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Huang Y, Zhou Y, Hong Y, Dai W, Lin K, Liu Y, Yan Y, Huang S, Li X, Yang Y, Jiang H. Development of a risk estimation model for condomless sex among college students in Zhuhai, China: a cross-sectional study. BMC Public Health 2024; 24:742. [PMID: 38459535 PMCID: PMC10921646 DOI: 10.1186/s12889-024-18183-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/22/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Condom use at last intercourse is an effective indicator for human immunodeficiency virus (HIV) prevention. To identify at-risk individuals and improve prevention strategies, this study explored factors associated with condomless sex at last intercourse in the last year and developed a risk estimation model to calculate the individual possibility of condomless sex among college students in Zhuhai, China. METHODS A cross-sectional study was conducted among 1430 college students who had sex in the last year from six universities in Zhuhai. The least absolute shrinkage and selection operator (LASSO) and logistic regression were performed to explore the predictors of condomless sex. The nomogram was constructed to calculate the individual possibility of condomless sex. Discrimination and calibration of the nomogram were evaluated using the area under the receiver-operator characteristic curve (AUROC) and the calibration curve. RESULTS The proportion of students who had condomless sex at last intercourse was 18.2% (260/1430). Students who had experienced more types of intimate partner violence (aOR, 1.58; 95% CI, 1.31 ~ 1.92) and had anal sex (aOR, 1.75; 95% CI, 1.06 ~ 2.84) were more likely to have condomless sex. Students who had heterosexual intercourse (aOR, 0.37; 95% CI, 0.21 ~ 0.70), used condoms at first sex (aOR, 0.20; 95% CI, 0.14 ~ 0.27), had high attitudes towards condom use (aOR, 0.87; 95% CI, 0.80 ~ 0.95) and self-efficacy for condom use (aOR, 0.84; 95% CI, 0.78 ~ 0.90) were less likely to have condomless sex. The nomogram had high accuracy with an AUROC of 0.83 and good discrimination. CONCLUSIONS Intimate partner violence, anal sex, condom use at first sex, attitude towards condom use, and self-efficacy for condom use were associated with condomless sex among college students. The nomogram was an effective and convenient tool for calculating the individualized possibility of condomless sex among college students. It could help to identify individuals at risk and help universities and colleges to formulate appropriate individualized interventions and sexual health education programs.
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Affiliation(s)
- Ying Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yi Zhou
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Yeting Hong
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Wencan Dai
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Kaihao Lin
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yawei Liu
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Yao Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Shanzi Huang
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Xiaofeng Li
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Yi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Hongbo Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
- Institute for Global Health, University College London, London, UK.
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2
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Lin K, Tan Z, Li J, Cheng W, Yang Y, Jiang H. Prevalence of and Factors Associated With Intimate Partner Violence Victimhood Among Men Who Have Sex With Men in Guangzhou, China. Sex Transm Dis 2023; 50:432-438. [PMID: 36943817 DOI: 10.1097/olq.0000000000001807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND Intimate partner violence (IPV) has been a concern among men who have sex with men (MSM), but less attention has been paid to the factors associated with this population in China. AIMS We investigated the prevalence of and factors associated with IPV victimhood among MSM in Guangzhou, China. METHODS Men who have sex with men were recruited from May to November 2017, and data were collected using an anonymous electronic questionnaire. χ2 Tests and nonconditional logistic regressions were used to explore the factors associated with IPV victimhood. RESULTS A total of 129 in 976 MSM (13.22%) reported experiencing IPV victimhood. Multivariable logistic regression analysis showed that individuals who had condomless anal intercourse (CAI; adjusted odds ratio [aOR], 1.47; 95% confidence interval [CI], 1.00-2.17) or had sex with a female partner (aOR, 1.81; 95% CI, 1.15-2.83) in the past 6 months were at a higher risk of IPV victimhood. Participants who had ever experienced child sexual abuse (CSA) were more likely to experience IPV (aOR, 1.97; 95% CI, 1.32-2.94). Individuals who used rush poppers before sex had a higher risk of IPV (aOR, 1.79; 95% CI, 1.21-2.63). In addition, ever having sex with a female sex partner (aOR, 1.65; 95% CI, 1.04-2.60), ever having used rush poppers before sex (aOR, 1.79; 95% CI, 1.22-2.64) in the past 6 months, and ever having experienced CSA (aOR, 2.01; 95% CI, 1.35-3.01) were associated with experiencing more types of IPV. CONCLUSIONS Intimate partner violence victimhood was relatively common among MSM in Guangzhou, particularly among those who had CAI, experienced CSA, had sex with a female partner, used rush poppers before sex, and with less education.
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Affiliation(s)
| | - Zhimin Tan
- From the Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, Guangzhou
| | - Jing Li
- From the Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, Guangzhou
| | - Weibin Cheng
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yi Yang
- From the Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, Guangzhou
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3
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Meinhart M, Seff I, Villaveces A, Roa AH, Stark L. Violence Exposure Among Adolescent Boys and Young Men in Colombia With a Lifetime History of Transactional Sex. J Adolesc Health 2022; 71:696-704. [PMID: 36088231 PMCID: PMC9891716 DOI: 10.1016/j.jadohealth.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/13/2022] [Accepted: 07/21/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE There is a paucity of research examining the contextual factors that shape the violence experienced by those engaged in transactional sex, particularly among adolescent boys and young men. Recognizing the acute vulnerability among youth engaged in transactional sex, this analysis examined the associations between lifetime transactional sex and experience of violence among 13- to 24-year-old males. METHODS Using data from two strata of the 2018 Violence Against Children and Youth Survey from Colombia, logistic regressions were used to estimate the association between engagement in transactional sex and violence exposure. Three groups of violence outcomes were examined: violence victimization, violence perpetration, and witnessing violence. RESULTS Violence victimization and witnessing violence were widespread. Adolescent boys and young men with a lifetime history of transactional sex were significantly more likely to experience violence victimization than those without a lifetime history of transactional sex, particularly intimate partner violence (adjusted odds ratio [aOR]: 5.23 and 5.41) and caregiver emotional violence (aOR: 7.23 and 8.74). In the national and priority samples respectively, those with a lifetime history of transactional sex were also significantly more likely to witness violence within the home (aOR: 4.42 and 4.99) and outside of the home (aOR: 7.24 and 28.32). DISCUSSION Although research is needed to determine causal pathways, our findings highlight the ubiquity of violence and the criticality of supporting this group of adolescent boys and young men. Interventions for those with a history of transactional sex should address factors that may contribute to drivers of violence and transactional sex.
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Affiliation(s)
- Melissa Meinhart
- National Coalition of Independent Scholars, Brattleboro, Vermont
| | - Ilana Seff
- Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri
| | - Andrés Villaveces
- Division of Violence Prevention, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Lindsay Stark
- Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri.
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4
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Chuang DM, Newman PA, Fang L, Lai MC. Familism and HIV Risk Among Men Who Have Sex With Men in Taiwan: The Mediating Roles of Stressful Life Events and Coping Strategies. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:1-S2. [PMID: 35192392 DOI: 10.1521/aeap.2022.34.1.1] [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: 06/14/2023]
Abstract
Familism may play an important role in HIV risk behaviors among men who have sex with men (MSM) living in a collectivist culture. This study examined a hypothesized path from familism, stressful life events (i.e., adverse childhood experiences, intimate partner violence, and sexuality-related discriminatory experiences), and coping strategies to condomless anal sex (CAS) among Taiwanese MSM. Participants were 1,000 MSM (mean age = 28.5 years) recruited through five community-based organizations. Structural equation modeling using bootstrapping with 3,000 iterations evaluated the mediating effects of 14 coping strategies. We found a pathway from familism to CAS through stressful life events and substance use coping. The protective effects of familism on stressful life events and CAS suggest that integrating components of family support and family connection into HIV prevention and education programs may increase the effectiveness of these programs in reducing HIV risk behaviors and dysfunctional coping strategies among MSM in Taiwan.
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Affiliation(s)
- Deng-Min Chuang
- Assistant Professor at the Graduate Institute of Social Work, National Taiwan Normal University
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5
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Valente PK, Edeza A, Masvawure TB, Sandfort TGM, Gichangi PB, Restar AJ, Tocco JU, Chabeda SV, Lafort Y, Mantell JE. Violence and Victimization in Interactions Between Male Sex Workers and Male Clients in Mombasa, Kenya. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP1784-NP1810. [PMID: 32552195 PMCID: PMC7612270 DOI: 10.1177/0886260520922361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Male sex workers (MSWs) and male clients (MCMs) who engage their services face increased vulnerability to violence in Kenya, where same-sex practices and sex work are criminalized. However, little is known about how violence might arise in negotiations between MSWs and MCMs. This study explored the types of victimization experienced by MSWs and MCMs, the contexts in which these experiences occurred, and the responses to violence among these groups. We conducted in-depth interviews with 25 MSWs and 11 MCMs recruited at bars and clubs identified by peer sex worker educators as "hotspots" for sex work in Mombasa, Kenya. Violence against MSWs frequently included physical or sexual assault and theft, whereas MCMs' experiences of victimization usually involved theft, extortion, or other forms of economic violence. Explicitly negotiating the price for the sexual exchange before having sex helped avoid conflict and violence. For many participants, guesthouses that were tolerant of same-sex encounters were perceived as safer places for engaging in sex work. MSWs and MCMs rarely reported incidents of violence to the police due to fear of discrimination and arrests by law enforcement agents. Some MSWs fought back against violence enacted by clients or tapped into peer networks to obtain information about potentially violent clients as a strategy for averting conflicts and violence. Our study contributes to the limited literature examining the perspectives of MSWs and MCMs with respect to violence and victimization, showing that both groups are vulnerable to violence and in need of interventions to mitigate violence and protect their health. Future interventions should consider including existing peer networks of MSWs in efforts to prevent violence in the context of sex work. Moreover, decriminalizing same-sex practices and sex work in Kenya may inhibit violence against MSWs and MCMs and provide individuals with safer spaces for engaging in sex work.
