Abstract
BackgroundHealth-related quality of life (HRQOL) has become commonly used both as a concept and as a field of research. However, little is known about the HRQOL of men who have sex with men and women (MSMW). The aim of this study was to examine HIV-related behaviors, social support, and HRQOL status and explore its predictors among MSMW.MethodsAn anonymous cross-sectional study was conducted by snowball sampling method in 2013. A total of 563 Chinese MSM completed a structured questionnaire. The HRQOL and social support were measured with the Chinese version of the World Health Organization Quality of Life Scale (WHOQOL-BRFE) and the Social Support Rating Scale (SSRS), respectively.ResultsOf the 563 MSM analyzed, 77 (13.68%) were MSMW who had a higher proportion of in-marriage and preference for an insertive role as compared with the men who have sex with men only (MSMO) (P<0.05). As high as 70.13% of MSMW had no regular sex partners and 72.73% of MSMW reported engaging in unprotected anal sex in the last six months. 36.36% had tested for HIV, while only 12.99% had accepted HIV voluntary counseling and testing (VCT) services. The scores of objective support and subjective support in MSMW were significantly higher than that of MSMO (P<0.05). No statistically significant difference was found in scores of all the four domains of the HRQOL between MSMW and MSMO. When comparing the HRQOL scores of MSMW with the Chinese general population reference group, the scores of MSMW were significantly lower in physical health domain. In a multivariate regression model, age, monthly income, sexual role, VCT acceptability, subjective support were associated with variability in HRQOL.ConclusionsTo improve the HRQOL among MSMW, more attention needs to be paid to those with low social support, low-income, the old and those prefer a receptive role during anal sex populations.
Highlights
As time passed, men who have sex with men (MSM) populations gradually manifested a high burden of HIV in many countries around the world
As high as 70.13% of MSMW had no regular sex partners and 72.73% of MSMW reported engaging in unprotected anal sex in the last six months. 36.36% had tested for HIV, while only 12.99% had accepted HIV voluntary counseling and testing (VCT) services
No statistically significant difference was found in scores of all the four domains of the Health-related quality of life (HRQOL) between MSMW and men who have sex with men only (MSMO)
Summary
Men who have sex with men (MSM) populations gradually manifested a high burden of HIV in many countries around the world. Low rates of condom use, multiple sexual partners and limited HIV testing were likely to increase the risk of HIV transmission. Men who have sex with men and women (MSMW) represent an important target population for understanding the spread of HIV because of the inherent bridging aspect of their sexual behavior [8]. In America, several studies have noted that black MSMW have higher risk behaviors, including more sexual partners and lower rates of condom use, and higher HIV infection rates compared with black men who have sex with men only (MSMO) and with heterosexual men [10]. Preexisting risk factors and mediational mechanisms may operate differently among MSMW; it is extremely urgent to examine the disparities in HIV related-behaviors among MSMW and MSMO in China. The aim of this study was to examine HIV-related behaviors, social support, and HRQOL status and explore its predictors among MSMW.
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