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Experiences of homophobia are related to concurrent sexual partnerships and unprotected anal intercourse among men who have sex with men (MSM) in Shanghai, China

Kyung Hee Choi, PhD and Esther Hudes, PhD. Center for AIDS Prevention Studies, University of California, San Francisco, 50 Beale Street, Suite 1300, San Francisco, CA 94105, 415-597-9281, Kyung-Hee.choi@ucsf.edu

Background: Social discrimination has been shown to affect various health outcomes. However, little is known about mechanisms (e.g., sex partner concurrency) through which experiences of homophobia and poverty operate in determining HIV risk among MSM in China.

Methods: We analyzed data obtained from 477 MSM in Shanghai who were recruited from September 2004 to June 2005 and completed a face-to-face standardized questionnaire.

Results: The mean age of participants was 28; 74% had no college education; 13% were currently married; 57% self-identified as gay and 38% as bisexual. During the six months prior to interview, 57% of participants reported unprotected anal intercourse with men and 33% reported having concurrent male sex partners. In bivariate analyses, experiences of homophobia were associated with having concurrent male sex partners (OR=1.51; 95% CI=1.02, 2.24); having concurrent male sex partners was associated with having unprotected anal intercourse (OR=2.69; 95% CI=1.78, 4.09); and experiences of homophobia was associated with having unprotected anal intercourse (OR=2.78; 95% CI=1.32, 5.82). In multivariate analysis, experiences of homophobia (OR=2.69; 95% CI=1.25, 5.79) and having concurrent male partners (OR=2.61; 95% CI=1.71, 3.98) were associated with having unprotected anal intercourse. Experiences of financial hardships were not related to either concurrency or having unprotected anal intercourse.

Conclusions: We found a direct relationship between experiences of homophobia and unprotected anal intercourse among MSM in China, and this relationship remained strong when we controlled for concurrent partnerships. These results suggest that stigmatization issues should be addressed to help reduce sexual risk for HIV in this population.

Learning Objectives:

Keywords: Gay Men, Homophobia

Awards: Excellence in Abstract Submission on an International Topic--Award Winner - Recipient

Presenting author's disclosure statement:

Not Answered

Global Issues in HIV/AIDS

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA