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Religion and homonegativity among men who have sex with men (MSM) in North China: Implications for HIV vulnerability and psychological distress
The growth of Buddhism, Christianity, and Islam in China reflects differential religious moral belief systems that potentially impact MSM sexual health and mental well-being. Religious stigmatization of MSM can inhibit the sexual inclinations of some MSM, but may exacerbate mental distress in the process. Religious male circumcision might also help protect Muslim MSM from HIV infection. This study examines how religious affiliation and religiosity among MSM in China may shape their HIV vulnerability and psychological distress—directly and via mediation by homonegativity.
Methods
From 2013-2014, structured questionnaires were administered at MSM HIV testing clinics in North China (n=400). Scales measuring homonegativity, religiosity, and psychosocial distress were previously validated. Correlations were assessed with logistic regression.
Results
Compared to areligious counterparts, Muslim MSM were likelier to be circumcised [adjusted odds ratio (AOR): 3.04, 95% confidence interval (CI): 1.45–6.40], but less likely to have unprotected anal intercourse (UAI) (AOR: 0.47, 0.24–0.93). Buddhist MSM had higher odds of UAI (AOR: 2.06, 95% CI: 1.13–3.75). Frequent participants of religious social activities had lower odds of receptive anal sex positioning (AOR: 0.26, 95% CI: 0.08–0.91).
Internalized homonegativity was associated with anxiety (AOR: 4.45, 95%: 2.63–7.53) and depression (AOR: 5.66, 95%CI: 3.18–10.05). Perceived homonegativity was associated with UAI (AOR: 1.77, 95% CI: 1.15–2.71). Neither religious affiliation nor religiosity was associated with homonegativity.
Conclusion
Religion likely influences HIV vulnerability among MSM in China, but homonegativity may not be a mediating factor. Nonetheless, homonegativity is independently undermining MSM mental and sexual health.
Learning Areas:
Diversity and culturePublic health or related research
Social and behavioral sciences
Learning Objectives:
Describe potential health implications of intersecting sexual and religious identities within the mainland Chinese context.
Explain how religion and homonegativity may impact HIV vulnerability and psychological distress among men who have sex with men (MSM).
Demonstrate how homonegativity and religion independently correlates with sexual behaviors and mental well-being.
Discuss potential public health strategies to ensure sexual health and mental well-being among the growing population of religiously-affiliated MSM in mainland China.
Keyword(s): International Health, Lesbian, Gay, Bisexual and Transgender (LGBT)
Qualified on the content I am responsible for because: I designed and personally oversaw the study to be discussed during the presentation. I have been collaborating with public health researchers in China for eight years, and have co-authored over 15 peer reviewed articles concerning ethnocultural health issues, HIV, and/or men who have sex with men. I have also been the recipient of research grants from the National Institutes of Health, US State Department, and University of British Columbia.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.