Sex In China Research Articles

Stroke Mortality Attributable to Low Fruit Intake in China: A Joinpoint and Age-Period-Cohort Analysis.

Stroke is the first leading cause of death in China, and low fruit intake is suggested to be one of the most important risk factors for stroke mortality. However, the trends of stroke mortality attributable to low fruit intake remain unclear in China. Therefore, this study aimed to investigate the long-term trends of stroke mortality attributable to low fruit intake by sex in China during 1990–2017. Data were obtained from the Global Burden of Disease 2017 study; the annual percentage change (APC) and average annual percentage change (AAPC) were estimated by joinpoint regression analysis, and the net age, period, and cohort effects were estimated using the age–period–cohort model with an intrinsic estimator algorithm (APC-IE). The crude mortality rates (CMRs) increased for males and decreased for females from 1990 to 2017. The age-standardized mortality rates (ASMRs) for both males and females showed consecutive significant declines from 1990 to 2017. By APC analysis, substantially increasing age effects were presented from 25 to 79 years for both sexes. The independent period and cohort effects progressively decreased during the entire period for both sexes, with a faster decrease for females than for males. Males and elder groups were the high-risk population for stroke mortality caused by low fruit intake. Although the mortality risk showed a decreasing trend, the fruit intake was still low for the Chinese population. Therefore, effective strategies and global awareness are essential to improve the current situation of low fruit intake, thereby preventing and reducing the stroke mortality risk caused by low fruit intake in China.

Trends in Disease Burden Attributable to Tobacco in China, 1990-2017: Findings From the Global Burden of Disease Study 2017.

In 2018, there were more than 371 million cigarette smokers and 12. 6 million electronic cigarette users, with 340.2 million non-smokers exposed to secondhand smoke (SHS) in China, which resulted in heavy tobacco-attributable disease burden. According to the definition by the Global Burden of Disease Study 2017 (GBD 2017), tobacco is a level 2 risk factor that consists of three sublevel risk factors, namely, smoking, SHS, and chewing tobacco. In this study, we aimed to evaluate the trends in deaths and disability-adjusted life years (DALYs) attributable to tobacco, smoking, SHS, and chewing tobacco by sex in China from 1990 to 2017 and to explore the leading causes of tobacco-attributable deaths and DALYs using data from the GBD 2017. From 1990 to 2017, the tobacco-attributable death rates per 100,000 people decreased from 75.65 [95% uncertainty interval (95% UI) = 56.23–97.74] to 70.90 (95% UI = 59.67–83.72) in females and increased from 198.83 (95% UI = 181.39–217.47) to 292.39 (95% UI = 271.28–313.76) in males. From 1990 to 2017, the tobacco-attributable DALY rates decreased from 2209.11 (95% UI = 1678.63–2791.91) to 1489.05 (95% UI = 1237.65–1752.57) in females and increased from 5650.42 (95% UI = 5070.06–6264.39) to 6994.02 (95% UI = 6489.84–7558.41) in males. In 2017, the tobacco-attributable deaths in China were concentrated on chronic obstructive pulmonary disease, ischemic heart disease, lung cancer, and stroke. The focus of tobacco control for females was SHS in 1990, whereas smoking and SHS were equally important for tobacco control in females in 2017. Increasing tobacco taxes and prices may be the most effective and feasible measure to reduce tobacco-attributable disease burdens.

Peripheral perfusion index percentiles for healthy newborns by gestational age and sex in China

