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Adverse childhood experiences, sexual minority stigma, social support and depressive symptoms among Chinese men who have sex with men: A moderated mediation modelling analysis. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04324-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Xue S, Xu W. Childhood Sexual Abuse and Associated Suicidal Ideation and Attempts Among Gay and Bisexual Men in China: A Moderated Mediation Model. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:2881-2909. [PMID: 35608248 DOI: 10.1177/08862605221104528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Childhood sexual abuse (CSA) is a critical risk factor for suicidal ideation and attempts, especially among gay and bisexual men who experience living as a minority. However, whether internalized homophobia (IH) underlies suicide risk and the role of outness to one's family in this association warrants investigation to inform preventive interventions. Using a cross-sectional survey of 570 gay and bisexual men in China, we examined the relationship between CSA and suicidality in the Chinese context and tested a moderated mediation model in this relationship. Nearly 65.6% of the participants had experienced suicidal ideation and 36.8% had attempted suicide. Participants with a history of CSA had higher suicidal ideation (r = 0.33, p < .01) and attempts (r = 0.48, p < .01). Our bootstrapped mediation analysis showed that IH partially mediated the relationship between CSA and suicidal ideation and attempts. Moreover, outness to one's family (parents and other family members) strengthened the direct association of CSA and IH, and the indirect relationship between CSA and suicidal ideation and attempts. These findings highlight the significance of identifying risk factors and mechanisms for suicidality among Chinese gay and bisexual men, suggesting the importance of early intervention, especially for those who have experienced CSA, to eliminate their IH and to improve family support for coming out to prevent the onset of suicidal ideation and attempts.
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Affiliation(s)
- Shuang Xue
- Department of Sociology and Psychology, School of Public Administration, 12530Sichuan University, Chengdu, China
- Institute of Psychology, 12530Sichuan University, Chengdu, China
| | - Wenjian Xu
- Department of Sociology and Psychology, School of Public Administration, 12530Sichuan University, Chengdu, China
- Institute of Psychology, 12530Sichuan University, Chengdu, China
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Solehati T, Pramukti I, Hermayanti Y, Kosasih CE, Mediani HS. Current of Child Sexual Abuse in Asia: A Systematic Review of Prevalence, Impact, Age of First Exposure, Perpetrators, and Place of Offence. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Child sexual abuse (CSA) is a serious global problem and challenge for all people because it increases the risk of various issues.
AIM: This study investigated the CSA in Asian countries focusing on prevalence rates, impact, victim’s age of first exposure, type of CSA, perpetrator, and places of CSA offence.
METHODS: We searched PubMed, Medline, ProQuest, ScienceDirect, CINAHL, Academic Search Complete, ClinicalKey, PsycINFO, Google Scholar, and manual search for studies published between January 2011 and November 2020. Only articles related to CSA in Asia were included in this review.
RESULTS: The results showed that prevalence of CSA ranged from 2.2% - 94% for girls and 1.7% - 49.5% for boys. The prevalence rates for non-contact abuse were 12.6% - 56.5% for girls and 0.7% - 68.7% for boys; contact abuse was 5.3% - 67.2% for girls and 2.2% - 53.3% for boys; penetrating abuse was 0.5% - 88.24% for girls and 1.7% - 57.1% for boys. The findings reported most victims’ age of first exposure was preteen. The rate of the violation occurring in the victim’s house was 6.1% - 41.9%; most CSA perpetrators are known by victims. This study reported adverse impacts on CSA victims such as psychological, health, and physical disorders, and changes in behavior. In addition, other findings were found, including recovery, perceptions, values, causes, and expectations of victims of CSA.
CONCLUSIONS: The incidence of CSA in Asia is still high and the age of the first victims is early adolescence. The majority of victims are women who already know the perpetrator, and taboo cultural factors are thought to play a role in increasing CSA in Asia. The results indicate the need to develop CSA prevention efforts that involve culture.
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Chuang DM, Newman PA, Fang L, Lai MC. Syndemic Conditions, Sexual Risk Behavior, and HIV Infection Among Men Who Have Sex with Men in Taiwan. AIDS Behav 2021; 25:3503-3518. [PMID: 33950337 DOI: 10.1007/s10461-021-03269-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2021] [Indexed: 11/29/2022]
Abstract
Men who have sex with men (MSM) continue to constitute the majority of HIV incidence in Taiwan. This study examined the associations between five co-occurring psychosocial health conditions (PHCs)-childhood physical abuse (CPA), childhood sexual abuse (CSA), intimate partner violence (IPV), internalized homophobia (IH), and methamphetamine use (MU), and two outcomes (HIV infection and condomless anal sex) among a community sample of 1,000 Taiwanese MSM (mean age 28.5 years). Compared to MSM who had never experienced any PHC, MSM with one or more PHCs had greater than twofold higher odds of being HIV-positive, and those with three or more PHCs had twofold higher odds of having condomless anal sex. Interactive effects on HIV infection were identified from CPA + CSA + MU and CPA + IPV + MU. An interactive effect on condomless anal sex was detected between IH and MU. In order to control the escalating HIV epidemic among MSM in Taiwan, interventions are needed to address syndemic psychosocial health conditions.