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Affiliation(s)
- Pablo K. Valente
- Brown University, Providence, RI, USA
- New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY, USA
| | | | | | - Theo G. M. Sandfort
- New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY, USA
| | - Peter B. Gichangi
- Technical University of Mombasa, Mombasa, Kenya
- Ghent University, Ghent, Belgium
- University of Nairobi, Nairobi, Kenya
| | - Arjee J. Restar
- Brown University, Providence, RI, USA
- New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY, USA
| | - Jack Ume Tocco
- New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY, USA
| | | | | | - Joanne E. Mantell
- New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY, USA
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6
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Wei D, Hou F, Hao C, Gu J, Dev R, Cao W, Peng L, Gilmour S, Wang K, Li J. Prevalence of Intimate Partner Violence and Associated Factors Among Men Who Have Sex with Men in China. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP11968-NP11993. [PMID: 31789088 DOI: 10.1177/0886260519889935] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Intimate partner violence (IPV) in the heterosexual population has gained increasing public concern in China, but little is known about it among men who have sex with men (MSM).1 This study aimed to investigate the prevalence of IPV and associated factors among MSM in Chengdu, China. Participants were recruited from a local MSM-friendly health consulting center. This study used the adjusted Intimate Partner Violence Scale among Gay and Bisexual Men (IPV-GBM scale) to capture lifetime IPV experiences including physical, sexual and emotional violence, monitoring, and controlling behaviors. Among 431 participants, 153 (35.5%) reported any IPV experiences, and 119 (27.6%) reported themselves as being the perpetrator. Adjusted logistic regression models revealed that having been engaged in transactional sex was positively associated with victimization through monitoring behaviors (adjusted odds ratio [ORa] = 2.7, 95% confidence interval CI = [1.7, 7.4]) and perpetration of monitoring behaviors (ORa = 3.9, 95% CI = [1.5, 13.3]); drug use was positively associated with victimization through controlling behaviors (unadjusted odds ratio [ORu] = 2.5, 95% CI = [1.2, 5.0]) and emotional violence (ORa = 1.9, 95% CI = [1.0, 3.5]); older age (≥18 years) of first homosexual intercourse was negatively associated with perpetration of physical violence (ORu = 0.3, 95% CI = [0.2, 0.7]) and sexual violence (ORu = 0.4, 95% CI = [0.2, 1.0]); higher self-esteem was negatively associated with both victimization and perpetration of sexual and emotional violence. We found that victimization and perpetration experiences were correlated in all dimensions of IPV. Violence was prevalent among MSM and merits public attention. This study provides more evidence about IPV among Chinese MSM and identifies two significant factors contributing to IPV (self-esteem and age of first homosexual intercourse), which have been overlooked in previous studies. Researchers should take these factors into consideration for interventions developments.
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Affiliation(s)
- Dannuo Wei
- Sun Yat-sen University, Guangzhou, China
| | - Fengsu Hou
- Sun Yat-sen University, Guangzhou, China
- Kangning Hospital, Shenzhen, China
| | - Chun Hao
- Sun Yat-sen University, Guangzhou, China
| | - Jing Gu
- Sun Yat-sen University, Guangzhou, China
| | - Rubee Dev
- Sun Yat-sen University, Guangzhou, China
| | | | | | | | - Keru Wang
- Sun Yat-sen University, Guangzhou, China
| | - Jinghua Li
- Sun Yat-sen University, Guangzhou, China
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7
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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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8
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Prevalence of Intimate Partner Violence Among Men Who Have Sex With Men: An Updated Systematic Review and Meta-Analysis. Sex Med 2021; 9:100433. [PMID: 34571326 PMCID: PMC8766270 DOI: 10.1016/j.esxm.2021.100433] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/03/2021] [Accepted: 08/10/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction Intimate partner violence (IPV) among men who have sex with men (MSM) has become a serious and widespread public health issue, which might result in low quality of life and increase the global burden of diseases. Aim To quantitatively estimate the pooled prevalence of IPV and its specific forms (physical violence, sexual violence and emotional violence) among MSM. Methods Databases of PubMed, Cochrane Library, CINAHL, MEDLINE, PsycINFO, CNKI, WANFANG Data, and Weipu (CQVIP) Data were searched for identified studies published between January 1990 and August 2020. Random effect meta-analyses were used to synthesize the pooled prevalence and 95% CIs of IPV. Main Outcome Measures The pooled prevalence of IPV in victimization and in perpetration among MSM. Results A total of 52 studies with 32,048 participants were included for final analysis. The pooled prevalence of IPV was 33% (6,342 of 19,873; 95%CI, 28–39%) in victimization and 29% (1,491 of 5,983; 95%CI, 17 –40%) in perpetration across all recall periods among MSM population. Furthermore, the pooled prevalence of physical violence was 17% (3,979 of 22,928; 95%CI, 14 –20%) and 12% (942 of 9,236; 95%CI, 10 –15%), of sexual violence was 9% (1,527 of 19,511; 95%CI, 8 –11%) and 4% (324 of 8,044; 95%CI, 3 –5%), of emotional violence was 33% (5,147 of 17,994; 95%CI, 25 –40%) and 41% (1,317 of 3,811; 95%CI, 17 –65%) in victimization and perpetration, respectively. Out of all the IPV identified, emotional violence was estimated at the highest level. Conclusion This study demonstrated a high prevalence of IPV both in victimization and perpetration among MSM, and emotional violence was estimated at the highest level out of all IPV forms. Efforts are needed to develop corresponding prevention programs for victims with an intent to increase the accessible availability of health services, and ultimately improve their life quality. Liu M., Cai X., Hao G. et al., Prevalence of Intimate Partner Violence Among Men Who Have Sex With Men: An Updated Systematic Review and Meta-Analysis. Sex Med 2021;9:100433.
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9
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Zhu Y, Hou F, Chen C, Wei D, Peng L, You X, Gu J, Hao C, Hao Y, Li J. Moderating effect of self-efficacy on the association of intimate partner violence with risky sexual behaviors among men who have sex with men in China. BMC Infect Dis 2021; 21:895. [PMID: 34470607 PMCID: PMC8408951 DOI: 10.1186/s12879-021-06618-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/22/2021] [Indexed: 11/24/2022] Open
Abstract
Background In China, men who have sex with men (MSM) face a high risk of HIV infection. Intimate partner violence (IPV) is common in this population and leads to various adverse consequences, including risky sexual behaviors, substance abuse, and poor mental health, which pose huge challenges to HIV prevention and control. Methods An anonymous cross-sectional study was conducted to investigate the lifetime prevalence of IPV and prevalence of risky sexual behaviors during the previous 6 months in a convenience sample of 578 MSM from 15 cities covering seven geographical divisions in mainland China. The associations between IPV and risky sexual behaviors and the moderating effect of self-efficacy on these associations were explored through univariate and multivariate regression analyses. Results The prevalence rates of IPV perpetration and victimization were 32.5% and 32.7%, respectively. The proportions of participants who reported inconsistent condom use with regular or casual partners and multiple regular or casual sexual partners were 25.8%, 8.3%, 22.2%, and 37.4%, respectively. Multiple IPV experiences were positively associated with risky sexual behaviors; for example, any IPV victimization was positively associated with multiple regular partners, adjusted odds ratio (ORa) = 1.54, 95% CI [1.02,2.32], and multiple casual partners, ORa = 1.93, 95% CI [1.33, 2.80]. Any IPV perpetration was positively associated with inconsistent condom use with regular partners, ORa = 1.58, 95% CI [1.04, 2.40], and multiple casual partners, ORa = 2.11, 95% CI [1.45, 3.06]. Self-efficacy was identified as a significant moderator of the association between multiple casual sexual partnership and emotional IPV. Conclusions In conclusion, given the high prevalence of both IPV and risky sexual behaviors among Chinese MSM in this study, the inclusion of self-efficacy in interventions targeting IPV and risky sexual behaviors should be considered.
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Affiliation(s)
- Yang Zhu
- School of Public Health, Sun Yat-Sen University, North Campus, 74# Zhongshan 2nd Road, Guangzhou, 510000, China
| | - Fengsu Hou
- Department of Public Mental Health, Shenzhen Kangning Hospital, Shenzhen, China.,Sun Yat-Sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China
| | - Chun Chen
- Department of Mechanical and Automation Engineering, Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong, China
| | - Dannuo Wei
- School of Public Health, Sun Yat-Sen University, North Campus, 74# Zhongshan 2nd Road, Guangzhou, 510000, China
| | - Liping Peng
- School of Public Health, Sun Yat-Sen University, North Campus, 74# Zhongshan 2nd Road, Guangzhou, 510000, China
| | - Xinyi You
- School of Public Health, Sun Yat-Sen University, North Campus, 74# Zhongshan 2nd Road, Guangzhou, 510000, China
| | - Jing Gu
- School of Public Health, Sun Yat-Sen University, North Campus, 74# Zhongshan 2nd Road, Guangzhou, 510000, China.,Sun Yat-Sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China
| | - Chun Hao
- School of Public Health, Sun Yat-Sen University, North Campus, 74# Zhongshan 2nd Road, Guangzhou, 510000, China.,Sun Yat-Sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China
| | - Yuantao Hao
- School of Public Health, Sun Yat-Sen University, North Campus, 74# Zhongshan 2nd Road, Guangzhou, 510000, China
| | - Jinghua Li
- School of Public Health, Sun Yat-Sen University, North Campus, 74# Zhongshan 2nd Road, Guangzhou, 510000, China. .,Sun Yat-Sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China.
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10
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Rahmayani M, Waluyo A, Maria R. Sexual violence experiences and pornography media exposure with sexual risk behavior among PLWHA MSM in Bandung, Indonesia. J Public Health Res 2021; 10. [PMID: 34060744 PMCID: PMC9309623 DOI: 10.4081/jphr.2021.2338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 11/28/2022] Open
Abstract
Background HIV number continues to increase, especially among the minority of Men who
have Sex with Men (MSM) due to the high risks of their sexual behavior. This
study aims to identify the correlation between sexual violence experiences
and pornography media exposure to sexual risk behavior among people with
HIV/AIDS (PLWHA) MSM. Design and Method The study employed a cross-sectional design with the consecutive sampling
technique and involved 258 PLWHA MSM under the guidance of an NGO in
Bandung, Jawa Barat, Indonesia. The data were collected by employing an
online questionnaire. Result The results show that there is a significant correlation between sexual
violence experiences and sexual risk behavior (p-value = 0.000, α = 0.05; OR
= 6.496), pornography media exposure and sexual risk behavior (p-value =
0.000, α = 0.05; OR = 4.271). The multivariate analysis of multiple
logistics regression results reveals that the sexual violence experience is
the factor that mostly influences the sexual risk behavior among PLWHA MSM
(p-value = 0.000, α = 0.05; OR = 3.784). Conclusions The sexual violence experiences and pornography media exposure have a
significant positive relationship to sexual risk behavior. Therefore, nurses
need to improve a comprehensive assessment, counseling, and personal
education to reduce sexual risk behavior that can transmit HIV and other
sexually transmitted diseases and create innovations through positive
activities to reduce pornography consumption.
