Abstract
Objective. This research was conducted to assess the correlates of alcohol consumption and HIV/AIDS-related stigmatizing and discriminatory attitudes among men who have sex with men (MSM) in Shandong province, China. Methods. A cross-sectional survey provided demographics, sexual behaviors, illicit drug use, alcohol consumptions, and service utilization. Results. Of 1,230 participants, 82.8% were single, 85.7% aged <35 years, 47.2% had college or higher education, and 11.7% drank alcohol >3 times per week in the past six months. The average total score of stigmatizing and discriminatory attitude was 37.4 ± 4.4. More frequent episodes of alcohol use were independently associated with higher levels of HIV/AIDS-related stigma and discrimination, unprotected anal sex, bisexual identity, multiple male sex partners, drug use, and lower levels of education. Expressing higher levels of HIV/AIDS-related stigmatizing and discriminatory attitudes was independently associated with alcohol use, unprotected male anal sex, bisexuals, more male sex partners, commercial sex with men, and non-receipt of peer education in the past year. Conclusion. HIV/AIDS-related stigmatizing and discriminatory attitudes are common and associated with alcohol use and unprotected sex among MSM. The finding highlights the needs to develop programs that would reduce HIV/AIDS-related stigmatizing and discriminatory attitudes and strengthen alcohol use prevention and risk reduction initiatives among MSM.
Highlights
The rapid rise in HIV prevalence among men who have sex with men (MSM) in many cities across the nation has drawn attention to the dynamics of the HIV epidemic in China [1,2,3]
91.4% of participants reported having had sex with men in the past six months, 54.3% had more than two male sex partners in the past week, 70.8% used a condom at last anal sex, and 31.3% consistently used condoms in the past 6 months with male partners
To the best of our knowledge, this is the first study from China that assesses HIV/AIDS-related stigmatizing and discriminatory attitudes and its relationship with alcohol consumption among MSM
Summary
The rapid rise in HIV prevalence among men who have sex with men (MSM) in many cities across the nation has drawn attention to the dynamics of the HIV epidemic in China [1,2,3]. It is estimated that about 2.2% of Chinese adult males had sex with another male [4]. According to the 2011 estimates for the HIV/AIDS epidemic in China, 81.6% of 48,000 HIV new cases were infected through sexual contact, 29.4% of those infected from sexual contact were through homosexual contact [2]. Under the strong influence of Confucianism and collectivism, Chinese traditional culture emphasizes familial responsibilities; MSM behaviors are highly stigmatized and MSM face strong social pressure to hide their identity [5]. Stigma surrounding HIV/AIDS has been shown to act as a barrier to HIV prevention, treatment, and care [6, 7]. People who hold stigmatizing attitudes are less likely to adopt preventive behaviors and more likely to have multiple sexual partners, a commercial sex partner, and some other HIV-related high-risk behaviors [8, 9]
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