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Affiliation(s)
- Deng-Min Chuang
- Graduate Institute of Social Work, National Taiwan Normal University, No. 162, Sec. 1, Heping E. Rd., Da'an Dist., Taipei, 106, Taiwan, ROC.
| | - Peter A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Lin Fang
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Meng-Chuan Lai
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Azrieli Adult Neurodevelopmental Centre, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
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Li X, Guo M, Wang W, Wei L, Xiao C, Yu L, Yan H. Association between childhood sexual abuse and patterns of HIV risky sexual behaviors among men who have sex with men in China: A latent class analysis. CHILD ABUSE & NEGLECT 2021; 120:105164. [PMID: 34225216 DOI: 10.1016/j.chiabu.2021.105164] [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: 12/28/2020] [Revised: 05/03/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Increasing prevalence of risky sexual behaviors among men who have sex with men (MSM) exacerbate the transmission of HIV. Previous studies had demonstrated that childhood sexual abuse (CSA) was associated with one or more sexual behaviors, but few studies have been conducted among MSM in China. OBJECTIVE This present study aimed to estimate latent classes of risky sexual behaviors and test for CSA differences in latent class memberships among Chinese MSM. PARTICIPANTS AND SETTING The eligible participants were MSM aged 16 years or older who reported ever having oral or anal sex with men in the past 6 months. METHODS Data were obtained from an anonymous questionnaire between September 2017 to January 2018 in three cities in China, and contained questions about sexual-related behaviors and CSA experience. Latent class analysis (LCA) was used to classify the patterns of sexual behaviors and binomial regression was used to examine the relationships among these variables. RESULTS Among 628 MSM, 22.6% reported experiencing CSA. A two-classes pattern of sexual behaviors was identified, with 46.7% in the low-risk class and 53.3% in the high-risk class. MSM who experienced CSA were more likely to be high-risk group compared to those without CSA experiences [odds ratio (OR) = 1.981; 95% confidence interval (CI) =1.329-2.954)]. CONCLUSIONS CSA was prevalent among Chinese MSM. And MSM with CSA experiences are more prone to be assigned to the high-risk group. Future HIV interventions need to focus on MSM who experienced CSA.
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Affiliation(s)
- Xiaoyan Li
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Menglan Guo
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Wei Wang
- School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Liqing Wei
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Chenchang Xiao
- City College, Wuhan University of Science and Technology, Wuhan, China
| | - Liping Yu
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Hong Yan
- School of Health Sciences, Wuhan University, Wuhan, China.
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Association between sexual abuse victimization during the life course and suicidal behaviors in male and female college students in China: Timing, duration, types and patterns. J Affect Disord 2021; 280:30-38. [PMID: 33221605 DOI: 10.1016/j.jad.2020.11.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/15/2020] [Accepted: 11/08/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND A certain link between sexual abuse (SA) victimization and suicidal behaviors has been confirmed, but it remains unclear whether this association varies with regard to SA characteristics and gender. METHODS Participants were 4034 college students drawn from a cross-sectional study conducted in Hefei, China. Gender-stratified latent class analysis (LCA) and logistic regression models were used to examine the relationships between timing, duration, types and patterns of SA victimization and suicidal behaviors. RESULTS For the males, SA in the elementary school or earlier period was associated with suicidal ideation (OR: 3.29, 95%CI: 2.20-5.38), plans (OR: 3.44, 95% CI: 1.54-7.77) and preparations (OR:3.05, 95% CI: 1.19-7.74). All types of SA were significantly associated with the four types of suicidal behaviors. Dose-response relationship and cumulative effect were found between duration, types of SA victimization and suicidal behaviors. Three latent classes of SA victimization were identified for males and females, respectively. For males, the "moderate SA" class and "persistent SA" class were associated with the four types of suicidal behaviors. For the females, SA during the university period was associated with suicidal ideation (OR: 2.47, 95% CI: 1.24-4.93). Only suicidal ideation was associated with the "moderate SA" class. LIMITATIONS The cross-sectional survey design did not allow to conclude any causality. CONCLUSIONS The relationship between SA victimization and suicidal behaviors varies in terms of SA victimization characteristics and the relationships were stronger in males than in females.