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Affiliation(s)
- Melly Rahmayani
- Faculty of Nursing, Universitas Indonesia, Depok, West Java.
| | - Agung Waluyo
- Department of Medical surgical Nursing Faculty of Nursing, Universitas Indonesia, Depok.
| | - Riri Maria
- Department of Medical surgical Nursing Faculty of Nursing, Universitas Indonesia, Depok, West Java.
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11
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Mimiaga MJ, Hughto JM, Klasko-Foster L, Jin H, Mayer KH, Safren SA, Biello KB. Substance Use, Mental Health Problems, and Physical and Sexual Violence Additively Increase HIV Risk Between Male Sex Workers and Their Male Clients in Northeastern United States. J Acquir Immune Defic Syndr 2021; 86:305-312. [PMID: 33148992 PMCID: PMC8343953 DOI: 10.1097/qai.0000000000002563] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 10/27/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND Male sex workers (MSW) are disproportionately affected by HIV/AIDS, with an estimated HIV prevalence in the United States of 19.3%. Existing research suggests that MSW are also at risk of adverse psychosocial problems. Cross-sectional studies of MSW have suggested that co-occurring epidemics or a "syndemic" of psychosocial problems may increase vulnerability to HIV acquisition/transmission by elevated sexual risk. To the best of our knowledge, there are no published studies examining this relationship longitudinally among MSW. This study examined how a syndemic of 6 psychosocial problems result in additive risk for condomless anal sex (CAS) with male clients among a multicity, longitudinal cohort of MSW. SETTING Community-based organization and health center in 2 Northeastern US cities. METHODS Between 2015 and 2017, 100 MSW from Boston, MA and Providence, RI completed behavioral/psychosocial surveys at baseline, 6 months, and 12months. Generalized estimating equation modeling was used to examine the prospective relationship of additive psychosocial problems and subsequent CAS with male clients, adjusting for age, site, race/ethnicity, MSW-type, and HIV serostatus. RESULTS Mean age = 34.7 (SD = 11.8); 62% racial/ethnic minority; and 20% HIV+. The prevalence of 6 psychosocial syndemic problems was substantial at baseline and remained high at each time point (all within the past 6 months): 74% problematic depressive symptoms, 27% polydrug use (3+ drugs, not including stimulants), 57% stimulant (methamphetamine/cocaine/crack) use, 44% hazardous drinking, 15% experienced client-specific physical/sexual violence, and 57% childhood sexual abuse. Looking at the number of psychosocial problems experienced, 7% had zero, 27% had 1, 24% had 2, 27% had 3, and 15% had 4 or more. We identified a statistically significant positive "dose-response" relationship between the number of psychosocial problems and CAS with male clients over time, with the greatest odds of engaging in CAS with a male client over follow-up among those with 4 or more psychosocial problems (adjusted odds ratio = 5.18, 95% CI: 1.61 to 16.62). CONCLUSIONS Internet escorts and street-based MSW are likely to experience psychosocial problems and engaging in HIV sexual risk with male clients. The accumulation of psychosocial problems additively predicted CAS with male clients in a prospective cohort of MSW. The specification of psychosocial problems presents distinct treatment targets for HIV prevention among MSW in the United States.
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Affiliation(s)
- Matthew J. Mimiaga
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, UCLA Geffen School of Medicine, Los Angeles, CA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Jaclyn M.W. Hughto
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Center for Health Promotion and Health Equity, Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Lynne Klasko-Foster
- Center for Health Promotion and Health Equity, Brown University, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI, USA
| | - Harry Jin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Infectious Diseases, Harvard Medical School/Beth Israel Deaconess Medical, Center, Boston, MA, USA
| | - Steven A. Safren
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Katie B. Biello
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Center for Health Promotion and Health Equity, Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
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12
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Raine G. Violence Against Male Sex Workers: A Systematic Scoping Review of Quantitative Data. JOURNAL OF HOMOSEXUALITY 2021; 68:336-357. [PMID: 31469348 DOI: 10.1080/00918369.2019.1656029] [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] [Indexed: 06/10/2023]
Abstract
Sex workers are recognized to be potentially vulnerable to violence and abuse. However, the extent and nature of violence committed against male sex workers remains under reported. The aim of this evidence scoping review was to identify the prevalence of violence against male sex workers globally. A systematic search was conducted of 8 databases from 1990 to the end of December 2016. In total, quantitative data from 27 studies conducted in 18 countries were included in the review. Evidence indicates that some male sex workers, especially those in non-Western countries, do experience high levels of violence. The largest proportion of studies reported data on sexual violence, whilst the most common type of violence experienced overall by male sex workers was that of 'verbal or emotional abuse or threats'. The views and experiences of male sex workers should be integrated fully into sex work debates, policy and service provision.
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Affiliation(s)
- Gary Raine
- Faculty of Social Sciences, University of York , York, UK
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13
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Huynh A, Yu N, Zhang J, Chevrier C, Lazarus L, Blanchard J, Lorway R. Money boys in Chengdu, China: migration, entrepreneurial precarity and health service access. CULTURE, HEALTH & SEXUALITY 2020; 22:1333-1348. [PMID: 31661667 DOI: 10.1080/13691058.2019.1679393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 10/08/2019] [Indexed: 06/10/2023]
Abstract
This qualitative study highlights the complex interplay between the social and structural conditions in Chengdu, China that shape the possibilities and vulnerabilities of money boys' sexual health. Within the context of China's liberalised market economy, we explore (1) how money boys' enter the sex trade market and navigate their sexual networks; (2) how their lives are enmeshed in fields of sexual desire, stigma and coercion; and (3) how the illicit and stigmatising nature of their work poses barriers to health service access. Findings reveal how the sex trade market and clinic are precarious spaces in which entrepreneurial ethics of the self and stigma-related coercive relations simultaneously enable and constrain money boys' sexual freedom and safer sex practices. By understanding this entrepreneurial precarity through the co-articulation of clinical and organisational work spaces, public health and social service providers can have a stronger sense of how various vulnerabilities configure to affect safer sex practices.
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Affiliation(s)
- Anthony Huynh
- Center for Global Public Health, University of Manitoba, Winnipeg, MB, Canada
| | - Nancy Yu
- Center for Global Public Health, University of Manitoba, Winnipeg, MB, Canada
| | - Juying Zhang
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Claudyne Chevrier
- Center for Global Public Health, University of Manitoba, Winnipeg, MB, Canada
| | - Lisa Lazarus
- Center for Global Public Health, University of Manitoba, Winnipeg, MB, Canada
| | - James Blanchard
- Center for Global Public Health, University of Manitoba, Winnipeg, MB, Canada
| | - Robert Lorway
- Center for Global Public Health, University of Manitoba, Winnipeg, MB, Canada
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14
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Effects of emotion regulation and perpetrator-victim roles in intimate partner violence on mental health problems among men who have sex with men in China. Epidemiol Psychiatr Sci 2020; 29:e159. [PMID: 32792037 PMCID: PMC7443802 DOI: 10.1017/s2045796020000712] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIMS This study assessed the relationships between different perpetrator-victim roles in intimate partner violence (IPV), emotion regulation (ER) and mental health problems among men who have sex with men (MSM) in China. METHODS From April to June 2019, 1233 participants were approached via gay-friendly non-governmental organisations in 15 cities across mainland China. RESULTS Of the total, 578 eligible participants completed an anonymous online survey. All participants provided informed consent and information about their violent perpetrator-victim role and mental health status. The results revealed a high prevalence of IPV in this study sample, with 32.7% of participants reporting IPV victimisation and 32.5% of participants reporting IPV perpetration during their lifetime. A total of 81 (14.0%) participants were suicidal, 309 (53.5%) participants reported poor general mental health and 208 (36.0%) had significant depressive symptoms. Adjusted logistic regression models revealed that both physical victimisation (adjusted odds ratio [ORa] = 3.22, 95% confidence interval [CI] = 1.11-9.32) and sexual victimisation (ORa = 2.90, 95% CI = 1.39-6.05) had positive associations with suicidality, and unidirectional and bidirectional psychological perpetration were associated with poor general mental health and significant depressive symptoms. Although high cognitive reappraisal showed a negative association with poor general mental health (ORa = 0.89,95% CI = 0.86-0.92), the correlation with victims of IPV was weaker than it was with non-victims. CONCLUSIONS This study revealed that different perpetrator-victim roles in different IPV situations should be considered comprehensively in research, prevention and intervention. ER is not enough to buffer the effects of IPV on the mental health of MSM victims.
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15
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Barriers to Accessing Sexual Health Services for Transgender and Male Sex Workers: A Systematic Qualitative Meta-summary. AIDS Behav 2020; 24:682-696. [PMID: 30868447 DOI: 10.1007/s10461-019-02453-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Access to safe and effective sexual healthcare services for transgender and male sex workers (TMSW) is a human right. Globally, TMSW experience a higher prevalence of human immunodeficiency virus (HIV) and sexually transmitted infections than the general population or other sex workers, suggesting the existence of unique challenges for this group when accessing healthcare. A systematic database search identified 22 qualitative papers addressing barriers to accessing sexual healthcare services for TMSW. These papers were critically evaluated for adherence to best practice standards for qualitative research and research with sex workers. A coding process identified five themes. Stigma was the predominant barrier, and was divided into stigma related to sexuality, gender identity, HIV status, sex worker status, and internalised stigma. Other barriers were confidentiality concerns, sexual health literacy, fatalism, and structural barriers. Each of these themes were informed by the wider context of stigma. The literature presents a complex syndemic of social disadvantage and exclusion acting to produce and reinforce health disparities related to sexual health and access to screening and treatment for TMSW.
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16
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Wei D, Cao W, Hou F, Hao C, Gu J, Peng L, Li J. Multilevel factors associated with perpetration of five types of intimate partner violence among men who have sex with men in China: an ecological model-informed study. AIDS Care 2020; 32:1544-1555. [PMID: 32093496 DOI: 10.1080/09540121.2020.1734523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In China, intimate partner violence (IPV) among men who have sex with men remains poorly investigated. Informed by the ecological model, this study explored multilevel factors associated with perpetration of IPV among men who have sex with men. The participants were recruited from 15 cities in mainland China. Univariate and multivariate regression analyses showed that the prevalence of committing physical, sexual, monitoring, controlling and emotional IPV was 8.6%, 7.1%, 15.2%, 7.6% and 17.1%, respectively. Committing physical IPV showed a positive association with perceived public discrimination and self-stigma towards homosexuality. Committing sexual IPV showed a positive association with involvement with a homosexual support agency and more sex partners. Monitoring IPV was positively associated with higher education and perceived stress, but negatively associated with instrumental and emotional support. Committing controlling IPV showed a positive association with drug use during sex and self-stigma but a negative association with self-esteem, self-efficacy and older age at first homosexual sex. Committing emotional IPV showed a positive association with commercial sex behaviour and perceived stress, but a negative association with resilience. Committing IPV was prevalent in this population. It is necessary to distinguish the various types of IPV in future studies, given their differences in associated factors.
