Objectives
To understand the stigma and discrimination experienced by MSM in Chengdu, and to evaluate their impact on effective HIV prevention.
Methods
Focus group discussions and individual in-depth interviews were conducted from June to September, 2006.
Results
Stigma and social pressure for MSM were reported to mainly arise from their families to get married and have children to protect family reputation and lineage. Few participants reported experiencing stigma and discrimination from friends, colleagues, or general society. Nevertheless, fear of being ostracized because of their sexual orientation was frequently expressed, and was a major barrier for participating in HIV/AIDS prevention programs. Fear of stigma and discrimination related to HIV infection from inside the MSM community was also identified as a major reason for MSM reluctance to seek HIV testing and treatment.
Conclusions
Stigma and discrimination related to homosexual activities and HIV/STD infection have been major barriers against MSM seeking health services. HIV/AIDS programs must be sensitive to issues of stigma both from outside and inside the MSM community.
Objective
To assess the prevalence of HIV and selected STDs among MSM in Chengdu, China and the risk factors associated with HIV infection.
Methods
A cross-sectional study using a snowball sampling method was conducted from March to July, 2007. Participants were asked to complete a questionnaire about sexual history, high risk behaviors, STD infection history, HIV knowledge and testing, and an assessment of depression. Blood samples were taken for antibody testing for HIV, HSV-2, and syphilis.
Results
A total of 538 MSM were recruited and 513 (95.4%) consented to complete the questionnaire. HIV, HSV-2 and syphilis prevalence were 9.1%, 24.7%, and 28.1%, respectively. The rate of consistent condom use was low and varied by types of sexual partners. The highest was with casual male partners (38.6%) and the lowest was with wife or girl friend (17.8%). Money boys (MB) were 6 times more likely to be infected with HIV compare to clerks/students. Infection with either HSV or syphilis increased the risk of HIV infection more than 4 fold.
Conclusions
The prevalences of HIV and STDs were high among MSM in Chengdu. To prevent HIV/STDs, campaigns promoting condom use are needed not only to boost the frequency of condom use, but also to educate MSM about proper condom use.
Education about HIV/AIDS and VCT needs to be improved, and levels of stigma and discrimination reduced, in order to enhance the uptake of VCT services, an essential step for the initiation of treatment.
High-risk sexual practices were common among MSW regardless of their high level of HIV awareness. The working venues were associated with HIV infection and a recent test for HIV was a potential predictor of HIV infection. The time-location sampling method was found to be an appropriate way of recruiting MSW for this study, especially those without fixed working places.
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