Association between a syndemic of psychosocial problems and unprotected anal intercourse among men who have sex with men in Shanghai, China

BMC Infectious Diseases

Research Article

Ajuan Liang¹  Yichen Wang²  Feng Gan³  Zhe Sun⁴  Mengmeng Jia⁴  Zhiruo Zhang⁴  Ying Wang⁴  Zezhou Wang⁴  Yong Cai⁴  Dong Yuan⁵ 

[1] Renji Hospital, affiliated with School of Medicine Shanghai Jiao Tong University, 200127, Shanghai, China;Ruijin Hospital, affiliated with School of Medicine, Shanghai Jiao Tong University, 200032, Shanghai, China;School of Continuing Education, Shanghai Jiao Tong University, 200030, Shanghai, China;School of Public Health, affiliated with School of Medicine, Shanghai Jiao Tong University, 200025, Shanghai, China;Shanghai Municipal Center for Disease Control and Prevention, 200336, Shanghai, China;

关键词: MSM;    Psychosocial problems;    Syndemic;   

DOI  :  10.1186/s12879-016-2132-8

 received in 2016-04-15, accepted in 2016-12-15,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundPrevious studies have discussed the overlapping and reinforcing effects (defined as a syndemic) of psychosocial problems on high-risk sexual behaviors among men who have sex with men (MSM). The present study aimed to apply the syndemic theory to verify the reinforcing effects of psychosocial problems on unprotected anal intercourse (UAI) among MSM in Shanghai, and determine if other important psychosocial factors fit into the syndemic theory.MethodsData were collected from 547 MSM in Shanghai, China, through face-to-face interviews. The measures for psychosocial problems included the Rosenberg Self-Esteem Scale; the Generalized Anxiety Disorder-7; the Center for Epidemiological Studies Depression Scale; the University of California, Los Angeles Loneliness Scale; and the Sexual Compulsivity Scale. We used multivariate analysis and binary logistic regression to investigate the associations between psychosocial problems and high-risk sexual behaviors.ResultsThe prevalence of UAI among MSM in the past 6 months was 54.5%. Education (graduate from college vs. high school) served as a protective factor against UAI (OR 0.59, 95% CI: 0.38–0.94). There was a high prevalence of psychosocial problems, and at least one-third of participants reported experiencing more than two psychosocial symptoms. Of these psychosocial factors that we investigated, lower self-esteem was associated with UAI in both univariate and multivariate regression model (P = 0.009). Result suggests that overlapping and reinforcing effects of psychosocial problems may increase high risk sexual behaviors among MSM in Shanghai, China (OR 1.65, 95% CI: 1.09–2.50; P = 0.018).ConclusionsWe found further evidence for a syndemic of psychosocial problems among MSM in Shanghai, China. This syndemic may also increase high risk sexual behaviors among MSM. Most HIV prevention interventions are focused on behavior change and only have moderate effects; our findings suggest that a shift from behavior-focused interventions to a more comprehensive strategy that addresses psychosocial factors may be necessary.

【 授权许可】

CC BY   
© The Author(s). 2017