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Affiliation(s)
- Dannuo Wei
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, People's Republic of China
| | - Wangnan Cao
- Center for Evidence Synthesis in Health, School of Public Health, Brown University, Providence, RI, United States
| | - Fengsu Hou
- Department of Public Mental Health, Kangning Hospital, Shenzhen, Guangdong, People's Republic of China.,Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Chun Hao
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, People's Republic of China.,Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jing Gu
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, People's Republic of China.,Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Liping Peng
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, People's Republic of China
| | - Jinghua Li
- School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, People's Republic of China
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17
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Peng L, She R, Gu J, Hao C, Hou F, Wei D, Li J. The mediating role of self-stigma and self-efficacy between intimate partner violence (IPV) victimization and depression among men who have sex with men in China. BMC Public Health 2020; 20:2. [PMID: 31900234 PMCID: PMC6942407 DOI: 10.1186/s12889-019-8125-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/24/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Previous studies have shown that intimate partner violence (IPV) is prevalent in men who have sex with men (MSM). Mental health problems among MSM with IPV victimization have become a growing concern. The present study examined homosexual self-stigma and self-efficacy as potential mediators of the association between IPV victimization and depression. METHODS We recruited 578 MSM from 15 cities across China. Participants completed sociodemographic measures, the IPV-GBM (IPV among gay and bisexual men) scale, the Self-Stigma Scale-Short Form (SSS-S), the General Self-Efficacy (GSE) Scale and the Center for Epidemiologic Studies Depression 10 (CES-D-10). We calculated bias-corrected 95% confidence interval (CI) for total, direct and indirect effects using bootstrapping to conduct mediation analyses. RESULTS Findings showed that the prevalence of IPV victimization and depression were 32.7% (189/578) and 36.0% (208/578), respectively. Result from mediation analysis using structural equation modeling indicated that the association between level of IPV victimization and depression among MSM was fully mediated by higher homosexual self-stigma and lower self-efficacy. Homosexual self-stigma had a direct effect and an indirect effect via self-efficacy on depression. CONCLUSION The results provided evidence that integrated interventions that reduce self-stigma and foster self-efficacy could be promising approaches to decrease depression among MSM with IPV victimization.
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Affiliation(s)
- Liping Peng
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan second road, Guangzhou, China
| | - Rui She
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Jing Gu
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan second road, Guangzhou, China
- Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Chun Hao
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan second road, Guangzhou, China
- Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Fengsu Hou
- Department of Public Mental Health, Shenzhen Kangning Hospital, Shenzhen, Guangdong China
| | - Dannuo Wei
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan second road, Guangzhou, China
| | - Jinghua Li
- School of Public Health, Sun Yat-sen University, No.74, Zhongshan second road, Guangzhou, China
- Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
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18
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Jiang H, Li J, Tan Z, Chen X, Cheng W, Gong X, Yang Y. Syndemic Factors and HIV Risk Among Men Who Have Sex with Men in Guangzhou, China: Evidence from Synergy and Moderated Analyses. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:311-320. [PMID: 31617111 DOI: 10.1007/s10508-019-01488-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 04/24/2019] [Accepted: 06/06/2019] [Indexed: 06/10/2023]
Abstract
Syndemic factors tend to co-occur and increase the risks of condomless anal intercourse (CAI), multiple sexual partners (MSP) and HIV vulnerability among men who have sex with men (MSM). This study aimed to test the synergistic effects of syndemic factors on HIV risk and to further explore the moderators between syndemics and HIV risk among Chinese MSM. A cross-sectional study was conducted to recruit MSM in Guangzhou to collect data on syndemic factors (depression, intimate partner violence, childhood sexual abuse [CSA], alcohol, and rush popper use before anal sex). The relative excess risk due to interactions (RERIs) was calculated to test the synergy in adjusted regression models. A moderated analysis was conducted to test the buffer effects of potential resilience factors (education and income). Among the 976 included MSM, individuals experiencing more syndemic factors were more likely to have CAI (odds ratio [OR]= 1.26, 95% confidence interval [CI] 1.11-1.44), MSP (OR= 1.33, 95% CI 1.16-1.52), and HIV infection (OR= 1.46, 95% CI 1.12-1.90). RERIs showed a synergy of depression and rush popper use prior to sex for MSP (1.17, 95% CI 0.03-2.03) and CSA and rush popper use prior to sex for HIV infection (1.72, 95% CI 0.05-3.43). However, no significant association was found for the interaction between the number of syndemic factors and education or income. Our findings support the synergy approach in syndemic studies and highlight the need for comprehensive and multifactorial intervention strategies on sexual health of MSM. Future studies are needed to identify potential resilience factors among Chinese MSM.
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Affiliation(s)
- Hongbo Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China
| | - Zhimin Tan
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China
| | - Xiaobin Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China
| | - Weibin Cheng
- Dermatology Hospital of Southern Medical University, Guangzhou, China
| | - Xiao Gong
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China
| | - Yi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China.
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19
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Guo C, Yu M, Deng X, Gong H, Li Y, Li C, Liu Y, Guo M, Gong X, Feng S, Xu J, Li Z, Gao Y, Yang J, Cui Z, Ma J. The characteristics of internet-based venue sex-seeking and mobility among money boys in Tianjin, China. HIV Med 2019; 20:473-484. [PMID: 31006956 DOI: 10.1111/hiv.12746] [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] [Accepted: 03/05/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Internet-based venue sex-seeking is prevalent among money boys (MBs), as is a high degree of mobility, which is crucial for HIV transmission in key populations with high risks of HIV infection. However, correlation studies in MBs are scarce because of the secretive nature of this hard-to-reach subpopulation. We conducted this project to explore the characteristics of MBs. METHODS This survey was conducted from December 2014 to June 2015 in Tianjin; a total of 330 MBs were recruited by convenience sampling. Demographic and behavioural data were collected for analysis. RESULTS Among the investigated MBs, 38 (11.52%) were HIV positive, 147 (44.55%) reported using internet-based venues to seek sexual partners and 257 (77.88%) had travelled to two or more destinations in the past 6 months. Compared with non-internet-based venue-using MBs, internet-based venue-using MBs were more likely to have part-time employment as MBs, to have a longer duration of working in the sex trade, to engage in finger intercourse and to present a history of substance abuse and sexually transmitted infections. However, internet-based venue-using MBs were less likely to exhibit consistent condom usage and undergo HIV testing. Origin of residence data showed that most MBs were from northern China, with Tianjin, Beijing and Shanghai as the main travel destinations. Mobile MBs were characterized as a group who were fully engaged in the sex trade and frequently took part in sexual activities but had a weak sense of self-protection. CONCLUSIONS Internet-based venue sex-seeking and mobility are prevalent in MBs. Renewed efforts in internet-based health promotion and school-based primary health examination programmes may benefit more mobile and/or internet-based venue sex-seeking MBs.
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Affiliation(s)
- C Guo
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - M Yu
- STD & AIDS Control and Prevention Section, Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - X Deng
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - H Gong
- STD & AIDS Control and Prevention Section, Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Y Li
- STD & AIDS Control and Prevention Section, Tianjin Nankai District Center for Disease Control and Prevention, Tianjin, China
| | - C Li
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - Y Liu
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - M Guo
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - X Gong
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - S Feng
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - J Xu
- National Center for AIDS/STD Control and Prevention, Beijing, China
| | - Z Li
- GAP Program Office of US CDC, Atlanta, GA, USA
| | - Y Gao
- STD & AIDS Control and Prevention Section, Tianjin HongQiao District Center for Disease Prevention and Control, Tianjin, China
| | - J Yang
- Tianjin ShenLan Public Health Counseling Service Center, Tianjin, China
| | - Z Cui
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - J Ma
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
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20
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Jiang H, Chen X, Li J, Tan Z, Cheng W, Yang Y. Predictors of condom use behavior among men who have sex with men in China using a modified information-motivation-behavioral skills (IMB) model. BMC Public Health 2019; 19:261. [PMID: 30832640 PMCID: PMC6399930 DOI: 10.1186/s12889-019-6593-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 02/25/2019] [Indexed: 01/11/2023] Open
Abstract
Background Men who have sex with men (MSM) are at high risk for human immunodeficiency virus (HIV) infection in China. Correct and consistent condom use is one of the most effective strategies for preventing the spread of HIV. This study developed a modified Information-Motivation-Behavioral Skills (IMB) model to predict condom use behavior among Chinese MSM. Methods A cross-sectional study was conducted to collect data using self-administered electronic questionnaire. Participants were recruited from HIV Voluntary Counseling and Testing clinics in six district Centers for Disease Control and Prevention in Guangzhou and two community-based HIV service centers (Lingnan Partners and Zhitong Charity) from May to September 2017. Structural equation modeling was performed to develop the modified IMB model with extended multilevel factors. Results Among the 976 MSM included, 52.05% had engaged in anal intercourse with a condom every time. The final modified IMB model fitted the data more ideally than the conventional model. The final modified IMB model revealed that behavioral skills positively contributed directly to condom use (β = 0.385, p < 0.001) and partially mediated the associations between information (β = 0.106, p = 0.005) and motivation (β = 0.390, p < 0.001) and condom use. Regarding the extended multilevel factors, education, income, receiving HIV prevention services, sexual partner seeking behavior, depression, intimate partner violence, and child sexual abuse had indirect impacts on condom use that were mediated by information, motivation, and/or behavioral skills (p < 0.05). All paths from the latent variable to the corresponding observed variables were statistically significant (p < 0.001). Conclusion The modified IMB model with extended multilevel factors could serve as a theoretical framework for behavioral interventions for condom use among Chinese MSM. Further prospective studies are needed to examine the predictive power of the modified IMB model. Electronic supplementary material The online version of this article (10.1186/s12889-019-6593-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hongbo Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China
| | - Xiaobin Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China
| | - Zhimin Tan
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China
| | - Weibin Cheng
- Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, No. 1 Qide Road, Baiyun District, Guangzhou, China.
| | - Yi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China.