Peripheral perfusion index (PPI) percentiles for newborns serve as an important observation tool in clinical practice, but research pertaining to reference ranges are lacking. The aim of this study was to establish PPI percentiles for healthy newborns by gestational age and sex at 24–48 hours of life. We conducted an observational study and examined PPI values at 24–48 hours of life in 3814 asymptomatic newborns born between 35 and 41 weeks gestation who did not need medical treatment from June 1, 2016 to May 31, 2017 at two maternity hospitals in Shanghai. Linear regression analysis was carried out on the associations between PPI values and variables such as gestational age, sex, and birthweight. Pre-ductal PPI values linearly increased with gestational age (β: 0.072; 95% CI: 0.037, 0.107; P = 0.000). Post-ductal PPI values were also mainly related to gestational age (β: 0.051; 95% CI: 0.018, 0.085; P = 0.003). Smoothed reference curves for pre- and post-ductal PPI values by gestational age and sex were derived from LMS Chart Maker. Our study is the first study to establish PPI percentiles curves for healthy newborns by gestational age and sex at 24–48 hours of life. Further research is required for the implementation of PPI curves into clinical practice.

Age-wise trends in alkaline phosphatase activity in 167,625 Chinese children aged 0–18 years

ObjectiveAlkaline phosphatase (ALP) serves as a biomarker for diagnosing several types of diseases in adults; nonetheless, its use is restricted in children because of changes in ALP activity during different physiological phases. The present study aimed to investigate ALP activity and its dynamics in children of different ages to establish the reference values for ALP activity in children. MethodsTotal 167,625 samples of children aged 0–18 years were enrolled in this study. ALP activity was measured using the 4-nitrophenyl-1-phosphate disodium salt (4-NPP)–2-amino-2-methyl-1-propanol (AMP) method with an automatic biochemical analyzer. Patients with known diagnoses that may affect ALP activity were excluded. A percentile curve was plotted using MATLAB software, and the curve was fitted using the skewness–median–coefficient of variation (LMS) method. ResultsALP activity reached the highest peak at 12–13 years of age and then gradually decreased to the lowest peak at 18–19 years of age in boys, whereas it reached the highest at 10–11 years and then gradually reduced to the lowest at 17–18 years in girls. Furthermore, the highest peak of ALP activity appeared substantially earlier in children of either sex in China than in those in Germany. ConclusionsWe showed the dynamics of ALP activity in both boys and girls between the ages of 0 and 18 years in China and compared the difference in ALP activity between children in China and Germany. Our findings provide a reference for clinicians.

How Bachelorhood and Migration Increase the HIV Transmission Risk Through Commercial Sex in China?

In China, the serious involuntary bachelorhood due to sex ratio imbalance in decades is expected to dramatically increase the spread of HIV through heterosexual contact. However, the higher HIV transmission risk and its correlates among never married men in rural China are not well understood. This study explored whether and how bachelorhood and migration increased the HIV transmission risk through commercial sex. By combining two cross-sectional survey data from never married men in rural areas and male migrants (including both married and unmarried men) in urban areas, a total of 1030 participants who were never married and age 28 and above or married male migrants were included in this study. The results show that both bachelorhood and migration put the never married male migrants at particularly higher HIV transmission risk by increasing both the possibility of engaging in commercial sex, and the frequency and inconsistency of condom use in commercial sex. Selection bias into marriage and neighborhood characteristics associated with exposure to commercial sexual risk may partly explain why male migrants that never married had a higher commercial sex related risk than that of married male migrants and never married non-migrant males.

Age-Period-Cohort Analysis of Stroke Mortality Attributable to High Sodium Intake in China and Japan.

Background and Purpose- The aim of this study is to assess the long-term trends in stroke mortality attributable to high sodium intake in China and Japan during the period 1990 to 2016. Methods- The mortality data were obtained from the GBD study (Global Burden of Disease) 2016 and were analyzed using an age-period-cohort method. Results- The age-standardized mortality rates showed declining trends for high sodium intake-related stroke mortality. The overall net drifts per year were -3.1% for Chinese men and -5.0% for Chinese women; and -4.6% for Japanese men and -5.7% for Japanese women. The local drift values were below zero in all age groups for both sexes in both countries, and all local drift values of female participants were below their counterparts of male participants. The longitudinal age curves of high sodium intake-attributable stroke mortality increased rapidly for both sexes in China, whereas those of Japanese were slowly rising. The period and cohort rate ratios were found to have similar downward patterns for both sexes in both countries, with a quicker decline for women than for men (significantly with P<0.05 for all). Conclusions- The age-standardized mortality rates, the period effect and the cohort effect of stroke mortality attributable to high sodium intake in China and Japan have been declining in both sexes and all age groups from 1990 to 2016. Consequently, sodium-reduction strategies are of low cost and effective for the prevention of stroke. It is necessary to educate the nation with the correct knowledge on healthy diet and techniques to reduce salt consumption.

