323817
Ethnicity, ethnic identity affirmation, and language proficiency among men who have sex with men in North China: Implications for HIV vulnerability and psychological distress
China’s 56 ethnic groups (including the Han majority) represent diverse belief systems, cultural practices, and languages that can affect the sexual health and mental well-being of men who have sex with men (MSM). However, ethnocultural research among China’s MSM remains scant. This study examines how ethnic affiliation, ethnic identity affirmation, and Mandarin proficiency may be impacting Chinese MSM’s HIV vulnerability and psychological distress.
Methods
From 2013-2014, structured questionnaires were administered at MSM HIV testing clinics in a multi-ethnic Northern Chinese megalopolis (n=400). Correlations were assessed with logistic regression.
Results
Compared to ethnic Han, ethnic minorities from Southern China had greater odds of HIV infection [adjusted odds ratio (AOR): 7.40, 95% confidence interval (CI): 2.33–23.47] and forced sex (AOR: 3.27, 95% CI: 1.12–9.52). Ethnic Muslims had lower odds of unprotected anal intercourse (AOR: 0.41, 95% CI: 0.21–0.82), but greater odds of circumcision (AOR: 2.62, 95% CI: 1.24–5.51).
Weak sense of ethnic belonging was marginally associated with anxiety (AOR: 1.54, 95% CI: 0.99–2.38). Weak ethnic peer socialization was marginally associated with never testing for HIV (1.63, 95% CI: 0.93–2.86) and HIV infection (AOR: 2.08, 95% CI: 0.87–5.00). Poorer Mandarin proficiency was associated with anxiety (AOR: 2.59, 95% CI: 1.19–5.63) and marginally associated with forced sex (AOR: 2.43, 95% CI: 0.99–6.00).
Conclusion
Heterogeneous HIV vulnerabilities between ethnic groups challenge current practices of aggregating all ethnic minorities into one ‘non-Han’ category. The health implications of co-occurring ethnocultural and sexual marginalization in China warrants further research.
Learning Areas:
Diversity and culturePublic health or related research
Social and behavioral sciences
Learning Objectives:
Describe potential health implications of intersecting sexual and ethnic identities within the mainland Chinese context.
Demonstrate how ethnic affiliation, ethnic identity affirmation, and language proficiency may impact HIV vulnerability and psychological distress among men who have sex with men (MSM).
Discuss potential public health strategies to ensure sexual health and mental well-being among ethnic and linguistic minority MSM in mainland China.
Keyword(s): Lesbian, Gay, Bisexual and Transgender (LGBT), International Health
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 training grants from the National Institutes of Health, US State Department, and the 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.