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21
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Liu Y, Zhang Y, Ning Z, Zheng H, Ding Y, Gao M, Wong FY, He N. Intimate partner violence victimization and HIV infection among men who have sex with men in Shanghai, China. Biosci Trends 2018; 12:142-148. [PMID: 29760357 DOI: 10.5582/bst.2018.01035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Intimate partner violence (IPV) and its association with HIV infection among men who have sex men (MSM) in China are not understood. In this study, 732 MSM recruited from Shanghai, China between March and August 2015 were administered with a questionnaire survey and HIV blood testing. IPV victimization was measured by 25 forced-choice items capturing lifetime experience of physical, sexual, psychological, deprivation or neglect, and other forms of violence. Of them, 179 (24.3%) reported having experienced at least one type of IPV victimization. In separate multivariable analyses, sexual violence was associated with age over 35 years (AOR = 0.26, 95% CI: 0.07-1.02), ever had male-to-male commercial sex (AOR = 2.53, 95%CI: 1.19-5.39), and diagnosis of a sexually transmitted infection (STI) (AOR = 2.14, 95%CI: 0.98-4.66). Both psychological violence (AOR = 2.53, 95%CI: 1.25-5.12)and deprivation or neglect violence (AOR = 1.75, 95%CI: 1.14-2.68) were associated with ever had sex with a casual male partner(s). Having experienced at least one type of IPV victimization was significantly associated with ever had sex with a causal partner(s) (AOR = 1.72, 95%CI: 1.15-2.57) and ever had a diagnosis of a STI (AOR = 1.80, 95% CI: 1.12-2.88). HIV infection was marginally associated with having experienced any form of IPV victimization. IPV victimization is common among MSM, especially young MSM, in China, although its association with HIV infection is not conclusive in our sample. Nonetheless, our findings highlight the importance of the needs of individualized IPV interventions for certain target risk groups of MSM.
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Affiliation(s)
- Ying Liu
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University.,Collaborative Innovation Center of Social Risks Governance in Health, Fudan University.,Putuo District Center for Disease Control and Prevention
| | - Yuyan Zhang
- Putuo District Center for Disease Control and Prevention
| | - Zhen Ning
- Shanghai Center for Disease Control and Prevention
| | | | - Yingying Ding
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University.,Collaborative Innovation Center of Social Risks Governance in Health, Fudan University
| | - Meiyang Gao
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University
| | - Frank Y Wong
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University.,Department of Tropical Medicine, John A. Burns School of Medicine, University of Hawai'i at Mānoa.,Department of Psychology, College of Social Sciences, University of Hawai'i at Mānoa
| | - Na He
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University.,Collaborative Innovation Center of Social Risks Governance in Health, Fudan University
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22
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Intimate Partner Violence Correlates With A Higher HIV Incidence Among MSM: A 12-Month Prospective Cohort Study in Shenyang, China. Sci Rep 2018; 8:2879. [PMID: 29440761 PMCID: PMC5811488 DOI: 10.1038/s41598-018-21149-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 01/29/2018] [Indexed: 01/05/2023] Open
Abstract
Intimate partner violence (IPV) and HIV are highly prevalent worldwide among MSM. However, the association between IPV and HIV seroconversion is virtually unknown. This 12-month prospective cohort study was conducted among MSM in Shenyang, China to explore the causality between IPV and the incidence of HIV. Adjusted Hazard Ratios (aHRs) of HIV acquisition were derived from a multivariate time-dependent Cox model and applied to calculate population attributable fractions (PAFs). Among 476 HIV-negative MSM subjects, 89(18.7%) reported being victims of IPV in the past 3 months (P3M). IPV was significantly correlated with lower education, having more condomless anal intercourse (CAI) and being depressed (each P < 0.05). The incidence of HIV among IPV victims was 11.3/100 PY compared to 3.8/100 PY in non-IPV-victims. Furthermore, IPV victimization was independently associated with HIV seroconversion (aHR = 4.1, PAF = 37.9%). Other predictors for seroconversion included non-local residence in Liaoning province (aHR = 3.9, PAF = 45.2%), engaging in condomless receptive anal intercourse (CRAI)(aHR = 3.1, PAF = 24.2%) or CAI with casual male partners (aHR = 3.8, PAF = 26.3%) in the P3M and syphilis infection (aHR = 4.7, PAF = 33.7%) (each P < 0.05). IPV increased the HIV seroconversion risk of MSM, with a high PAF. HIV prevention programs should integrate IPV screening and intervention, and MSM affected by IPV need to be preferentially enrolled in pre-exposure prophylaxis.
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23
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Kumi Smith M, Jewell BL, Hallett TB, Cohen MS. Treatment of HIV for the Prevention of Transmission in Discordant Couples and at the Population Level. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1075:125-162. [PMID: 30030792 DOI: 10.1007/978-981-13-0484-2_6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The scientific breakthrough proving that antiretroviral therapy (ART) can halt heterosexual HIV transmission came in the form of a landmark clinical trial conducted among serodiscordant couples. Study findings immediately informed global recommendations for the use of treatment as prevention in serodiscordant couples. The extent to which these findings are generalizable to other key populations or to groups exposed to HIV through nonsexual transmission routes (i.e., anal intercourse or unsafe injection of drugs) has since driven a large body of research. This review explores the history of HIV research in serodiscordant couples, the implications for management of couples, subsequent research on treatment as prevention in other key populations, and challenges in community implementation of these strategies.
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Affiliation(s)
- M Kumi Smith
- University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
| | | | | | - Myron S Cohen
- University of North Carolina Chapel Hill, Chapel Hill, NC, USA
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24
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Mgopa LR, Mbwambo J, Likindikoki S, Pallangyo P. Violence and depression among men who have sex with men in Tanzania. BMC Psychiatry 2017; 17:296. [PMID: 28810838 PMCID: PMC5558659 DOI: 10.1186/s12888-017-1456-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 08/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Men who have sex with men (MSM) continue to be at an increased risk of Violence, HIV transmission and Mental Disorders such as depression on top of many other bio-psycho-socio challenges they face as a result of their sexual orientation. METHODS We recruited 345 MSM using a respondent driven sampling technique. Revised Conflict Tactic Scale, PHQ-9 and questions adapted from the TDHS 2010 were used to assess for violence, depression and HIV-risk behaviors respectively. Continuous and categorical variables were analyzed with student's t-test and chi-square test respectively. Logistic regression analyses were performed to assess for predictors of depression and HIV-risk behaviors. All tests were two sided and p < 0.05 was taken as significance level. RESULTS Overall, 325 (94.2%) of participants experienced any form of violence, with emotional violence constituting the majority (90.1%), while physical and sexual violence were reported by 254 (73.6%) and 250 (72.5%) of participants respectively. Depressive symptoms were present in 245 (70.0%) and participants who experienced violence had a 3 times increased risk of depressive symptoms compared to their violence-free counterparts, p < 0.001. On the other hand, participants who experienced any form of violence displayed an over 11 times increased rate of depressive symptoms compared to their counterparts who were violence free, p < 0.001. Violence experience was found to be the strongest associated factor for depressive symptoms. CONCLUSIONS The rates of violence, depressive symptoms and HIV risk behaviors amongst MSM are astoundingly high thus necessitating extensive interventions. In view of this, deliberate measures to deal with the reported high rates necessitate joint intervention efforts from the policy makers, health providers and community at large.
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Affiliation(s)
- Lucy R. Mgopa
- 0000 0001 1481 7466grid.25867.3eDepartment of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, School of Medicine, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Jessie Mbwambo
- 0000 0001 1481 7466grid.25867.3eDepartment of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, School of Medicine, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Samuel Likindikoki
- 0000 0001 1481 7466grid.25867.3eDepartment of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, School of Medicine, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Pedro Pallangyo
- The Jakaya Kikwete Cardiac Institute, Directorate of Research & Publications, P.O Box 65141, Dar es Salaam, Tanzania
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25
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Wong NS, Tang W, Han L, Best J, Zhang Y, Huang S, Zheng H, Yang B, Wei C, Pan SW, Tucker JD. MSM HIV testing following an online testing intervention in China. BMC Infect Dis 2017; 17:437. [PMID: 28629439 PMCID: PMC5477382 DOI: 10.1186/s12879-017-2546-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 06/13/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Scaling up HIV testing is the first step in the HIV treatment continuum which is important for controlling the HIV epidemic among men who have sex with men (MSM). Following an online HIV testing intervention among MSM, we aim to examine sociodemographic and spatial factors associated with HIV testing. METHODS We conducted a secondary analysis on data from an online HIV testing intervention among MSM who had never-tested for HIV. The survey was distributed through online networks connected to all provinces and regions of China. Univariate and multivariable analyses were performed to examine factors associated with testing three weeks post-intervention. RESULTS At three weeks after the intervention, 36% of 624 followed-up MSM underwent HIV testing, 69 men reported positive HIV test results. Having money for sex, ever tested for sexually transmitted infections and intimate partner violence experience were significant factors of post-intervention HIV testing. Students were less likely to undergo HIV testing at follow-up compared to others (adjusted odds ratio=0.69, 95% C.I.=0.47-0.99), adjusted by age and type of intervention. Moderate provincial spatial variation of testing was observed. CONCLUSIONS While high risk men generally had higher HIV testing rates, some MSM like students had lower testing rates, suggesting the need for further ways to enhance HIV testing in specific MSM communities.