Diabetes, Employment and Behavioural Risk Factors in China: Marginal Structural Models Versus Fixed Effects Models

A diabetes diagnosis can motivate its recipients to reduce their health risks by changing lifestyles but can adversely affect their economic activity. We investigate the effect of a diabetes diagnosis on employment status and behavioural risk-factors taking into account their potentially intertwined relationships. Longitudinal data from the China Health and Nutrition Survey covering the years 1997 to 2011 are used to estimate the effect of a diabetes diagnosis on employment probabilities, alcohol consumption, smoking cessation, body mass index, physical activity and hypertension. To deal with potential confounding, two complementary statistical techniques - marginal structural and fixed effects models - are applied. The marginal structural and fixed effects models generate similar results despite their different underlying assumptions. Both strategies find patterns distinct for males and females, suggesting a decrease in employment probabilities after the diagnosis for women but not for men. Further, few improvements and even further deterioration of behavioural risk factors are found for women, while for men these risk factors either improve or remain the same. These results suggest differences in the impact of diabetes between sexes in China and highlight the potential of reducing behavioural risk factors for women to narrow these inequities.

Incidence and mortality of lung cancer in China, 2008-2012.

ObjectiveTo analyze the incidence and mortality rates of lung cancer in China from 2008 to 2012.MethodsIncident and death cases of lung cancer were retrieved from the National Central Cancer Registry (NCCR) database collecting from 135 cancer registries in China during 2008−2012. The crude incidence and mortality rates of lung cancer were calculated by area (urban/rural), region (eastern, middle, western), gender and age group (0, 1−4, 5−9, …, 85+). China census in 2000 and Segi’s world population were applied for age-standardized rates. JoinPoint (Version 4.5.0.1) model was used for time trend analysis.ResultsThe crude incidence rate of lung cancer was 54.66/100,000 which ranked the first in overall cancers. The age-standardized incidence rates by China population (ASIRC) and by World population (ASIRW) were 35.13/100,000 and 34.86/100,000, respectively. The crude mortality of lung cancer in China was 45.60/100,000 and it was the first cause of cancer-related death in overall cancers. The age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 28.57/100,000 and 28.22/100,000, respectively. Incidence and mortality rates of lung cancer were higher in males than in females and higher in urban areas than in rural areas. Eastern areas had the highest incidence and mortality rates followed by middle and western areas. Incidence and mortality rates of lung cancer retained low level in age groups before 40 years old but increased greatly after and peaked in age group of 80−84. During 2003−2012, the temporal trend of the incidence rate of lung cancer in both sexes in China was general stable (P<0.05). The lung cancer incidence rate increased by 0.71% per year in females (P<0.05) and 2.26% per year in rural areas (P<0.05). The mortality rate of lung cancer decreased slightly annually during 2003−2012 in China (P>0.05). In urban areas, it declined by 0.76% per year (P<0.05), but rose by 2.09% per year (P<0.05) in rural areas.ConclusionsAppropriate targeted prevention, early detection and treatment programs should be carried out to control the local burden of lung cancer.

Sex in China, by Elaine Jeffreys with Haiqing Yu . Cambridge, UK: Polity Press, 2015. vi+ 232 pp. £50.00/€62.50 (cloth), £15.99/€20.00 (paper).

Sex in China, by Elaine Jeffreys with Haiqing Yu . Cambridge, UK: Polity Press, 2015. vi+ 232 pp. £50.00/€62.50 (cloth), £15.99/€20.00 (paper).

