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Public health
Research
Sexual risk behaviour, sexual victimisation, substance use and other factors related to depression in men who have sex with men in Wenzhou, China: a cross-sectional study
  1. Xiaohong Pan1,
  2. Runhua Li1,2,
  3. Qiaoqin Ma1,
  4. Hui Wang1,
  5. Tingting Jiang1,
  6. Lin He1,
  7. Shidian Zeng3,
  8. Dayong Wang3,
  9. Zhenmiao Ye3,
  10. Haishen Zhu4,
  11. Dongshe Zhao4,
  12. Shichang Xia1
  1. 1 Department of HIV/AIDS and STDs Control & Prevention, Center for Disease Control and Prevention of Zhejiang Province, Hangzhou, Zhejiang, China
  2. 2 Department of Epidemiology & Biostatistics, School of Medicine, Ningbo University, Ningbo, Zhejiang, China
  3. 3 Department of HIV/AIDS and STDs Control & Prevention, Wenzhou Center for Disease Control and Prevention, Wenzhou, Zhejiang, China
  4. 4 Department of HIV/AIDS and STDs Control & Prevention, Lucheng Center for Disease Control and Prevention, Wenzhou, Zhejiang, China
  1. Correspondence to Dr Shichang Xia; shchxia{at}cdc.zj.cn

Abstract

Objectives Men who have sex with men (MSM) are a marginalised population at high risk for a variety of mental health problems that may mutually facilitate HIV transmission. We assessed factors associated with depressive symptoms among MSM, which can provide some guidance for future mental health interventions with the MSM population for prevention of HIV infection and transmission.

Methods A cross-sectional study was conducted in Wenzhou city, China using respondent-driven sampling (RDS) between December 2013 and June 2014. A face-to-face questionnaire survey was employed to collect information about mental and psychosocial health conditions and sexual behaviour characteristics among MSM. Bivariate and multivariable logistic regression analyses were used to identify factors associated with major depressive symptoms.

Results Of the 454 participants in the study, prevalence of major depressive symptoms was 34.6%. During the past 6 months, 85% had anal sex with men, and rate of consistent condom use during anal intercourse was 45.1%. Of the respondents, 16.1% reported suicidal ideation, 62.6% had a history of smoking and 41.4% had a history of drinking alcohol, of which 46.3% reported that they were once drunk. Drug use was reported in 3.7% of the sample. Adult sexual violence from same-sex partners was 7.9%, and 5.1% reported childhood sexual abuse. ARDS-weighted multivariable analysis showed that major depressive symptoms among MSM were associated with inconsistent condom use during anal sex with men, multiple oral male sexual partners, suicidal ideation, adult sexual violence from male partners and being once drunk in the past year.

Conclusion We found high levels of depressive symptoms, unprotected sex and suicidal ideation among MSM. Comprehensive intervention strategies that combine psychological, behavioural and social aspects are needed to address the mental health issues of MSM, with special attention given to suicidality and high-risk behaviours in mental health and HIV prevention interventions.

  • Epidemiology
  • HIV & aids
  • Public health
  • Mental health

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/bmjopen-2016-013512

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    Footnotes

    • XP and RL contributed equally.

    • Contributors SX, XP and QM were involved in the study design. HW, TJ, LH, SZ, DW, ZY, HZ and DZ performed the experiments. RL, XP and SX analysed the data. RL, XP and SX wrote the paper. XP, SX and QM critically revised the manuscript. All authors read and approved the final manuscript.

    • Funding Key Project on Social Development among S&T Major Project of Zhejiang Province, China (2013C03047-1) and General Program on Medicine and Health of Zhejiang Province, China (2016KYA066).

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The study was approved by the ethical review board of Zhejiang Provincial Center for Disease Control and Prevention.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.