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Affiliation(s)
- Ngai Sze Wong
- University of North Carolina Project-China, Guangzhou, Guangdong China
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, Guangdong China
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- SESH Global, Guangzhou, Guangdong China
| | - Larry Han
- University of North Carolina Project-China, Guangzhou, Guangdong China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, Guangdong China
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - John Best
- University of North Carolina Project-China, Guangzhou, Guangdong China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, Guangdong China
- School of Medicine, University of California, San Francisco, CA USA
| | - Ye Zhang
- University of North Carolina Project-China, Guangzhou, Guangdong China
- SESH Global, Guangzhou, Guangdong China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, Guangdong China
| | - Shujie Huang
- SESH Global, Guangzhou, Guangdong China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, Guangdong China
- Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong China
| | - Heping Zheng
- SESH Global, Guangzhou, Guangdong China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, Guangdong China
- Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong China
| | - Bin Yang
- SESH Global, Guangzhou, Guangdong China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, Guangdong China
- Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong China
| | - Chongyi Wei
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA USA
| | - Stephen W. Pan
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Joseph D. Tucker
- University of North Carolina Project-China, Guangzhou, Guangdong China
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- SESH Global, Guangzhou, Guangdong China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, Guangdong China
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26
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Semple SJ, Stockman JK, Goodman-Meza D, Pitpitan EV, Strathdee SA, Chavarin CV, Rangel G, Torres K, Patterson TL. Correlates of Sexual Violence Among Men Who Have Sex With Men in Tijuana, Mexico. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:1011-1023. [PMID: 27178173 PMCID: PMC5107348 DOI: 10.1007/s10508-016-0747-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 02/12/2016] [Accepted: 03/21/2016] [Indexed: 05/14/2023]
Abstract
Sexual violence among men who have sex with men (MSM) is prevalent in developing countries and is associated with increased HIV/STI risk. Despite high HIV prevalence (20 %) among MSM in Tijuana, Mexico, little attention has been paid to the occurrence of sexual violence in this high-risk group. The present study used a syndemic conditions framework to examine correlates of sexual violence victimization in a sample of 201 MSM surveyed in Tijuana, Mexico during 2012 and 2013. Participants were recruited through respondent-driven sampling and underwent a 2-h baseline interview and testing for HIV and syphilis. Sexual violence was defined as any incident during the past year in which the participant had been raped, sexually molested, or sexually harassed. The majority of participants self-identified as gay or bisexual, had never married, were employed, and had a high school education or greater. The average age was 29.7 years. Thirty-nine percent reported sexual violence in the past year. A hierarchical multiple linear regression model predicting more experiences of sexual violence was tested. In a final model, a higher number of experiences of sexual violence was associated with a history of childhood sexual abuse, more adult experiences of homophobia, more depression and hostility symptoms, and not living with a spouse or steady partner. The findings from this study support a model of co-occurring psychosocial factors that increase the likelihood of sexual violence experiences among MSM. Multi-level approaches to the prevention of childhood and adult experiences of sexual violence and homophobia are needed to avert the development of adverse mental and physical health outcomes associated with sexual violence victimization.
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Affiliation(s)
- Shirley J Semple
- Department of Psychiatry, University of California San Diego, Mail Code 0680, 9500 Gilman Drive, La Jolla, CA, 92093-0680, USA
| | - Jamila K Stockman
- Division of Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - David Goodman-Meza
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Eileen V Pitpitan
- Division of Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Steffanie A Strathdee
- Division of Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Claudia V Chavarin
- Department of Psychiatry, University of California San Diego, Mail Code 0680, 9500 Gilman Drive, La Jolla, CA, 92093-0680, USA
| | | | - Karla Torres
- Agencia Familiar Binacional, A.C., Tijuana, Mexico
| | - Thomas L Patterson
- Department of Psychiatry, University of California San Diego, Mail Code 0680, 9500 Gilman Drive, La Jolla, CA, 92093-0680, USA.
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27
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Miedema SS, Yount KM, Chirwa E, Dunkle K, Fulu E. Integrating male sexual diversity into violence prevention efforts with men and boys: evidence from the Asia-Pacific Region. CULTURE, HEALTH & SEXUALITY 2017; 19:208-224. [PMID: 27552806 DOI: 10.1080/13691058.2016.1214747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Men's perpetration of gender-based violence remains a global public health issue. Violence prevention experts call for engagement of boys and men to change social norms around masculinity in order to prevent gender-based violence. Yet, men do not comprise a homogenous category. Drawing on probability estimates of men who report same-sex practices and preferences captured in a multi-country gender-based violence prevention survey in the Asia-Pacific region, we test the effects of sexuality-related factors on men's adverse life experiences. We find that sexual minority men face statistically higher risk of lifetime adversity related to gender-based violence, stemming from gender inequitable norms in society. Sexuality is thus a key axis of differentiation among men in the Asia-Pacific region, influencing health and wellbeing and reflecting men's differential engagement with dominant norms of masculinity. Integrating awareness of male sexual diversity into gender-based violence prevention interventions, particularly those that work with boys and men, and bridging violence prevention programming between sexual minority communities and women, are essential to tackle the root drivers of violence.
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Affiliation(s)
| | - Kathryn M Yount
- b Hubert Department of Global Health and Department of Sociology , Emory University Atlanta , USA
| | - Esnat Chirwa
- c Gender & Health Research Unit , Medical Research Council , Pretoria , South Africa
| | - Kristin Dunkle
- c Gender & Health Research Unit , Medical Research Council , Pretoria , South Africa
| | - Emma Fulu
- d The Equality Institute , Thornbury , Australia
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28
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Zhang Y, Best J, Tang W, Tso LS, Liu F, Huang S, Zheng H, Yang B, Wei C, Tucker JD. Transgender sexual health in China: a cross-sectional online survey in China. Sex Transm Infect 2016; 92:515-519. [PMID: 27052037 PMCID: PMC5053843 DOI: 10.1136/sextrans-2015-052350] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 02/25/2016] [Accepted: 03/12/2016] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Transgender individuals are at increased risk for HIV infection around the world, yet few studies have focused on transgender individuals in China. We conducted an online cross-sectional survey of men who have sex with men (MSM) and transgender individuals to examine sociodemographics, intimate partner violence (IPV) and sexual behaviours in China. METHODS We recruited participants (born biologically male, ≥16 years old, ever engaged in anal sex with men and agreed to provide cell phone number) from three web platforms in 2014. Data on sociodemographics, IPV and sexual behaviours were collected. Logistic regressions were performed to compare the differences between transgender individuals and non-transgender MSM. RESULTS Overall, 1424 eligible participants completed our online survey. Of these participants, 61 (4.3%) were transgender individuals, including 28 (2.0%) identifying as women and 33 (2.3%) identifying as transgender. Compared with MSM, transgender individuals were more likely to have experienced IPV and sexual violence (economic abuse, physical abuse, threat to harm loved ones, threat to 'out', forced sex). In addition, transgender individuals were more likely to have engaged in commercial sex (21.3% vs 5.1%, aOR 4.80, 95% CI 2.43 to 9.51) and group sex (26.2% vs 9.2%, aOR 3.47, 95% CI 1.58 to 6.48) in the last 12 months. CONCLUSIONS Our study is consistent with the emerging literature demonstrating increased sexual risk behaviours and high levels of IPV among transgender individuals. Future research should further investigate transgender individuals' experiences of IPV and explore ways to promote disclosure of gender identity to healthcare providers. Furthermore, transgender research in China should be expanded independently of MSM research.
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Affiliation(s)
- Ye Zhang
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China
- Institute of Global Health and Infectious Diseases, University of North Carolina Project-China, Guangzhou, China
| | - John Best
- School of Medicine, University of California, San Francisco, California, USA
| | - Weiming Tang
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China
- Institute of Global Health and Infectious Diseases, University of North Carolina Project-China, Guangzhou, China
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lai Sze Tso
- Institute of Global Health and Infectious Diseases, University of North Carolina Project-China, Guangzhou, China
| | - Fengying Liu
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China
| | - Shujie Huang
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China
| | - Heping Zheng
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China
| | - Bin Yang
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, China
| | - Chongyi Wei
- Department of Epidemiology and Biostatistics & Global Health Sciences, University of California, San Francisco, California, USA
| | - Joseph D Tucker
- Institute of Global Health and Infectious Diseases, University of North Carolina Project-China, Guangzhou, China
- School of Medicine, University of California, San Francisco, California, USA
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29
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George PE, Bayer AM, Garcia PJ, Perez-Lu JE, Burke JG, Coates TJ, Gorbach PM. Is Intimate Partner and Client Violence Associated with Condomless Anal Intercourse and HIV Among Male Sex Workers in Lima, Peru? AIDS Behav 2016; 20:2078-89. [PMID: 26880321 PMCID: PMC4985504 DOI: 10.1007/s10461-016-1327-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Violence experience can increase HIV risk behaviors; however, literature is scarce on violence among male sex workers (MSWs) globally. In 2014, 210 Peruvian MSWs (median age 24.9) were interviewed about their experience of physical, emotional, and sexual violence and condom use with non-paying intimate partners and clients and were tested for HIV. Multivariable models examined relationships between violence in the past 6 months, condomless anal intercourse (CLAI) in the past 3 months and HIV infection. HIV infection (24 %), CLAI (43 %), being a violence victim (42 %) and perpetrator (39 %) were common. In separate multivariable models, being a violence victim [adjusted prevalence ratio aPR = 1.49 (95 % CI 1.09-2.03)] and perpetrator [aPR = 1.39 (1.03-1.87)] were associated with CLAI. Further, being a victim [aPR = 1.65 (1.04-2.62)] was associated with HIV infection. Violence, which was significantly associated with CLAI and HIV infection, is common among Peruvian MSWs, reinforcing the importance of violence awareness and prevention as HIV risk-reduction strategies.
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Affiliation(s)
- Paul E George
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, 10833 LeConte Ave., CHS 12-105, Los Angeles, CA, 90095, USA.
- Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
| | - Angela M Bayer
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, 10833 LeConte Ave., CHS 12-105, Los Angeles, CA, 90095, USA
- Epidemiology, STD, and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Patricia J Garcia
- Epidemiology, STD, and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Jose E Perez-Lu
- Epidemiology, STD, and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jessica G Burke
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Thomas J Coates
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, 10833 LeConte Ave., CHS 12-105, Los Angeles, CA, 90095, USA
| | - Pamina M Gorbach
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, 10833 LeConte Ave., CHS 12-105, Los Angeles, CA, 90095, USA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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30
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Stahlman S, Grosso A, Ketende S, Pitche V, Kouanda S, Ceesay N, Ouedraogo HG, Ky-Zerbo O, Lougue M, Diouf D, Anato S, Tchalla J, Baral S. Suicidal ideation among MSM in three West African countries: Associations with stigma and social capital. Int J Soc Psychiatry 2016; 62:522-31. [PMID: 27515832 DOI: 10.1177/0020764016663969] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Suicidal ideation is understudied among men who have sex with men (MSM) across Sub-Saharan Africa. AIMS This study aimed to explore social capital and sexual behavior stigma associated with suicidal ideation among MSM in the West African nations of The Gambia, Burkina Faso and Togo. METHODS Participants were recruited using respondent-driven sampling and snowball sampling across multiple cities (n = 1555) from July 2011 to August 2013. During a single study visit, participants completed a survey. Logistic regression models were used to assess bivariate and multivariable associations with suicidal ideation. RESULTS The prevalence of lifetime suicidal ideation was 13% overall and ranged 6%-17% across study sites. After adjusting for potential confounders, MSM who reported stigma as a result of having sex with men were more likely to report suicidal ideation. Physical and sexual violence was strongly associated with suicidal ideation, including being physically harmed (adjusted odds ratio (aOR) = 2.94, 95% confidence interval (CI) = 1.91, 4.52), tortured (aOR = 3.86, 95% CI = 2.17, 6.86) and raped (aOR = 3.07, 95% CI = 2.05, 4.60). In contrast, increasing social participation with the broader community was associated with decreased report of suicidal ideation (aOR = 0.91, 95% CI = 0.85, 0.99). CONCLUSION Sexual behavior stigma should be addressed to improve mental health among MSM in Western Sub-Saharan Africa.