Treatment and outcomes of acute coronary syndromes in women: An analysis of a multicenter quality improvement Chinese study

BackgroundVariations in care and outcomes by sex in patients with acute coronary syndrome (ACS) have been reported worldwide. The aims of this study are to describe ACS management according to sex in China and the effects of a quality improvement program in Chinese male and female ACS patients. Methods and resultsClinical Pathways for Acute Coronary Syndromes - Phase 2 (CPACS-2) was a cluster randomized trial to test whether a clinical pathways-based intervention would improve ACS management in China. The study enrolled 15,141 hospitalized patients [4631 (30.6%) were women] from 75 hospitals throughout China between October 2007 and August 2010. The intervention included clinical pathway implementation and performance measurement using standardized indicators with 6 monthly audit-feedback cycles. Eight key performance indicators reflecting in hospital management of ACS were measured. After adjustment for differences in patient characteristics and comorbidities at presentation, women were significantly less likely to undergo coronary angiography when indicated (RR 0.88 [0.85 to 0.92], P<0.001), less likely to receive guideline recommended medical therapies at discharge (RR 0.94 [0.91 to 0.98], P=0.003) and more likely to be hospitalized for shorter (mean difference −0.42 [−0.73 to −0.12] days, P=0.007). However, in-hospital clinical outcomes did not differ by sex. There was no evidence of heterogeneity in the relative effects of the quality improvement initiative by sex. ConclusionsSex disparities were apparent in some key quality of care indicators for patients with suspected with ACS presenting to hospitals in China. The beneficial effect of the quality improvement program was consistent in women and men. Clinical trial registrationhttp://www.anzctr.org.au/default.aspx. Unique identifier: ACTRN12609000491268.

Book Review: Elaine Jeffreys with Haiqing Yu, Sex in China

Book Review: Elaine Jeffreys with Haiqing Yu, <i>Sex in China</i>

Elaine Jeffreys with Haiqing Yu, Sex in China

Elaine Jeffreys with Haiqing Yu, <i>Sex in China</i>

Sex in China, by Elaine Jeffreys, with Haiqing Yu. Cambridge: Polity Press, 2015. xii+232 pp. £50.00/€62.50 (cloth), £15.99/€20.00 (paper).

<i>Sex in China</i>, by Elaine Jeffreys, with Haiqing Yu. Cambridge: Polity Press, 2015. xii+232 pp. £50.00/€62.50 (cloth), £15.99/€20.00 (paper).

Sex in China

Sex in China

Psychological Stressors in the Context of Commercial Sex Among Female Sex Workers in China

Because of the illegality and stigma associated with female sex workers (FSWs) in China, data were limited regarding their psychological stressors examined through the lens of occupational health. Analyzing qualitative data from 16 gatekeepers and 38 FSWs, we explored these stressors in the context of commercial sex in China. We found that FSWs faced a continuum of stressors that resulted from poverty, limited employment, lack of social protection, violence perpetrated by clients, and limited social support from peers and stable partners. We call for empowerment and a structural approach to address the needs of FSWs to improve their psychological well-being.

New Perspectives from the Oldest Profession: Abuse and the Legal Consciousness of Sex Workers in China

Although prostitution is illegal, millions of women sell sex in China. In the process, they experience significant abuse and harm at the hands of clients, madams, pimps, the police, and health officials. This article examines the legal consciousness of Chinese sex workers through their interpretations of these abusive experiences. It reveals how they think and talk about them, and how their reactions sometimes translate into concrete actions. My evidence shows that sex workers name abuse as harmful, blame others for it, and occasionally make claims. They also have strong opinions about prostitution policies, and the relationship between these regulations and their experiences of abuse. These findings place scope conditions on previous theories of marginalized people and the law, which suggest that powerless individuals perceive a more peripheral role of the law in their lives. In addition, this evidence enriches our understanding of legal consciousness in China by showing how debates around the concept apply more broadly than previously recognized.

