In China, men who have sex with men (MSM) are at increasingly high risk for HIV. However, prevention efforts targeting this population may be hindered because of the stigma associated with homosexuality in traditional Chinese culture. We conducted qualitative interviews with 30 MSM in Shanghai to better understand the types and sources of stigma and discrimination and how MSM respond to them. The stigma associated with homosexuality can be traced back to four culturally based factors: social status and relationships, the value of family, perceptions of immorality and abnormality, and gender stereotypes of masculinity. In particular, the centrality of the family and the importance of maintaining key relationships caused stress and anxiety, contributing to more frequent encounters with felt stigma. In response, MSM often evaded the scrutiny of family members through various tactics, even prompting some to leave their rural homes. Implications of these findings on HIV/AIDS prevention are discussed.

E-cadherin is a key cell adhesion molecule implicated as a tumor suppressor, which is frequently altered in hepatocellular carcinoma, especially in hepatitis B virus (HBV)-related tumors. Here, we report that HBV X protein (HBx) represses E-cadherin expression at the transcription level. Based on the differential effects of HBx natural variants, we determined that Lys-130 in the transactivation domain of HBx is critical for the E-cadherin repression. The repression effect of HBx was abolished after treatment with DNA methyltransferase inhibitor, 5 0 -Aza-2 0 dC. In addition, methylation-specific PCR analysis revealed that the CpG island 1 of E-cadherin promoter is hypermethylated by HBx. Furthermore, HBx induces DNA methyltransferase 1 expression by stimulating its transcription. Therefore, we conclude that HBx represses E-cadherin expression by inducing methylation-mediated promoter inactivation. The reduced E-cadherin expression results in dramatic morphological changes of the HBxexpressing cells. In addition, HBx-expressing cells aggregate poorly in suspension culture, reflecting their altered intercellular interactions. The biological significance was further demonstrated by the increased collagen invasion ability of HBx-expressing cells. Therefore, the present study suggests that HBx plays a role during hepatocellular carcinogenesis by favoring cell detachment from the surrounding cells and migration outside of the primary tumor site.

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