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Affiliation(s)
- Shauna Stahlman
- Center for Public Health and Human Rights and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ashley Grosso
- Center for Public Health and Human Rights and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sosthenes Ketende
- Center for Public Health and Human Rights and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Vincent Pitche
- Conseil National de Lutte contre le SIDA-Togo (National AIDS Council), Faculté des Sciences de la Santé, Université de Lomé, Lomé, Togo
| | - Seni Kouanda
- Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso Institut Africain de Santé Publique, Ouagadougou, Burkina Faso
| | | | - Henri G Ouedraogo
- Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
| | - Odette Ky-Zerbo
- Programme d'Appui au Monde Associatif et Communautaire (PAMAC), Ouagadougou, Burkina Faso
| | - Marcel Lougue
- Programme d'Appui au Monde Associatif et Communautaire (PAMAC), Ouagadougou, Burkina Faso
| | | | | | | | - Stefan Baral
- Center for Public Health and Human Rights and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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31
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Biello KB, Thomas BE, Johnson BE, Closson EF, Navakodi P, Dhanalakshmi A, Menon S, Mayer KH, Safren SA, Mimiaga MJ. Transactional sex and the challenges to safer sexual behaviors: a study among male sex workers in Chennai, India. AIDS Care 2016; 29:231-238. [PMID: 27397549 DOI: 10.1080/09540121.2016.1204421] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Male sex workers (MSW) are a significant but invisible population in India who are at risk for HIV/sexually transmitted infections (STIs). Few studies from India have documented HIV risk factors and motivations for sex work in this population. Between 2013 and 2014, a community-based convenience sample of 100 MSW in Chennai (south India) completed a baseline risk assessment as part of a behavioral intervention. Participants were ≥18 years, and reported current sex work. We report medians and proportions, and Wilcoxon-Mann-Whitney and chi-square tests are used to examine differences between sex work and sexual behavior measures by income source. Participants were engaged in sex work for 5.0 years (IQR = 2.3-10.0), and earned 3000 (IQR = 2000-8000) Rupees (<50 USD) per month from sex work. Sixty-four percent reported ever testing for HIV and 20.2% for any STI. The most common reasons for starting sex work were money (83.0%) and pleasure (56.0%). Compared to participants with an additional source of income, those whose only source of income was sex work reported more male clients in the past month (10.0 vs. 6.0, p = .017), as well as more condomless anal sex acts with male clients (8.0 vs. 5.0, p = .008). Nearly 70.0% were offered more money not to use a condom during sex with a client, and 74.2% reported accepting more money not to use a condom. Three-quarters reported having experienced difficulty using condoms with clients. MSW in India engage in high levels of sexual risk for HIV/STIs. Money appears to be a driving factor for engaging in sex work and condomless sex with clients. HIV prevention interventions with MSW should focus on facilitating skills that will support their ability to negotiate sexual safety in the context of monetary disincentives.
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Affiliation(s)
- Katie B Biello
- a Institute for Community Health Promotion, Brown University , Providence , RI , USA.,b Departments of Behavioral & Social Sciences and Epidemiology , Brown University School of Public Health , Providence , RI , USA.,c The Fenway Institute, Fenway Health , Boston , MA , USA
| | - Beena E Thomas
- d National Institute for Research in Tuberculosis (NIRT) , Chennai , India
| | - Blake E Johnson
- c The Fenway Institute, Fenway Health , Boston , MA , USA.,e Department of Epidemiology , Harvard T. H. Chan School of Public Health , Boston , MA , USA
| | | | | | - A Dhanalakshmi
- d National Institute for Research in Tuberculosis (NIRT) , Chennai , India
| | | | - Kenneth H Mayer
- c The Fenway Institute, Fenway Health , Boston , MA , USA.,g Division of Infectious Diseases , Harvard Medical School/Beth Israel Deaconess Medical Center , Boston , MA , USA.,h Department of Global Health and Population , Harvard T. H. Chan School of Public Health , Boston , MA , USA
| | - Steven A Safren
- c The Fenway Institute, Fenway Health , Boston , MA , USA.,h Department of Global Health and Population , Harvard T. H. Chan School of Public Health , Boston , MA , USA.,i Department of Psychology , University of Miami , Coral Gables , FL , USA
| | - Matthew J Mimiaga
- a Institute for Community Health Promotion, Brown University , Providence , RI , USA.,b Departments of Behavioral & Social Sciences and Epidemiology , Brown University School of Public Health , Providence , RI , USA.,c The Fenway Institute, Fenway Health , Boston , MA , USA
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Yang GL, Zhang AD, Yu Y, Liu H, Long FY, Yan J. Drug use and its associated factors among money boys in Hunan Province, China. Public Health 2016; 140:213-220. [PMID: 27381058 DOI: 10.1016/j.puhe.2016.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 04/24/2016] [Accepted: 06/07/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To describe drug use, types of drugs and related factors among money boys in Hunan Province, China. STUDY DESIGN A cross-sectional study was conducted between July 2012 and January 2013. METHODS Based on respondent-driven sampling, researchers located seven 'seeds' via a gay-dating website: http://www.ixxqy.org. After three waves of recruitment, 234 money boys were enrolled. They were asked to complete a 23-item questionnaire regarding demographic characteristics, drug use, a history of human immunodeficiency virus infection and family environment. Descriptive statistics and logistic regression analysis were conducted using Statistical Package for the Social Sciences Version 20.0. RESULTS In total, 205 valid questionnaires were collected. Based on the data collected, 80 (39.0%) money boys had used drugs within the last 3 months. Rush popper (36.6%) and methamphetamine (12.7%) were used most commonly, and other drugs used were ecstasy (7.8%), ketamine (5.9%), marijuana (2.4%), morphine (1.5%), heroin (1.0%) and cocaine (0.5%). Factors included in the logistic regression were length of service (odds ratio [OR] 0.395, 95% confidence interval [CI] 0.175-0.896), being an only child (OR 2.272, 95% CI 1.108-4.659), relationship between parents (OR 0.428, 95% CI 0.213-0.858) and social network (OR 2.387, 95% CI 1.144-4.970). A shorter length of service and a good relationship between parents were protective factors against drug use, while being an only child and having a wide social network were risk factors. CONCLUSION Drug use is common among money boys. This study found that length of service, being an only child, relationship between parents and social network are associated with drug use.
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Affiliation(s)
- G L Yang
- Third Xiangya Hospital, Central South University, Changsha, China
| | - A D Zhang
- Third Xiangya Hospital, Central South University, Changsha, China
| | - Y Yu
- School of Humanities and Management, Southern Medical University, Guangzhou, China
| | - H Liu
- Third Xiangya Hospital, Central South University, Changsha, China
| | - F Y Long
- Third Xiangya Hospital, Central South University, Changsha, China
| | - J Yan
- Third Xiangya Hospital, Central South University, Changsha, China.
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Intimate Partner Violence and Correlates With Risk Behaviors and HIV/STI Diagnoses Among Men Who Have Sex With Men and Men Who Have Sex With Men and Women in China: A Hidden Epidemic. Sex Transm Dis 2016. [PMID: 26222752 DOI: 10.1097/olq.0000000000000302] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Intimate partner violence (IPV) research has primarily focused on heterosexual couples but has largely ignored IPV among men who have sex with men (MSM). We examined IPV prevalence among MSM and men who have sex with men and women (MSMW) in China. METHODS Men who have sex with men older than 16 years were recruited through 3 MSM-focused Web sites in China. An online survey containing items on sociodemographics, risk behaviors, IPV, and self-reported HIV or sexually transmitted infection diagnosis was completed. Multivariate regression was used to examine associations between IPV and risk behaviors and an HIV or sexually transmitted infection diagnosis. RESULTS Among 610 participants, 182 (29.8%) reported experiencing at least 1 type of IPV. Men who have sex with both men and women were at significantly greater risk for IPV (adjusted odds ratio [AOR], 1.65; 95% confidence interval [CI], 1.08-2.53) compared with MSM. Men who had experienced IPV were more likely to have participated in group sex (AOR, 1.86; 95% CI, 1.08-3.21), to have had sex in exchange for gifts or money (AOR, 5.06; 95% CI, 2.47-10.35), and to report a positive HIV diagnosis (AOR, 2.59; 95% CI, 1.22-5.51). CONCLUSIONS There is a hidden epidemic of IPV among MSM in China, especially among MSMW. The hidden nature of MSM and MSMW suggests the need for a clinical environment more conducive to disclosure. Research is needed to understand the pathways linking IPV and HIV risk among MSM to optimize the design of effective interventions.
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Hypothetical Rectal Microbicide Acceptability and Factors Influencing It among Men Who Have Sex with Men in Tianjin, China. PLoS One 2016; 11:e0156561. [PMID: 27243457 PMCID: PMC4887105 DOI: 10.1371/journal.pone.0156561] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 05/16/2016] [Indexed: 11/19/2022] Open
Abstract
Objectives To measure potential acceptability of rectal microbicides and to explore factors likely to affect their acceptability among men who have sex with men (MSM). Methods Cross-sectional and retrospective surveys were conducted in this study. A questionnaire and a scale were used to measure the acceptability score for physical and functional characteristics of hypothetical rectal microbicides. We also evaluated the involvement of other factors such as sexual behaviors, social context, etc. Results MSMs we interviewed showed a high acceptability to rectal microbicides, indicated by the mean acceptability score of 2.92 (SD, 0.54, scale of 1–4). The results also suggested that microbicides were preferred in a cream form that can moisten and lubricate the rectum, prevent HIV infection and go unnoticed by their partners. Multivariate analysis showed that the microbicides acceptability varied significantly by education level (β = 0.135; P = 0.028), having casual partners (β = 0.174; P = 0.007), frequency of lubricant use (β = 0.134; P = 0.031), history of HIV test (β = 0.129; P = 0.036), willingness to use lubricant (β = 0.126; P = 0.045), locus of control by partners regarding STI infection (β = 0.168; P = 0.009). Conclusions A positive response to rectal microbicides among MSMs was found in our study, suggesting that rectal microbicides might have a potential market in MSMs and they might play an important role in HIV/STIs prevention as a supplement. Further studies may be considered to combine the acceptability study with clinical research together to understand the true feelings of MSMs when they use the products.