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Xu W, Zheng Y, Kaufman MR. Predictors of Recent HIV Testing Among Chinese Men Who Have Sex with Men: A Barrier Perspective. AIDS Patient Care STDS 2018; 32:408-417. [PMID: 30234365 DOI: 10.1089/apc.2018.0061] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
In China, men who have sex with men (MSM) account for an increasing proportion of new HIV infections. We aim to assess recent HIV testing (in the past 6 months) among Chinese MSM and to identify barriers to testing. A nationwide sample of MSM (n = 1100) from mainland China was recruited. Data on sociodemographics, HIV-related risks, perceived barriers to testing, and testing behaviors were collected. Approximately 30% of MSM had recently undergone HIV testing. With regard to testing, almost half endorsed each of three barriers: did not believe themselves to be at HIV risk, had a fear of being diagnosed HIV positive, and feared their privacy would be violated during testing. Five distinct classes of barriers were identified from the responses. The adjusted multivariable logistic regression model demonstrated that the participants in both the "uncertainty concerning testing sites" and "low risk and privacy violation" classes were less likely to undergo testing than those in the "minimal barrier" class. Men who were unsure of their HIV status were less likely to undergo testing. Furthermore, participants who had multiple male sexual partners and who engaged in substance use over the preceding 6 months were more likely to undergo testing. Distinct subgroups of testing and HIV status varied within the different barrier classifications. Recent HIV testing rates remain low among MSM in China. Barrier factors associated with testing point to the necessity for preventing and controlling HIV, including increasing the privacy of sites or educating MSM on the importance of testing regularly.
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Affiliation(s)
- Wenjian Xu
- Faculty of Psychology, Southwest University, Chongqing, China
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Yong Zheng
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Michelle R. Kaufman
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Xu W, Zheng L, Song J, Zhang X, Zhang X, Zheng Y. Relationship Between Childhood Sexual Abuse and HIV-Related Risks Among Men Who Have Sex with Men: Findings from Mainland China. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1949-1957. [PMID: 29134421 DOI: 10.1007/s10508-017-1104-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/12/2017] [Accepted: 10/21/2017] [Indexed: 06/07/2023]
Abstract
Men who have sex with men (MSM) carry the burden of HIV infection in China. Outside of China, a history of childhood sexual abuse (CSA) has been associated with HIV-related risks (behavioral, sexual, and mental health outcomes) among MSM. We therefore evaluated the relationship between CSA and these HIV-related risks among MSM in China. Cross-sectional data were collected via a survey from gay websites and social networking applications from MSM in 30 provinces in mainland China during a 3-month period in 2014 and 2015. Overall, 999 screened MSM who responded to questions on CSA were included. Multinomial logistic regression models-adjusted for sociodemographic confounders-showed that men who reported experiencing regular CSA and contact CSA, respectively, were more likely to use substances (adjusted odds ratio [AOR], 1.91; 95% confidence interval [CI] 1.39-2.62 and AOR, 1.70; 95% CI 1.25-2.31), had a history of sexually transmitted infections (AOR, 1.81; 95% CI 1.29-2.55 and AOR, 1.65; 95% CI 1.18-2.96), had more male sexual partners (AOR, 1.06; 95% CI 1.04-1.09 and AOR, 1.05; 95% CI 1.03-1.08), engaged in more condomless sex with men (AOR, 1.89; 95% CI 1.39-2.56 and AOR, 1.72; 95% CI 1.29-2.30), and experienced more psychological distress (AOR, 1.05; 95% CI 1.02-1.08 and AOR, 1.05; 95% CI 1.03-1.08). Both frequent and contact forms of CSA were positively associated with HIV-related risks among MSM, suggesting that general CSA prevention strategies and interventions are needed to support this population.
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Affiliation(s)
- Wenjian Xu
- Key Laboratory of Cognition and Personality, Southwest University, Chongqing, China
| | - Lijun Zheng
- Key Laboratory of Cognition and Personality, Southwest University, Chongqing, China
| | - Jingjing Song
- Key Laboratory of Cognition and Personality, Southwest University, Chongqing, China
| | - Xing Zhang
- Key Laboratory of Cognition and Personality, Southwest University, Chongqing, China
| | - Xuemeng Zhang
- Key Laboratory of Cognition and Personality, Southwest University, Chongqing, China
| | - Yong Zheng
- Key Laboratory of Cognition and Personality, Southwest University, Chongqing, China.
- Faculty of Psychology, Southwest University, Chongqing, 400715, China.
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