Abstract

BackgroundMen who have sex with men (MSM) are a high-risk group for sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV) infection. In China, the vast majority of MSM feel forced to marry or plan to marry women, according to traditional Chinese culture. Women who have regular sexual relations with MSM, called tongqi in mainland China, live with a high risk of STDs or HIV infection, but these risks are often ignored. Our investigation of this group of the women is a preliminary study that aims to understand the sexual health problems of tongqi and related factors.MethodsThis study relied on website mobilization and was funded by tongqi. Participants were limited to women who had sex with MSM to whom they were married (in-GWs), whom they had divorced (ex-GWs), or with whom they were friends (GGFs). The data were collected using questionnaire software.ResultsA total 144 valid surveys were returned from 100 in-GWs, 33 ex-GWs, and 11 GGFs. Average respondent age was 32.8 ± 6.4 years (range 22 to 58 years). Among in-GWs and ex-GWs, over 95% learned that their husbands were MSM after marriage. More than half of respondents had had sex before marriage, and one-third of those women had sex partners other than their husbands. In addition, 35.3% of tongqi had STDs symptoms. About 50% participants had had oral sex with sex partners of MSM and 10% had had passive anal sex, with low condom use during both oral (9.7%) and anal sex (23.1%). Most tongqi had misunderstandings about STDs and HIV and less than 30% had undergone HIV screening. Among participants tested, 5.6% were HIV positive. A total 93.5% of respondents believed that laws should be established to protect the sexual rights of women.ConclusionsWomen who have regular sexual relations with MSM face adverse sexual health issues and are susceptible to STDs and HIV infection. Measures must be taken to protect the rights and interests of tongqi in mainland China.

Highlights

  • Men who have sex with men (MSM) are a high-risk group for sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV) infection

  • Women who participated in the survey were required to meet three conditions: 1) they had had regular sex with MSM; 2) they had confirmed that their sex partners were not heterosexual and had had sex with other men; and 3) they had registered on the Tongqi Homeland website at least 1 month before the survey began

  • In traditional Chinese culture, procreation is considered to be the main purpose of sex and marriage; most MSM feel obligated to marry women

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Summary

Introduction

Men who have sex with men (MSM) are a high-risk group for sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV) infection. Women who have regular sexual relations with MSM, called tongqi in mainland China, live with a high risk of STDs or HIV infection, but these risks are often ignored. Our investigation of this group of the women is a preliminary study that aims to understand the sexual health problems of tongqi and related factors. Data from a 2010 survey of 443 MSM in Tanzania who did not use injection drugs showed that 29.1% of them were married and 11.9% were separated, divorced, or widowed [8] Another survey of MSM with HIV/AIDS carried out in India showed that women whose sex partners were MSM were at risk for HIV/AIDS [9]. Surveys of MSM with HIV/AIDS in some countries reveal a high percentage are married or have had sex with heterosexual women; few surveys have focused on these women [7, 10, 11]

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