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T -test, chi-square test and multivariate logistic analysis were carried out to test the relationship between quality of life and unprotected anal intercourse. The questionnaires of of China anal sex men who have sex with men that were surveyed met our validity criteria response rate: A total of subjects Multivariate analysis showed that psychological health adjusted odd ratio AOR 0. Psychological health, as one important aspect of quality of life, was negatively associated with unprotected anal intercourse.

Peer Review reports. HIV epidemics have been declining in many countries and in various populations, yet the incidence is increasing within men who have sex with men MSM population in most countries, including China [ 1 — 3 ]. Although the national HIV sentinel surveillance data showed that the HIV-positive rate of risk groups, including injection drug users, female sex workers, and pregnant women, have dropped somewhat or maintained a low level, the rate among Chinese MSM has increased by more than 8 fold from 0. studies have suggested that intervention efforts aimed at reducing UAI may facilitate a reduction in China anal sex transmission [ 1112 ].

Such factors, including mental issue [ 13 ], substance or alcohol use [ 14 ], HIV knowledge [ 15 ], social stigma and support [ 16 ], have been proven determinants of UAI. Wim et al. A study on MSM showed that less-supportive social relationship was related to higher rates of unsafe sex [ 16 ]. And China anal sex various influencing factors on HIV-risk behavior into for proposing intervention strategies could produce more sustained reduction in HIV transmission among MSM [ 71819 ].

Thus, surveying mental health and social roles, which are important aspects of quality of life QOL [ 20 ], should be of great concern for intervention aimed at reducing the risk of HIV [ 9 ]. Quality of life QOL is regarded as a good measure of overall health [ 21 ]. Dey et al. And Bouhnik et al.

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WHOQOL-BREF is an international cross-culturally comparable China anal sex of life assessment instrument to assess the whole health conditions [ 26 ], and this scale not only provides a direct quantitative indication of the physical and mental health states, but also provides information about social relationships and environment [ 27 ]. Written informed consent was obtained from each of the participants. Respondents were recruited from gay bars, gay saunas, and parks. Participants were eligible if they were at least 18 years old and had anal sex with men in the last 6 months before China anal sex study.

There were valid questionnaires obtained from the MSM surveyed response rate: Eligible MSM completed the questionnaire in a private room using the standardized version on their own. And if they had difficulty in understanding some questions as they filled out the questionnaire, the trained interviewers would provide an explanation. All subjects were given the option to decline participation at any time, and an incentive of 50 Yuan about 9 USD was given for participating in the survey.

The socio-demographic characteristics included age, marital status, education level, vocation and monthly income.

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The 26 items are scored from 1 to 5, and the scores of four domains are transformed into 0 towith higher scores indicating better QOL. Unprotected anal intercourse UAI was defined as having had at least one incident of anal intercourse without a condom with any male partner during the 6 months. All ificant variables in the univariate analysis were then entered into a multivariate regression China anal sex, and stepwise method was used to select risk factors of UAI in the model.

The data were analyzed using SPSS, version The median age of this population was 26 years range 18—63 years. The socioeconomic characteristics of the subjects are shown in Table China anal sex. The of Kaiser-Meyer-Olkin 0. Exploratory factor analysis showed that the accumulative variance contribution rate was The are shown in Table 3. Compared with those participants who aged less than 45, the participants aged 45 or more had ificant higher odds of engaging in UAI AOR 3.

The are shown in Table 4. Our study found that psychological health and social relationships as two out of four domains of QOL were statistically ificant factors of UAI among MSM in our study. Due to experiencing discrimination about sexual orientation by family and other institutions, many Chinese MSM had encountered stigma, which led to mood, anxiety disorders and depression more common in MSM than in men in the general population [ 3233 ].

Moreover, increasing evidence has shown that compared to heterosexuals, gays exhibited elevations in hopelessness caused by the stressors that sexual minorities confront [ 34 — 36 ]. Safren et al. And studies implied that community-based or structural interventions that reduce sexual minority prejudices, in combination with individual-based interventions that address negative beliefs about life, may help to alleviate the high rates of mental health problems among MSM [ 3437 ]. Our suggest that improving psychological health is an aspect that should be incorporated into UAI reduction-intervention strategies to facilitate HIV prevention among Chinese MSM.

China anal sex also suggested that sexual risk prevention interventions should take addressing their capacity to build adequate and supportive social relationships into to enhance HIV prevention programs among MSM population [ 16 ]. Tsui et al. A study on HIV-positive MSM showed that sex toy users reported higher levels of sexual satisfaction, and suggested that the effect of sex toys as tools on enhancing sexual pleasure and reducing HIV transmission should be explored in further studies [ 43 ].

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China anal sex, ageism and homosexual stigma could cause older MSM to hide their homosexual activity, thus increasing the difficulty of reaching them by prevention intervention [ 4748 ]. In sum, UAI intervention programs targeting MSM need to be evidence-based and would benefit from sound research support. Our study also had some limitations. Firstly, random sampling was not performed, and the sampling was venue based in this study. Secondly, the study was conducted in only two Chinese cities, and the may not be representative of all, or even most, Chinese MSM.

Further studies in more areas of China will determine whether these findings can be generalized. Poorer psychological health and social relationships, as the important aspects of QOL, were found in the present study to be associated with higher likelihood of engaging in UAI, and psychological health played a larger role. It therefore appears necessary to incorporate improved psychological health into future intervention strategies to prevent UAI in MSM.

All data is available in the paper. Data will be shared upon request and it is subjected to the data protection regulations. Drug Alcohol Depend. Article PubMed Google Scholar. PLoS One. June, 1— Accessed on 27 January, Biomed Res Int. Increasing prevalence of HIV and syphilis but decreasing rate of self-reported unprotected anal intercourse among men who China anal sex sex with men in Harbin, China: of five consecutive surveys from to Int J Epidemiol.

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Liu JX, Choi K. Experiences of social discrimination among men who have sex with men in Shanghai, China. Hatzenbuehler ML. A Psychological Mediation Framework. Psychol Bull. Suicidal acts and ideation in homosexual and bisexual young people: A study of prevalence and risk factors.

Soc Psychiatry Psychiatr Epidemiol. Suicidal ideation and attempts among sexual minority youths receiving social services. Soc Work. Promoting the sexual health of MSM in the context of comorbid mental health problems. A meta-analytic review of controlled trials. Mental health treatment to reduce HIV transmission risk behavior: a positive China anal sex model. Sex Transm Dis. J Sex Marital Ther. USA study of sex toy use by HIV-positive men who have sex with other men: implications for sexual health. High prevalence of HIV infection and unprotected anal intercourse among older men who have sex with men in China: a systematic review and China anal sex.

BMC Infect Dis. HIV prevention: Bring safe sex to China. AIDS Care. Download references. We are particularly grateful to all the participants in the survey and kindly responded to the questionnaire. The authors would like to thank Shijie Liang and Jing Guo who helped in the data collection.

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The National Natural Science Foundation of China had no role in the de of the study, in the collection, analysis or interpretation of data, or in the writing of the manuscript. You can also search for this author in PubMed Google Scholar. Correspondence to Bo Qu. BQ deed the research. YXZ wrote the manuscript. JL and YZ participated in data analysis.

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All authors read and approved the final manuscript. Reprints and Permissions.

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Relationship between quality of life and unprotected anal intercourse among Chinese men who have sex with men: a cross-sectional study