Factors Associated with Drinking Alcohol Before Visiting Female Sex Workers Among Men in Sichuan Province, China

Alcohol use in commercial sex is highly prevalent globally and alcohol use in conjunction with sexual activity might increase the probability of risky behaviors. In the current study, we explored individual and contextual factors associated with drinking alcohol before visiting female sex workers (FSWs) among 560 male clients in Sichuan province, China. A cross-sectional survey was conducted in Sichuan province, China. Over one-fifth (21.1 %) of the participants reported always using alcohol before having sex with FSWs. As compared to those who reported not always drinking alcohol before having sex with FSWs, male clients who reported always drinking alcohol before having sex with FSWs had higher income, were more likely to have main sex partners, to drink alcohol daily, to report minor depressive symptoms and were more likely to visit FSWs with friends rather than by themselves. Results from this study highlight the importance of addressing alcohol use among men who pay for sex in China. Future interventions should promote alcohol-related norms in reducing the harms associated with consuming alcohol.

Sexual revolution in China: implications for Chinese women and society

China is undergoing rapid changes in sexual mores due to several reasons such as decreasing control of the state over private lives of individuals, globalization of its economy, and some policies initiated by the state. There is increased acceptance of premarital sex and extramarital sex in China, especially among youth. In historically conservative China, influenced by Confucian ideals of patriarchal dominance for centuries, the sexual freedom currently enjoyed by many is unprecedented. This has impacted women's status and sexual lives in several positive ways such as increasing freedom of sexual expression, control over their bodies, sexual choices, and increasing equality with men in all spheres of life. However several negative consequences such as a rise in STD/HIV prevalence, commercial sex, and divorce rates have also been attributed to the ongoing sexual revolution in China. Recommendations combating these and suggestions for directions in future research are discussed.

Entertainment Venue Visiting and Commercial Sex in China

ABSTRACT Entertainment venues in China play an important role in the sexually transmitted disease (STD)/HIV epidemic. Most previous studies have focused on sex workers working in entertainment venues, but little is known about their clients. This study investigated the perceptions and behavior of the patrons visiting entertainment venues. Qualitative in-depth interviews were conducted with 30 male market vendors who visited entertainment venues at least once in the past 3 months in an eastern city in China. Information about their risky behavior, attitude toward commercial sex, and STD/HIV prevention approaches was collected. Saunas, karaoke bars, and massage centers are the most frequently visited entertainment venues. Seventy-three percent of study participants reported purchasing commercial sex at these entertainment venues. Participants expressed a very liberal attitude toward commercial sex. Seeking commercial sex was perceived as a characteristic of a male's nature. The perceived risks of STD/HIV infection do not deter participants from engaging in commercial sex. Commercial sex clients reported irregular condom use and a number of other misperceptions and improper practices toward preventing STD/HIV infection. Venue-based intervention is urgently needed to target the population. The sex workers themselves could potentially serve as “health educators” to communicate prevention information to their clients and encourage safer sex behavior.

Sociocultural Contexts and Communication about Sex in China: Informing HIV/STD Prevention Programs

HIV may be particularly stigmatizing in Asia because of its association with "taboo" topics, including sex, drugs, homosexuality, and death (Aoki, Ngin, Mo, & Ja, 1989). These cultural schemata expose salient boundaries and moral implications for sexual communication (Chin, 1999, Social Science and Medicine, 49, 241-251). Yet HIV/STD prevention efforts are frequently conducted in the public realm. Education strategies often involve conversations with health "experts" about condom use, safe sex, and partner communication. The gap between the public context of intervention efforts and the private and norm-bound nature of sex conversation is particularly challenging. Interviews with 32 market workers in eastern China focused on knowledge, beliefs, and values surrounding sexual practices, meanings, and communication. Sex-talk taboos, information seeking, vulnerability, partner communication, and cultural change emerged as central to understanding intervention information flow and each theme's relative influence is described. Findings illustrate the nature of how sexual communication schemata in Chinese contexts impact the effectiveness of sexual health message communication.