China. Population numbers, prevalence, and proportions were calculated where appropriate. χ2 tests were used to determine the difference within categorical variables. Multivariate logistic regression was used to calculate the adjusted odd ratios (AOR) and 95% confidence interval (CI). Results: The rate of any HSRB among sexually active youth was 79.43%, and the most common HSRB was lack of condom use during the first sexual experience (66.02%). After adjusting for demographic and socioeconomic variables (sex, age, residence, living with parents or not, father's education and annual family income), non-heterosexual orientation was found to significantly increase the odds of HSRB (AOR = 2.42, 95% CI: 1.16-5.05). Conclusions: Non-heterosexual youth are at a higher risk of partaking in HSRB. The high prevalence of HSRB indicates the insufficiency of sex education for Chinese youth, especially for non-heterosexual youth. Greater efforts should be made to increase reproductive and sexual health services for Chinese youth.
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Yan H, Ding Y, Wong FY, Ning Z, Zheng T, Nehl EJ, He N. Epidemiological and molecular characteristics of HIV infection among money boys and general men who have sex with men in Shanghai, China. INFECTION GENETICS AND EVOLUTION 2015; 31:135-41. [PMID: 25653132 DOI: 10.1016/j.meegid.2015.01.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 01/19/2015] [Accepted: 01/25/2015] [Indexed: 11/26/2022]
Abstract
To examine and compare the epidemiological and molecular characteristics of HIV infection between money boys (MBs) and general men who have sex with men (MSM) in Shanghai, China. Using a venue-based sampling strategy, a total of 535 MSM including 226 MBs and 309 general MSM were recruited to participate in a cross-sectional survey including a face-to-face questionnaire interview and HIV testing. Genotyping of HIV-1 pol gene was performed for HIV-positive participants. Compared with general MSM, MBs reported more sexual partners, more alcohol and drug use and more sex after alcohol or drug use. HIV prevalence was 10.7% overall, 14.6% for MBs and 7.8% for general MSM (p=0.011). Two independent multiple logistic regression analyses indicated that HIV infection was positively associated with non-Han ethnicity (Odds Ratio [OR]=4.79, 95% Confidence Interval [CI]: 1.08-21.28) and sex after drug use in the past 6months (OR=3.59, 95% CI: 1.50-8.61) among MBs, and with sex after drug use in the past 6months (OR=3.38, 95% CI: 1.10-10.34) among general MSM as well. HIV-1 pol gene was successfully amplified and sequenced for 52 (91.2%) of HIV-positive participants. Of them, 53.8% were genotyped as CRF01_AE, 36.5% as CRF07_BC and 9.6% as subtype B. Two CRF01_AE subtype-infected participants (3.8%), a 50years old MB and a 24years old general MSM, harbored viruses with a M46L mutation conferring resistance to protease inhibitors (PI). MSM particularly MBs in Shanghai, China were at high risk of HIV infection, underscoring an urgent need for joint intervention efforts for drug use and sexual behaviors. HIV drug resistance surveillance is also warranted although the relatively low prevalence of HIV drug resistance implies the effectiveness of current antiretroviral treatment regimen.
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Affiliation(s)
- Huamei Yan
- Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China
| | - Yingying Ding
- Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China
| | - Frank Y Wong
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA; The Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Zhen Ning
- Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China; Shanghai Center for Disease Control and Prevention, Shanghai, China
| | - Tony Zheng
- Shanghai Piaoxue Cultural Media Limited, Shanghai, China
| | - Eric J Nehl
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Na He
- Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China; Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Xu J, Tang W, Cheng S, Mahapatra T, Zhou L, Lai Y, Jiang Y, Liu F, Zhen X, He J, Zhang J, Lu J, Mahapatra S, Shang H. Prevalence and predictors of HIV among Chinese tuberculosis patients by provider-initiated HIV testing and counselling (PITC): a multisite study in South Central of China. PLoS One 2014; 9:e89723. [PMID: 24586987 PMCID: PMC3931821 DOI: 10.1371/journal.pone.0089723] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 01/22/2014] [Indexed: 12/02/2022] Open
Abstract
Background Tuberculosis (TB) and HIV are two worldwide public health concerns. Co-infection of these two diseases has been considered to be a major obstacle for the global efforts in reaching the goals for the prevention of HIV and TB. Method A comprehensive cross-sectional study was conducted to recruit TB patients in three provinces (Guangxi, Henan and Sichuan) of China between April 1 and September 30, 2010. Results A total of 1,032 consenting TB patients attended this survey during the study period. Among the participants, 3.30% were HIV positive; about one quarter had opportunistic infections. Nearly half of the participants were 50 years or older, the majority were male and about one third were from minority ethnic groups. After adjusting for site, gender and areas of residence (using the partial/selective Model 1), former commercial plasma donors (adjusted OR [aOR] = 33.71) and injecting drug users(aOR = 15.86) were found to have significantly higher risk of being HIV-positivity. In addition, having extramarital sexual relationship (aOR = 307.16), being engaged in commercial sex (aOR = 252.37), suffering from opportunistic infections in the past six months (aOR = 2.79), losing 10% or more of the body weight in the past six months (aOR = 5.90) and having abnormal chest X-ray findings (aOR = 20.40) were all significantly associated with HIV seropositivity (each p<0.05). Conclusions HIV prevalence among TB patients was high in the study areas of China. To control the dual epidemic, intervention strategies targeting socio-demographic and behavioral factors associated with higher risk of TB-HIV co-infection are urgently called for.
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Affiliation(s)
- Junjie Xu
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Weiming Tang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, United States of America
| | - Shiming Cheng
- Center for Tuberculosis Control and Prevention, National Center for Disease Control and Prevention (CDC), Beijing, China
| | - Tanmay Mahapatra
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, United States of America
| | - Lin Zhou
- Center for Tuberculosis Control and Prevention, National Center for Disease Control and Prevention (CDC), Beijing, China
| | - Yuji Lai
- Center for Tuberculosis Control and Prevention, National Center for Disease Control and Prevention (CDC), Beijing, China
| | - Yongjun Jiang
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Feiying Liu
- Center for Tuberculosis Control and Prevention, Guangxi Autonomous Region CDC, Nanning, China
| | - Xinan Zhen
- Center for Tuberculosis Control and Prevention, HenanProvincialCDC, Zhengzhou, China
| | - Jinge He
- Center for Tuberculosis Control and Prevention, SichuanProvincialCDC, Chengdu, China
| | - Jing Zhang
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Jinxin Lu
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Sanchita Mahapatra
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, United States of America
| | - Hong Shang
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
- * E-mail:
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