Gender Identity and Sexual Orientation in Chinese Men Who Have Sex with Men: A Latent Class Analysis

Abstract

Background: Men who have sex with men (MSM) are a diverse population yet are often treated as a monolithic risk group. In China, MSM have long been characterized as a "bridge population" of closeted men who are married to (or will marry) women due to sociocultural expectations. Latent class models can inform a more nuanced yet empirical characterization of this population.Methods: 1424 eligible respondents recruited online provided self-reported behavioral data. Nine items related to constructs including sexual behaviors, sexual orientation, and gender identity informed the latent class model. Logistic regression was used to measure associations between latent class membership and HIV-related sexual and health-seeking behaviors.Results: Model fit indicated a population structure made up of four classes that we characterized as "Gender nonconforming" (4.3%), "Closeted-unmarried" (29.9%), "Closeted-married" (24.6%), and "Out" (41.2%). Members of the "gender nonconforming" class were more likely to report HIV-related risk behaviors, and "Closeted-unmarried" class members were less likely to report health-seeking behaviors, both relative to "Out" members.Discussion: The largest latent class was made up of members of the "Out" class, an enlightening revision of a population traditionally viewed as largely closeted men. Two types of "closeted" classes emerged, distinguished by divergent tendencies regarding marriage and health seeking. Findings suggest that current understandings of Chinese MSM are simplistic (regarding closeted behaviors) and too narrow (in its definition of MSM as cisgender men). A more nuanced

Risk and Protective Profile of Men Who Have Sex With Men Using Mobile Voluntary HIV Counseling and Testing: Latent Class Analysis

“…Subgroup membership was assigned based on the class of each participant and the highest probability of belonging. A probability of ≥50% per item indicated that group members were more likely to possess a characteristic of interest [19]. The univariable multinomial logistic regression model was applied to determine differences in class characteristics and testing outcomes.…”

“…More specifically, LCA helps to identify similar characteristics among individuals to derive subgroups. LCA has been used to discern patterns of HIV risk based on demographic characteristics [18,19] and behaviors [20,21], helping define and target distinct groups. According to the theoretical basis and hypotheses of LCA, as well as previous research findings, LCA is appropriate for analysis of unidentified patterns in MSM who receive mobile VCT.…”

Sexual behaviours and sexual health among middle-aged and older adults in Britain

“…through their ability to characterise differing levels of risk 14 and health outcomes, including in sexual health. 15 Past LCAs that cluster symptoms and biomarkers to study disease profiles offer a model for translating demographic and behavioural characteristics into clinical guides that could push forward a personalised approach to sexual health service provision. 16 The purpose of this LCA subanalysis was to characterise the sexual health of this population and parse out differing sets of sexual health needs that can be used to develop and tailor appropriate services and interventions.…”

Chained multimediator model of sexual orientation disclosure, sexual minority stigma, sexual minority identity, social support, and resilience among ymsms

“…This heteronormative social environment [23] results in severe marginalization and stigma for MSMs [24], who may be exposed to negative experiences, such as social rejection, isolation, diminished social support, discrimination, and verbal and physical abuse [25]. The resulting negative effects for MSMs can include depression, anxiety, tension, and fear, as well as violence and a propensity for suicidal and antisocial behavior [26][27][28][29].…”