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Sabidó M, Kerr LRFS, Mota RS, Benzaken AS, de A Pinho A, Guimaraes MDC, Dourado I, Merchan-Hamman E, Kendall C. Sexual Violence Against Men Who Have Sex with Men in Brazil: A Respondent-Driven Sampling Survey. AIDS Behav 2015; 19:1630-41. [PMID: 25666270 DOI: 10.1007/s10461-015-1016-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We estimated the prevalence of sexual violence (SV) experience among men who have sex with men (MSM) in Brazil and identified its associated risk factors. We recruited 3859 MSM through respondent driven sampling. A multivariable hierarchical analysis was performed using an ecological model. The prevalence of having ever experienced SV was 15.9 % (95 % confidence interval [CI] 14.7-17.1). SV experience was independently associated with discrimination due to sexual orientation (odds ratio [OR] 3.05; 95 % CI 2.10-4.42), prior HIV testing (OR 1.81; 95 % CI 1.25-2.63), ≤14 years at first sex (OR 1.86; 95 % CI 1.28-2.71), first sex with a man (OR 1.89; 95 % CI 1.28-2.79), presenting STI symptoms (last year) (OR 1.66; 95 % CI 1.12-2.47), and having suicidal ideas (last 6 months) (OR 2.08; 95 % CI 1.30-3.35). The high levels of SV against MSM in Brazil place them at a markedly higher risk of SV than the general population. Homophobic prejudice is the strongest determinant of SV and urgently needs to be included at the forefront of the national response to SV.
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Affiliation(s)
- Meritxell Sabidó
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Avenida Pedro Teixeira 25, Manaus, AM, CEP: 69040-000, Brazil,
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Brawner BM, Alexander KA, Fannin EF, Baker JL, Davis ZM. The Role of Sexual Health Professionals in Developing a Shared Concept of Risky Sexual Behavior as it Relates to HIV Transmission. Public Health Nurs 2015; 33:139-50. [PMID: 26184496 DOI: 10.1111/phn.12216] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
"Risky sexual behavior" accounts for the majority of new HIV infections regardless of gender, age, geographic location, or ethnicity. The phrase, however, refers to a relatively nebulous concept that hampers development of effective sexual health communication strategies. The purpose of this paper was to propose development of a shared conceptual understanding of "risky sexual behavior." We reviewed multidisciplinary HIV/AIDS literature to identify definitions of risky sexual behavior. Both the linguistic components and the social mechanisms that contribute to the concept of risky sexual behaviors were noted. Risky sexual behavior was often defined in a subjective manner in the literature, even in the scientific research. We urge a paradigm shift to focus on explicit behaviors and the social context of those behaviors in determining HIV risk. We also propose a new definition that reduces individual biases and promotes a broader discussion of the degree of sexual risk across a diversity of behavioral contexts. Sexual health professionals can strengthen practice and research initiatives by operating from a concise working definition of risky sexual behavior that is broadly transferable and expands beyond a traditional focus on identity-based groups.
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Affiliation(s)
- Bridgette M Brawner
- Department of Nursing, Center for Health Equity Research and Center for Global Women's Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Kamila A Alexander
- Johns Hopkins School of Nursing, Department of Community Public Health, Baltimore, Maryland
| | - Ehriel F Fannin
- Center for Health Equity Research and Center for Global Women's Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Jillian L Baker
- Department of Urban Public Health & Nutrition, School of Nursing & Health Sciences, La Salle University, Philadelphia, Pennsylvania
| | - Zupenda M Davis
- Department of Urban Public Health & Nutrition, School of Nursing & Health Sciences, La Salle University, Philadelphia, Pennsylvania
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Davis A, Best J, Wei C, Luo J, Van Der Pol B, Meyerson B, Dodge B, Aalsma M, Tucker J. Intimate Partner Violence and Correlates With Risk Behaviors and HIV/STI Diagnoses Among Men Who Have Sex With Men and Men Who Have Sex With Men and Women in China: A Hidden Epidemic. Sex Transm Dis 2015. [PMID: 26222752 DOI: 10.1097/olq.00000000000003022017.03.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
BACKGROUND Intimate partner violence (IPV) research has primarily focused on heterosexual couples but has largely ignored IPV among men who have sex with men (MSM). We examined IPV prevalence among MSM and men who have sex with men and women (MSMW) in China. METHODS Men who have sex with men older than 16 years were recruited through 3 MSM-focused Web sites in China. An online survey containing items on sociodemographics, risk behaviors, IPV, and self-reported HIV or sexually transmitted infection diagnosis was completed. Multivariate regression was used to examine associations between IPV and risk behaviors and an HIV or sexually transmitted infection diagnosis. RESULTS Among 610 participants, 182 (29.8%) reported experiencing at least 1 type of IPV. Men who have sex with both men and women were at significantly greater risk for IPV (adjusted odds ratio [AOR], 1.65; 95% confidence interval [CI], 1.08-2.53) compared with MSM. Men who had experienced IPV were more likely to have participated in group sex (AOR, 1.86; 95% CI, 1.08-3.21), to have had sex in exchange for gifts or money (AOR, 5.06; 95% CI, 2.47-10.35), and to report a positive HIV diagnosis (AOR, 2.59; 95% CI, 1.22-5.51). CONCLUSIONS There is a hidden epidemic of IPV among MSM in China, especially among MSMW. The hidden nature of MSM and MSMW suggests the need for a clinical environment more conducive to disclosure. Research is needed to understand the pathways linking IPV and HIV risk among MSM to optimize the design of effective interventions.
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Affiliation(s)
- Alissa Davis
- From the *Department of Epidemiology & Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN; †UNC-Project China, Guangzhou, China; ‡Rural Center for AIDS/STD Prevention, Indiana University School of Public Health-Bloomington, Bloomington, IN; §School of Medicine and ¶Department of Epidemiology & Biostatistics and Global Health Sciences, University of California-San Francisco, San Francisco, CA; ∥School of Medicine, University of Alabama-Birmingham, Birmingham, AL; **Department of Applied Health Science and ††Center for Sexual Health Promotion, Indiana University School of Public Health-Bloomington, Bloomington, IN; ‡‡Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN; §§School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, CA; and ¶¶Social Entrepreneurship for Sexual Health Research Group, University of North Carolina and Guangdong Provincial Center for Skin Diseases & STI Control, Guangzhou, China
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Buller AM, Devries KM, Howard LM, Bacchus LJ. Associations between intimate partner violence and health among men who have sex with men: a systematic review and meta-analysis. PLoS Med 2014; 11:e1001609. [PMID: 24594975 PMCID: PMC3942318 DOI: 10.1371/journal.pmed.1001609] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 01/17/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) among men who have sex with men (MSM) is a significant problem. Little is known about the association between IPV and health for MSM. We aimed to estimate the association between experience and perpetration of IPV, and various health conditions and sexual risk behaviours among MSM. METHODS AND FINDINGS We searched 13 electronic databases up to 23 October 2013 to identify research studies reporting the odds of health conditions or sexual risk behaviours for MSM experiencing or perpetrating IPV. Nineteen studies with 13,797 participants were included in the review. Random effects meta-analyses were performed to estimate pooled odds ratios (ORs). Exposure to IPV as a victim was associated with increased odds of substance use (OR = 1.88, 95% CI(OR) 1.59-2.22, I² = 46.9%, 95% CI(I)² 0%-78%), being HIV positive (OR = 1.46, 95% CI(OR) 1.26-1.69, I² = 0.0%, 95% CI(I)² 0%-62%), reporting depressive symptoms (OR = 1.52, 95% CI(OR) 1.24-1.86, I² = 9.9%, 95% CI(I)² 0%-91%), and engagement in unprotected anal sex (OR = 1.72, 95% CI(OR) 1.44-2.05, I² = 0.0%, 95% CI(I)² 0%-68%). Perpetration of IPV was associated with increased odds of substance use (OR = 1.99, 95% CI(OR) 1.33-2.99, I² = 73.1%). These results should be interpreted with caution because of methodological weaknesses such as the lack of validated tools to measure IPV in this population and the diversity of recall periods and key outcomes in the identified studies. CONCLUSIONS MSM who are victims of IPV are more likely to engage in substance use, suffer from depressive symptoms, be HIV positive, and engage in unprotected anal sex. MSM who perpetrate IPV are more likely to engage in substance use. Our results highlight the need for research into effective interventions to prevent IPV in MSM, as well as the importance of providing health care professionals with training in how to address issues of IPV among MSM and the need to raise awareness of local and national support services.
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Affiliation(s)
- Ana Maria Buller
- Gender Violence and Health Centre, Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Karen M. Devries
- Gender Violence and Health Centre, Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Louise M. Howard
- Section of Women's Mental Health and King's Health Partners Women's Health Academic Centre, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Loraine J. Bacchus
- Gender Violence and Health Centre, Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Pan SW, Ruan Y, Spittal PM, Pearce ME, Qian HZ, Li D, Zhang Z, Shao Y. HIV vulnerabilities and coercive sex at same-sex sexual debut among men who have sex with men in Beijing, China. AIDS Care 2013; 26:742-9. [PMID: 24099311 DOI: 10.1080/09540121.2013.845284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Few studies have examined coercive sex and HIV vulnerabilities among men who have sex with men (MSM) in China. The present study seeks to compare individual characteristics between MSM who did and did not experience coercive sex at their MSM sexual debut and to identify HIV risk factors correlated with coercive sex at MSM sexual debut. In 2007, we recruited 167 MSM in Beijing, China by peer-referred social network sampling. Each participant then completed self-administered questionnaires regarding their sexual experiences and practices. Results show that 14% of participants reported coercive sex at MSM sexual debut, of whom 48% reported recent unprotected anal intercourse (UAI). Coercive sex at MSM sexual debut was significantly associated with UAI [adjusted odds ratio (AOR): 5.38, 95% confidence interval: 1.95-14.87] and lifetime number of male sex partners (AOR: 7.25, 95% CI: 2.39-22.01). Coercive sex is harming MSM in China and should be immediately addressed by researchers, public health officials, and MSM community stakeholders.
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Affiliation(s)
- Stephen W Pan
- a School of Population and Public Health , University of British Columbia , Vancouver , BC , Canada
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